Vacuum curettage by the Vabrar method. A simple procedure for endometrial diagnosis.

Out of 332 patients in whom endometrial biopsy was considered to be indicated, vacuum curettage by th VabraR method could be performed on 296 (89%)-age range 23 to 71 years, mean 45.7-in all cases as an outpatient procedure without anesthesia. Material sufficient for histological diagnosis was obtained in 276 (93.3%), 7 (2.4%) of whom had endometrial cancer, 14 (4.7%) adenomatous hyperplasia, and 29 (9.8%) cystic hyperplasia. Of the 20 patients in which the curettings could not be assessed, subsequent conventional curettage showed postmenopausal mucosa in 12 cases, endometrial polyps in 4 and atrophic mucosa due to contraceptive pill in 4. Moderate and severe pain was experienced by 47 (15.8%) and 7 (2.3%) patients respectively, and 2 (0.6%) had a vasovagal reaction. There was one case (0.3%) of endometritis and 6 (2%) of postoperative bleeding. During a follow-up period of 1-5.5 (mean 2.4) years, 16 patients have developed bleeding again, but repeated vacuum curettage disclosed benign conditions in all, with no endometrial cancer apart from the cases diagnosed primarily. Vacuum curettage is a quick, simple, and cheap method for histological diagnosis of endometrial tissue. It does not require anesthesia, patient acceptability is high, and reliability satisfactory.