The necessity of using tenaculum for endometrial sampling procedure with pipelle: a randomized controlled study

Güleç, Ümran Küçükgöz; Khatib, Ghanim; Güzel, Ahmet Barış; Akil, A; Ürünsak, İbrahim Ferhat; Özgünen, Fatma Tuncay

doi:10.1007/s00404-013-3005-7

Cited by 14 publications

(8 citation statements)

References 20 publications

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“…Although several studies concluded that Pipelle significantly produced less pain than D&C [10,11,12], other studies reported the occurrence of mild-to-severe pain during Pippelle endometrial sampling [13,14,15]. …”

Section: Discussionmentioning

confidence: 99%

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The Effectiveness and Acceptability of Pipelle Endometrial Sampling versus Classical Dilatation and Curettage: A Three-Year Observational Study

Rezk¹,

Sayyed²,

Dawood³

2016

Gynecol Obstet Invest

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Objective: To assess the effectiveness and acceptability of Pipelle endometrial sampling in comparison to dilatation and curettage (D&C). Methods: This was a prospective observational study including a total of 538 patients with abnormal uterine bleeding who were allocated to be treated using 2 sampling techniques: Pipelle sampler (n = 270) and D&C (n = 268). The primary outcome was the adequacy of both methods and concordance rate with hysterectomy specimens. The secondary outcome included drawbacks and patients' acceptability. Results: There was no significant difference between the 2 methods regarding adequacy and concordance rate with hysterectomy (p > 0.05). There was a statistically significant difference between the 2 groups regarding the requirement of analgesia and overall discomfort (p < 0.001), which was higher in the Pipelle group. No significant statistical difference was recognized between the study groups regarding the occurrence of cervical lacerations, fever or the rate of inadequate intrauterine sampling (p > 0.05). In addition, no significant statistical difference between both procedures was recognized concerning the overall satisfaction rate and the advisability of the procedure to other women (p > 0.05). Conclusion: Under the conditions of this study, Pipelle endometrial sampling is comparable to D&C biopsy in terms of adequacy and concordance rate with hysterectomy except that more pain and a higher overall discomfort rate were associated with it.

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Section: Discussionmentioning

confidence: 99%

“…VAS was implemented to assess patients' pain. Logistic regression analysis of this study disclosed that the use of cervical tenaculum was an independent risk factor for patients' pain perception [15]. …”

Section: Discussionmentioning

confidence: 99%

The Effectiveness and Acceptability of Pipelle Endometrial Sampling versus Classical Dilatation and Curettage: A Three-Year Observational Study

Rezk¹,

Sayyed²,

Dawood³

2016

Gynecol Obstet Invest

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“…stated that using the tenaculum increases the risk of painful endometrial sampling procedure 32‐fold. Also, post‐procedure pain scores were found to be higher in the tenaculum group, and they stated that using tenaculum can affect post‐procedure pain perception 6 . Sources of perceived pain are both the cervix grasping and the cervix and uterus pulling.…”

Section: Discussionmentioning

confidence: 99%

“…A pipelle is a 23.5 cm long, flexible polypropylene sheath with an outer diameter of 3.1 mm. An inner plunger is withdrawn, creating suction along a negative pressure gradient 6,8 (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

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Is Valsalva maneuver an alternative to use tenaculum for endometrial sampling procedure in cases where the cervix cannot be passed spontaneously with pipelle? A randomized study

Narin

Uysal

Baş

et al. 2020

J of Obstet and Gynaecol

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Aim To evaluate the effect of the Valsalva maneuver on ease of the endometrial sampling procedure in cases where the cervix cannot be passed spontaneously. Methods A randomized prospective trial was conducted in 84 patients whose cervix could not pass spontaneously with pipelle, and they were randomized for the Valsalva maneuver or tenaculum groups. In 43 of a total of 84 patients, we requested Valsalva maneuver throughout the process to pass the cervical canal, and in 41 patients, we performed tenaculum to pass the cervix. Results Valsalva and tenaculum groups did not differ in success rates (P = 0.314). There was no difference between the two groups in the history of the disease, past surgery and education (P > 0.05). Conclusion In endometrial sampling procedure with pipelle, when the cervix cannot be passed spontaneously, the transition with the Valsalva maneuver should be tried before using the tenaculum. Thus, a more painful procedure can be avoided and patient satisfaction may increase.

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Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination

Lensen

Manders

Nastri

et al. 2016

Cochrane Database of Systematic Reviews

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It is uncertain whether endometrial injury improves the probability of pregnancy and live birth/ongoing pregnancy in women undergoing IUI or attempting to conceive via sexual intercourse. The pooled results should be interpreted with caution as we graded the quality of the evidence as either low or very low. The main reasons we downgraded the quality of the evidence were most included studies were at a high risk of bias and had an overall low level of precision. Further well-conducted RCTs that recruit large numbers of participants and minimise internal bias are required to confirm or refute these findings.

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The necessity of using tenaculum for endometrial sampling procedure with pipelle: a randomized controlled study

Abstract: Endometrial sampling procedure without tenaculum is feasible and yields less pain perception than with tenaculum.

Cited by 14 publications

References 20 publications

The Effectiveness and Acceptability of Pipelle Endometrial Sampling versus Classical Dilatation and Curettage: A Three-Year Observational Study

The Effectiveness and Acceptability of Pipelle Endometrial Sampling versus Classical Dilatation and Curettage: A Three-Year Observational Study

Is Valsalva maneuver an alternative to use tenaculum for endometrial sampling procedure in cases where the cervix cannot be passed spontaneously with pipelle? A randomized study

Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination

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