Improved adequacy of endometrial tissue sampled from postmenopausal women using the MyoSure Lite hysteroscopic tissue removal system versus conventional curettage

Abstract

Peter Rosenblatt,1 Sara Barcia,2 Anthony DiSciullo,1 Hussein Warda1 1Division of Urogynecology, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, 2Department of Pathology, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA Objective: To compare the diagnostic suitability of endometrial tissues obtained from postmenopausal women using the MyoSure Lite tissue removal system versus conventional curettage.Materials and methods: Endometrial tissue was sampled in hysteroscopically normal extirpated uteri from seven postmenopausal women (65.9±6.6 years old) using both hysteroscopic-guided morcellation and curettage (two quadrants/uterus with each method). Endometrial sampling was performed immediately after hysterectomy for benign reasons unrelated to uterine pathology. Retrieved endometrial tissue samples were evaluated for volume and diagnostic suitability by a pathologist who was masked to the sampling technique used.Results: Endometrial tissue sampling times were similar for morcellation (44±23 s) and curettage (47±38 s). Mean tissue volume retrieved with MyoSure (1,411±775 mm3) was significantly greater than with curettage (1±2 mm3; p=0.0004, two-tailed t-test), with larger intact tissue fragments retrieved with morcellation. Both specimen volume and quality obtained by MyoSure Lite were deemed to be significantly better for histologic assessment than the tissues obtained with curettage (p=0.0006 by Fisher’s exact test and p=0.0137 by chi-square test, respectively). With dilation and curettage, samples were frequently too scanty for evaluation. Diagnostic concurrence between MyoSure Lite/dilation and curettage samples and histopathology of full-thickness samples taken afterward was also significantly better with MyoSure Lite than with curettage (p=0.0210).Conclusion: Endometrial tissue sampling using the minimally invasive MyoSure Lite hysteroscopic tissue removal system may provide larger volumes of higher-quality endometrial tissue specimens for pathology assessment compared to specimens obtained using conventional curettage, in postmenopausal women. Keywords: hysteroscopic morcellation, curettage, endometrial tissue sampling, endometrial pathology, abnormal uterine bleeding, extirpated uterus, postmenopausal

Keywords

• Hysteroscopic morcellation
• Curettage
• Endometrial tissue sampling
• Endometrial pathology
• Abnormal uterine bleeding
• Extirpated uterus
• Postmenopausal.