The Adequacy of Endometrial Sampling: Comparison between Manual Vacuum Aspiration and Metal Curettage Method

Siraya Kitiyodom MD*

Affiliation : * Department of Obstetrics and Gynecology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand

Objective : To compare the adequacy of endometrium and the post-procedural pain between the manual vacuum aspiration (MVA) and metal curettage method. Material and Method: The present research was a clinical experiment. A randomized controlled trial study was done with older than 35-year old females with abnormal intrauterine bleeding who attended the out-patient gynecology department of Maharat Nakhon Ratchasima Hospital between December 1, 2013 and April 30, 2014. Patients were allocated with simple randomization technique into two groups, the experimental group was using MVA and the control group was using conventional metal uterine curettage. Pain levels were assessed according to the visual analogue scale. All tissue samples were examined by pathologists. Statistics used were percentage and Chi-square.
Results : Percentages of tissue adequacy for pathological examination of control and experiment groups were 87.88 and 90.91, respectively. There was no significant difference between the two methods (p-value = 0.572). The patients with severe pain in the experiment group were less than that of the control group. The relative risk is 0.47 (95% CI = 0.30-0.72).
Conclusion : MVA caused less pain than the metal curette method, while both provided the same rate of adequacy of endometrial tissue sampling for pathological diagnosis. The MVA offered more humanized health care for gynecological patients who required such procedure. Further researches focusing on the cost-effectiveness or medical complications could benefit a practice guideline and the health care system for this patient group.

Keywords : Manual vacuum aspiration (MVA), Metal uterine curette, Endometrial adequacy, Pain

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