Comparison of Manual Vacuum Aspiration and Dilatation and Curettage for Endometrial Sampling Adequacy in Women With Abnormal Uterine Bleeding

Comparison of Manual Vacuum Aspiration and Dilatation and Curettage for Endometrial Sampling Adequacy in Women With Abnormal Uterine Bleeding

This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan, to compare two commonly used methods for obtaining endometrial tissue in women aged 30 to 60 years presenting with abnormal uterine bleeding. Endometrial sampling is required to identify the underlying cause of abnormal bleeding, including precancerous changes and endometrial cancer. Participants who met eligibility criteria and provided informed consent were allocated to undergo either manual vacuum aspiration or dilatation and curettage. The primary purpose was to determine whether there was a significant difference between the two procedures in obtaining an adequate endometrial sample for histopathological reporting, where adequacy was defined as tissue containing both endometrial glands and stroma in sufficient quantity for interpretation. Pain severity was additionally assessed 24 hours after the procedure using a visual analog scale. The study hypothesis was that a significant difference existed in endometrial sampling adequacy between manual vacuum aspiration and dilatation and curettage among women with abnormal uterine bleeding.

Inclusion Criteria:

• Females aged 30-60 years.
• Patients presenting with abnormal uterine bleeding (AUB) as per operational definition.
• Patients who provide informed consent to participate in the study.

Exclusion Criteria:

• Patients with known pregnancy, active pelvic infection, or untreated sexually transmitted infections as per medical records.
• Patients with known coagulopathy, bleeding disorders, or currently on anticoagulant therapy.
• Patients with a history of endometrial or cervical cancer, abnormal Pap smear, pelvic pathology, or current hormonal use for endometrial pathology.
• Patients who have undergone surgical intervention involving the uterus in the past three months.
• Patients with severe medical conditions that could interfere with the study outcomes or pose a risk during the procedure (e.g., severe cardiovascular disease, uncontrolled diabetes).
• Patients with a history of severe allergic reactions to local anesthesia or NSAIDs were used in the study.
• Patients with stenotic cervical ostium.
• Females with malignancy undergoing chemotherapy or radiotherapy (as per medical records).