The safety and acceptability of Pipelle endometrial sampling in premenopausal women in comparison to postmenopausal women with abnormal uterine bleeding

BACKGROUND: The aim of this study was to assess the safety and acceptability of Pipelle endometrial sampling in premenopausal women in comparison to postmenopausal women. METHODS: This was a prospective observational study including a total of 346 patients with abnormal uterine bleeding (AUB) who were divided into two groups, premenopausal group (N.=210) and postmenopausal group (N.=136). Primary outcome was safety and adequacy of Pipelle sampler. Secondary outcome included patients' acceptability. RESULTS: Pain scores by Visual Analogue Scale were significantly higher in postmenopausal women compared to premenopausal women (6.5±1.13 versus 4.85±0.86, P<0.001) during Pipelle endometrial sampling. There was also a higher rate of tenaculum use and analgesic requirements with less adequacy of the sample and less acceptability in postmenopausal women (P<0.001). CONCLUSIONS: Pipelle endometrial sampling is more painful, less adequate and less acceptable in postmenopausal women compared to premenopausal women with AUB. Further larger trials are needed to confirm these findings.