ABSTRACT
All patients presenting with post-menopausal bleeding (PMB) should be investigated, and selected individuals should undergo endometrial sampling. It is common practice to perform a transvaginal ultrasound (TVUS) prior to sampling to evaluate the dual layer of the endometrial echo complex (EEC). If the EEC is thin (≤4 mm with no suspicion of a focal lesion), sampling is not indicated unless bleeding is persistent.9-14 If the EEC is greater than 4 mm, or should a focal lesion be identified or suspected, endometrial sampling is indicated.9-14
Techniques
Endometrial suction/aspiration biopsy
The most commonly utilized technique for endometrial sampling is a single use catheter, with a distal fenestration,
and a mechanism used to provide suction (Figure 31.1). It is likely that the most commonly utilized device is the Pipelle® (Pipelle de Cornier, Paris, France), although there exists an array of such devices. Each of these is designed to essentially replicate the Novak curette, a nondisposable hollow catheter that can be fitted with a Luer-tipped syringe that can be used to provide suction (Figure 31.2).
