Full-bladder strategy enhances endometrial sampling experience

Pipelle endometrial sampling with a full bladder reduces initial insertion failure rate and procedure-related pain, thereby increasing patient satisfaction, as compared with the standard process, according to a study.

A total of 214 women who were scheduled for outpatient Pipelle endometrial sampling were randomly assigned to one of the following conditions: having a full bladder by oral water intake (n=107) or a standard process wherein bladder status was not taken into account (n=107). None of the participants had known cervical stenosis, gynaecologic malignancy, uterine anomalies, leiomyoma distorting the uterine cavity, acute cervicitis, urge bladder dysfunction, intense anxiety, requirement for anaesthesia or analgesic before the procedure, positive pregnancy test, or previous failed office endometrial sampling.

Insertion failure rate of endometrial sampling at first attempt was the primary outcome. Pain during procedure, satisfaction score, analgesia use, procedure duration, and need for cervical manipulation were also assessed as secondary outcomes.

Compared with the standard process, the full bladder strategy led to a significantly lower insertion failure rate (23.4 percent vs 42.1 percent; relative risk, 0.56, 95 percent confidence interval [CI], 0.37–0.84; number needed to treat to benefit, 6.0, 95 percent CI, 3.20–15.70).

Women who underwent a full bladder strategy versus standard process also had a lower pain score during the procedure (median, 4 vs 5; p=0.004), higher patient satisfaction score (median, 8 vs 7; p<0.001), and shorter procedure duration (mean, 3.0 vs 4.7 min; p<0.001).

Results for cervical laceration, analgesia use, and adequacy of endometrial tissue for histopathologic assessment did not significantly differ between the two groups.