Kocaeli Med J. 2025; 14(2): 107-113 | DOI: 10.5505/ktd.2025.35002

Comparing the Three Endocervical Sampling Methods: Which Method is Sufficient For Diagnostic Tissue Quality?

Hasan Saðdýç¹, Abdurrahman Alp Tokalýoðlu¹, Ali Doðukan Anðýn², Muzaffer Seyhan Çýkman^3
1Kocaeli City Hospital, Department of Gynecologic Oncology, Kocaeli, Turkiye.
²Private Clinic, Obstetrics and Gynecology, Istanbul, Turkiye.
³Gavle Hospital, Department of Obstetrics and Gynecology, Gavle, Sweden.

INTRODUCTION: Endocervical curettage (ECC) is a diagnostic method commonly performed as an outpatient procedure but often associated with pain and discomfort. This prospective randomized observational study aimed to evaluate the quality of histological specimens obtained using Novak curette, endocervical brush, and Pipelle, as well as the pain levels experienced during these procedures.
METHODS: Between April 2018 and August 2018, patients undergoing ECC at our hospital were included in the study. Novak curette, endocervical brush, and Pipelle were used as sampling instruments. Patients rated their pain levels during the procedures using a visual analog scale (VAS). Histological material was scored by a pathologist for tissue adequacy. The correlation between the quality of histological specimens and the surgical instruments used was analyzed.
RESULTS: The study included patients with a mean age of 41.9 ± 8.78 years, mean parity of 2.7 ± 1.23, mean BMI of 30.9 ± 3.11, and a smoking prevalence of 22%. The mean pathological examination scores were as follows: Novak curette, 3 ± 1.31; endocervical brush, 1.6 ± 1.14; and Pipelle, 1.6 ± 1.13. The mean VAS pain scores were 3.7 ± 1.21 for Novak curette, 3.1 ± 1.18 for endocervical brush, and 3.0 ± 1.02 for Pipelle.
DISCUSSION AND CONCLUSION: Among the instruments evaluated, the Novak curette caused the highest levels of pain, while pain levels associated with the endocervical brush and Pipelle were comparable. These findings suggest that while the Novak curette may provide high-quality samples, alternative methods such as Pipelle and endocervical brush offer comparable diagnostic value with potentially improved patient comfort.

Keywords: endocervical curettage, novak curette, pipelle, endocervical brush, colposcopy

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Üç Endoservikal Numune Alma Yönteminin Karþýlaþtýrýlmasý: Tanýsal Doku Kalitesi Ýçin Hangi Yöntem Yeterlidir?

Hasan Saðdýç¹, Abdurrahman Alp Tokalýoðlu¹, Ali Doðukan Anðýn², Muzaffer Seyhan Çýkman^3
1Kocaeli Þehir Hastanesi, Jinekolojik Onkoloji Cerrahisi, Kocaeli, Türkiye.
²Özel Klinik, Obstetri ve Jinekoloji, Ýstanbul, Türkiye.
³Gavle Hastanesi, Obstetri ve Jinekoloji, Gavle, Ýsveç.

GÝRÝÞ ve AMAÇ: Endoservikal küretaj (ECC) yaygýn olarak ayakta tedavi prosedürü olarak uygulanan ancak sýklýkla aðrý ve rahatsýzlýkla iliþkilendirilen tanýsal bir yöntemdir. Bu prospektif randomize gözlemsel çalýþmada Novak küret, endoservikal fýrça ve Pipelle kullanýlarak elde edilen histolojik örneklerin kalitesinin yaný sýra bu iþlemler sýrasýnda yaþanan aðrý düzeylerinin deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Nisan 2018-Aðustos 2018 tarihleri arasýnda hastanemizde ECC uygulanan hastalar çalýþmaya dahil edildi. Örnekleme aletleri olarak Novak küret, endoservikal fýrça ve Pipelle kullanýldý. Hastalar iþlemler sýrasýndaki aðrý düzeylerini görsel analog skala (VAS) kullanarak deðerlendirdi. Histolojik materyal doku yeterliliði açýsýndan bir patolog tarafýndan skorlanmýþtýr. Histolojik örneklerin kalitesi ile kullanýlan cerrahi aletler arasýndaki korelasyon analiz edildi.


BULGULAR: Çalýþmaya ortalama yaþý 41,9 ± 8.78 yýl, ortalama paritesi 2,7 ± 1,23, ortalama VKÝ 30,9 ± 3,11 ve sigara içme prevalansý %22 olan hastalar dahil edildi. Ortalama patolojik inceleme skorlarý aþaðýdaki gibidir: Novak küret, 3 ± 1,31; endoservikal fýrça, 1,6 ± 1,14; ve Pipelle, 1,6 ± 1,13. Ortalama VAS aðrý skorlarý Novak küret için 3,7 ± 1,21, endoservikal fýrça için 3,1 ± 1,18 ve Pipelle için 3,0 ± 1,02 idi.


TARTIÞMA ve SONUÇ: Deðerlendirilen aletler arasýnda Novak küret en yüksek düzeyde aðrýya neden olurken, endoservikal fýrça ve Pipelle ile iliþkili aðrý düzeyleri benzerdi. Bu bulgular, Novak küretinin yüksek kaliteli örnekler saðlayabilmesine karþýn, Pipelle ve endoservikal fýrça gibi alternatif yöntemlerin potansiyel olarak daha iyi hasta konforu ile karþýlaþtýrýlabilir tanýsal deðer sunduðunu göstermektedir.

Anahtar Kelimeler: endoservikal küretaj, novak küret, pipelle, endoservikal fýrça, kolposkopi

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