title: Comparison of tissue adequacy for histologic examination from Ipas MVA plus and Wallach Endocell in women with abnormal uterine bleeding.
abstract: OBJECTIVE
  The aim of this study was to compare endometrial tissue adequacy sampling by Wallach Endocell and manual vacuum aspiration (Ipas MVA plus) in women with abnormal uterine bleeding. Pain and immediate complications from each method were also compared.
  
  
  METHODS
  Two hundred and forty women with abnormal uterine bleeding were randomly assigned to two methods of endometrial sampling: MVA (n = 122) and Endocell (n = 118). The basic characteristic features of the women, the difficulty of the procedure, pain score by visual analogue scale, immediate complications, and treatment were recorded. Endometrial tissue adequacy and histopathologic diagnoses were evaluated.
  
  
  RESULTS
  The adequacy of tissue samples was 81.1% in the MVA group and 85.6% in the Endocell group (P = 0.356). There was a significant difference in the rates of difficult procedure between the two groups (27.0% in MVA vs 14.4% in Endocell; P = 0.016). Moderate to severe pain was significantly higher in the MVA group compared to the Endocell group: 60.7% and 19.5%, respectively (P < 0.001). Other immediate minor complications were also observed to be significantly higher in the MVA group (44.3%) than in the Endocell group (30.5%) (P = 0.028). Although medication required for pain was higher in the MVA group (23.0%) than in the Endocell group (12.0%), the difference was not significant (P = 0.130). The two most common histopathologic findings obtained from MVA and Endocell specimens were proliferative endometrium (32.4%) and atrophic endometrium (27.1%).
  
  
  CONCLUSIONS
  MVA was comparable to Endocell in terms of tissue adequacy. Moderate to severe pain was experienced significantly more in the MVA group; however, the requirement of pain treatment was not significantly different between the groups.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Paphada
authors.initials: P
authors.lastname: Wanijasombutti
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Arinporn
authors.initials: A
authors.lastname: Imruetaicharoenchok
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Siriwan
authors.initials: S
authors.lastname: Tangjitgamol
authors.affiliation: Department of Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Kongsak
authors.initials: K
authors.lastname: Loharamtaweethong
authors.affiliation: Department of Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Napaporn
authors.initials: N
authors.lastname: Phuriputt
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Chadakarn
authors.initials: C
authors.lastname: Phaloprakarn
mesh_terms: D000328:Adult; D000072601:Cannula; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013048:Specimen Handling / Q000295:instrumentation / Q000379:methods*; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000473:pathology; D064232:Visual Analog Scale
keywords: abnormal uterine bleeding; adequacy of tissue; endocell; manual vacuum aspiration