The Adequacy of Endometrial Sampling: Comparison between Manual Vacuum Aspiration and Metal Curettage Method
Siraya Kitiyodom MD*
Affiliation : * Department of Obstetrics and Gynecology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
Objective : To compare the adequacy of endometrium and the post-procedural pain between the manual vacuum aspiration
(MVA) and metal curettage method.
Material and Method: The present research was a clinical experiment. A randomized controlled trial study was done with
older than 35-year old females with abnormal intrauterine bleeding who attended the out-patient gynecology department
of Maharat Nakhon Ratchasima Hospital between December 1, 2013 and April 30, 2014. Patients were allocated with
simple randomization technique into two groups, the experimental group was using MVA and the control group was using
conventional metal uterine curettage. Pain levels were assessed according to the visual analogue scale. All tissue samples
were examined by pathologists. Statistics used were percentage and Chi-square.
Results : Percentages of tissue adequacy for pathological examination of control and experiment groups were 87.88 and
90.91, respectively. There was no significant difference between the two methods (p-value = 0.572). The patients with severe
pain in the experiment group were less than that of the control group. The relative risk is 0.47 (95% CI = 0.30-0.72).
Conclusion : MVA caused less pain than the metal curette method, while both provided the same rate of adequacy of
endometrial tissue sampling for pathological diagnosis. The MVA offered more humanized health care for gynecological
patients who required such procedure. Further researches focusing on the cost-effectiveness or medical complications could
benefit a practice guideline and the health care system for this patient group.
Keywords : Manual vacuum aspiration (MVA), Metal uterine curette, Endometrial adequacy, Pain
