Objective: Association of office hysteroscopy with outpatient endometrial b
iopsy is interesting to evaluate correctly endometrium. Purpose of this stu
dy was to evaluate and compare two endometrial biopsy devices during outpat
ient hysteroscopy, based on effectiveness and tolerance of the procedure. S
tudy Design: A single blind, randomised prospective study. Results: 200 pat
ients were randomised into two groups following outpatient hysteroscopy: 10
0 were biopsied with Vacurette and 100 biopsed with Pipelle. Pipelle was le
ss painful compared to Vacurette (1.1 + 0.2 versus 1.6 + 0.3; P < 0.001), n
o matter hormonal status (1 + 0.3 versus 2 + 0.6; P < 0.001 in premenopausa
l subgroup and 1 + 0.3 versus 1.4 + 0.3; P < 0.001 in postmenopausal subgro
up). Vacurette was more effective than Pipelle (64/100 versus 48/100; P = 0
.02), in case of normal or hypertrophic endometrium (56/72 (77%) versus 40/
65 (61%); P = 0.04) but not in case of atrophic endometrium (8/28 (29%) ver
sus 8/35 (23%); P = 0.6). Among the 112 patients with adequate sample, hist
ologic results were normal, except for three cases of endometrial hyperplas
ia. Among the 88 patients with inadequate sample, 47 (53%) presented an atr
ophic endometrial aspect at hysteroscopy, whereas 41 (47%) were considered
as normal. Conclusions: Vacurette was snore effective though more painful t
han Pipelle. Both instruments were, however, well tolerated. Both instrumen
ts were not very effective in case of atrophic endometrium. Outpatient hyst
eroscopy combined with endometrial biopsy may help avoid further investigat
ions. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.