Uterine microcurettage with combined endometrial histopathology and cytology. An alternative to conventional curettage.
A new disposable mechanical curette, the Inocurette, was used to obtain endometrial samples for histopathology and cytology. The instrument was tested on 120 patients; 37 patients were known from a previous conventional curettage (D & C) to have an endometrial cancer and 83 patients were referred to the County Hospital of Trelleborg for curettage because of dysfunctional bleedings. In all 120 patients a D & C followed the microcurettage procedure. The samples were randomized, coded and analyzed blind without any clinical information. In all but 3 patients with a known endometrial cancer, sufficient microcurettage sample material for either histopathology or cytology was obtained. In all but one of these 34 patients either a malignant diagnosis or seriously atypical cells were found. Using only cytology five out of 34 samples were designated adequate but normal. In a further 5 of the 37 patients the samples obtained at the subsequent D & C were inadequate for diagnosis; one sample was denoted as normal. In the 83 patients with dysfunctional bleedings, sufficient material for diagnosis after microcurettage, cytology and D & C was obtained in 74, 83 and 79 patients respectively. One endometrial cancer was disclosed by all three methods. Inocurette sampling causes little discomfort and requires no special training. The combined microcurettage--cytology procedure may be recommended as an alternative to conventional curettage, though, for the time being, D & C should not be replaced for cytology alone.