title: Pain experienced using two different methods of endometrial biopsy: a randomized controlled trial.
abstract: OBJECTIVE
  To compare patient-reported pain, provider- reported ease of use, and tissue sampling adequacy between endometrial biopsy instruments.
  
  
  METHODS
  Women presenting for endometrial biopsy were randomized to either Pipelle or Explora curette. The primary outcome was patient-reported pain with biopsy as measured by a 100-mm visual analog scale. Secondary outcomes included the adequacy of biopsy sample and provider-reported ease of instrument use.
  
  
  RESULTS
  Groups were similar in respect to age, parity, ethnicity, level of dysmenorrhea, menopausal status, and biopsy indication. The most common indication for biopsy was abnormal uterine bleeding. Subject reported pain with biopsy was similar between groups (Pipelle, 6.21 ± 2.41 cm; Explora, 6.91 ± 2.88 cm; P=.14), as was provider-reported ease of use. Although procedure length was significantly shorter for patients in the Pipelle group (4.05 ± 1.48 minutes compared with 5.27 ± 2.53 minutes; P=.007), 38% of Pipelle procedures required two or more passes to obtain a sample compared with only 9% using the Explora (P=.004). The Explora group had a higher proportion of adequate samples (97% compared with 91%; P=.33).
  
  
  CONCLUSIONS
  Women's pain during endometrial biopsy does not differ by type of biopsy instrument used.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov NCT00613925.
authors.affiliation: From the Departments of Obstetrics and Gynecology and Pathology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Leclair
authors.forename: Joy K
authors.initials: JK
authors.lastname: Zia
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Doom
authors.forename: Terry K
authors.initials: TK
authors.lastname: Morgan
authors.forename: Alison B
authors.initials: AB
authors.lastname: Edelman
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation; D004717:Endometrium / Q000473:pathology*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies