Vacuum curettage by the Vabra method. A simple procedure for endometrial diagnosis.
Of 332 patients for whom endometrial biopsy was indicated, vacuum curettage by the Vabra method was performed on 296 (89%) women as an outpatient procedure without anesthesia. The age range was 23-71 years, with a mean of 45.7. Material sufficient for histological diagnosis was obtained in 276 (93.3%), 7 (2.4%) of whom had endometrial cancer, 14 (4.7%) who had adenomatous hyperplasia, and 29 (9.8%) who had cystic hyperplasia. Of the 20 patients in whom the curettings could not be assessed, subsequent conventional curettage showed postmenopausal mucosa in 12 cases, endometrial polyps in 4, and atrophic mucosa due to the oral contraceptive pill in 4. 47 (15.8%) and 7 (2.3%) patients experienced moderate and severe pain respectively, and 2 (0.6%) had a vasovagal reaction. There was 1 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 is satisfactory. (author's modified)