Accuracy of Karman endometrial aspiration in comparison to conventional D and C in women with AUB at tertiary care hospital in North West Rajasthan

BACKGROUND: Approximately 33% of all gynaecological consultations are associated with abnormal vaginal bleeding, and this proportion increases to 70% in the peri and postmenopausal years. AIMS AND OBJECTIVE: To compare the diagnostic accuracy of Karman's cannula endometrial aspiration histopathology versus dilatation and curettage in patients with abnormal uterine bleeding. METHODOLOGY: In total 100 women of all age groups with a clinical diagnosis of AUB were included in this prospective comparative study. Endometrial aspiration with Karman cannula was performed in the operation theatre prior to curettage to maintain synchronization during sampling. RESULTS: In our study, no significant difference was observed between Karman and D and C regarding sample adequacy (P = 0.07), HPE findings (P = 1) and concordance rate with hysterectomy specimen (P = 1). 95% of the samples obtained by Karman and 98% of those obtained by D and C were adequate. For obtaining an adequate sample by Karman the sensitivity and accuracy was 96.94% and 96% when compared with D and C. Karman and D and C had comparable concordance rates (95% and 95%) with hysterectomy specimen. Karman endometrial sampling is an easy procedure when compared to D and C (P = 0.007). With considering D and C as gold standard Karman endometrial sampling demonstrated 100% accuracy for diagnosing adenocarcinoma, endometrial hyperplasia. CONCLUSION: Endometrial aspiration with Karman cannula is an easy, safe, cost-effective, accurate, convenient method of achieving histopathological diagnosis. It can be done as an outpatient procedure without analgesia and anaesthesia when compared to D and C which is expensive and invasive method and requires hospitalization and general anaesthesia.