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Blind vs. hysteroscopy-guided endometrial biopsy for endometrial pathologies
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Blind vs. hysteroscopy-guided endometrial biopsy for endometrial pathologies
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Journal Article
Blind vs. hysteroscopy-guided endometrial biopsy for endometrial pathologies
2025
Overview
Aims: The trend toward minimally invasive methods over basic classical techniques in surgical procedures is rapidly increasing. This study aimed to evaluate the sensitivity of blind biopsy (BB) vs. hysteroscopy-guided biopsy (HGB) for diagnosing malignancy in patients with endometrial pathology. Methods: This retrospective study included patients who underwent a BB (Group BB) and HGB (Group HGB) because of persistent uterine bleeding or unaltered ultrasonography findings after the initial biopsy at a tertiary facility from October 2022 through July 2023. Patients with a known history of malignancy were excluded. The primary objectives were to compare the performance of the two procedures and calculate a cut-off of endometrial thickness (ET) for a malignancy diagnosis. Results: The study included 150 patients (mean age: 46.20 [+ or -] 11.26 years in Group BB and 46.98 [+ or -] 9.77 years in Group HGB, p=0.520). The frequency of endometrial polyps was higher in group BB (61.3% vs. 35.3%, p<0.001), whereas functional endometrium was more frequent in group HGB (41.2% vs. 22%, p<0.001). Mean ET was similar in the two groups (Group BB vs. Group HGB: 11.21 [+ or -] 4.96 mm vs. 10.31 [+ or -] 5.63 mm, p=0.150). The cut-off of ET in predicting endometrial malignancy was 12.5 mm with a sensitivity of 75% and specificity of 74.6% [area under the curve: 0.775, 95% confidence interval: 0.6150.935; p=0.009]. Conclusions: The presented study showed no difference between HGB and BB in identifying benign endometrial pathologies. A cut-off of 12.5 mm ET was determined to predict malignancies, though the event rate was low to perform robust calculations. Keywords: Hysteroscopy guided biopsy, blind biopsy, abnormal uterine bleeding, endometrial thickness, endometrial pathologies
Publisher
Galenos Yayinevi Tic. Ltd
Subject
