Endometrial sampling

Question 1

When is endometrial sampling indicated?

Answer 1

Post menopausal bleeding
>45y with abnormal menstrual symptoms
Unexpected bleeding patterns in women on HRT

Question 2

What finding on USS would indicate endometrial sampling?

Answer 2

Endometrium >4mm thick or if polyps seen, always refer

Question 3

How is endometrial sampling performed?

Answer 3

Bimanual to assess size/position of uterus
Bend cannula to match uteral curve
Insert; observe resistance at cervical os and again as tip reaches fundus
With tip in fundus, create vacuum by pulling plunger, then move sampler around uterus to sample whole cavity
Remove, expel tissue into formalin and send to histology

Question 4

What could be used instead of standard cannula for endometrial sampling?

Answer 4

Vabra vacuum aspiration

Samples greater area of tissue and higher cancer detection, but less comfortable

Question 5

What are the risks of endometrial sampling?

Answer 5

Uncomfortable/painful
Failed entry
Trauma to cervix/endometrium
Inadequate sample obtained