A comparison of the Pipelle device and the Vabra aspirator as measured by endometrial denudation in hysterectomy specimens: the Pipelle device samples significantly less of the endometrial surface than the Vabra aspirator.

Abstract

The distribution and relative area of endometrial sampling of two endometrial biopsy techniques, Pipelle and Vabra aspiration biopsy, were compared. Twenty-five patients scheduled for hysterectomy were randomly assigned to undergo preoperative endometrial biopsy by Pipelle device (12 patients) or Vabra aspiration (13 patients). The endometrial cavities of the surgical specimens were photographed, and percent denudation was determined by a point-counting method. The percentage of endometrial surface area sampled by the Pipelle device was 4.2% +/- 0.92% (mean +/- SEM), and by Vabra aspirator 41.6% +/- 5.7% (p < 0.0001). The mean number of endometrial surfaces (one anterior and one posterior) sampled by the Pipelle device was 1.08 +/- 0.15, and by the Vabra aspirator 2 +/- 0 (p = 0.001). The mean number of endometrial quadrants (four anterior plus four posterior) sampled by the Pipelle device was 2.4 +/- 0.41, and by the Vabra aspirator 7.4 +/- 0.42 (p < 0.0001). We conclude that the Vabra aspirator is statistically superior to the Pipelle device for sampling the endometrial cavity when the total surface area sampled and the distribution of surfaces sampled are considered.