Why methodology matters in uterine pathology sampling

In 2021, Hologic conducted a random, blind survey of 120 physicians to better understand their experiences with tissue collection methods and tools used to diagnose endometrial abnormalities.1 We found that nearly 60% of physicians reported using endometrial biopsy for sample collection in patients with abnormal uterine bleeding (AUB).1

Perhaps that’s not surprising. After all, endometrial biopsy is familiar—a “tried and true” procedure.

But that doesn’t mean it’s always the best option.

The more accurate choice
Data shows that hysteroscopy with directed hysteroscopic biopsies of small lesions and/or continuous suction curettage of the whole uterine cavity has been shown to be more accurate than relying on blind tissue retrieval techniques.2

It makes sense. Especially when you consider that many women with gynecological complaints do not have focal pathologies, making it more difficult to tell if they have serious abnormalities.3

When comparing hysteroscopic morcellation to blind D&C, sampling collected via directed hysteroscopic procedures promotes:

  • Quality: intact, non-fragmented tissue4 and reduced blood obscurity
  • Quantity: a greater volume of representative endometrial tissue5
  • Accuracy: greater accuracy and superior yield2,6

Benefits that extend beyond accuracy
Obtaining an adequate sample is clearly a key parameter in choosing a methodology—in fact, in Hologic’s 2021 survey, the 54 physicians who reported using tissue removal devices for sampling chose them because they are likely to get an adequate sample.1 Other key rationales reported by these 54 physicians included ease of use, patient safety, patient comfort, patient satisfaction, cost, and ACOG guidelines.1

Those are rather compelling reasons.

Another way to think about this is to consider the possible consequences of incomplete sampling for your patients. Has incomplete sampling led to persistent symptoms, uncertainty and anxiety, follow-up visits, repeat procedures, and long-term risk of serious abnormalities for any of your patients?
It may be time to reconsider your methodology.

The MyoSure® tissue removal procedure
The MyoSure procedure is a hysteroscopic treatment that removes uterine tissue, including fibroids and polyps. The MyoSure and Omni® hysteroscopes offer clear visualization with high quality optics that afford a direct view of the uterine cavity, so you can see the anatomy and guide the procedure from start to finish.

The full suite of MyoSure devices gives you a solution for tissue removal in a wide range of sizes and locations:

  • MyoSure XL device: designed to optimize cutting efficiency with a large cutting window and suction on demand
  • MyoSure REACH device: access hard-to-reach pathology
  • MyoSure LITE device: visualize the entire uterine cavity to get a quality tissue specimen; remove small polyps up to 3 cm with minimal dilation
  • MyoSure MANUAL device: perform in-office polypectomy and targeted biopsy under continuous visualization with the Hologic hysteroscope without the complexity, logistics, and costs of the operating room

To learn more about sampling collected via directed hysteroscopy and the MyoSure suite of devices, visit our virtual Learning Lab and contact your local sales representative.

References:

  1. Hologic, Inc. Data on file. Tissue Collection Methods Survey, Conducted June 2021 by Gerson Lehrman Group for Hologic, Inc, N=121.
  2. Loffer F. The time has come to quit relying on a blind endometrial biopsy or a D & C to rule out malignant endometrial changes. J Minim Invas Gynecol. 2019, doi: https://doi.org/10.1016/j.jmig.2019.04.011
  3. Svirsky R, Smorgick N, Rozowski U, Sagiv R, Feingold M, Halperin R, Pansky M. Can we rely on blind endometrial biopsy for detection of focal intrauterine pathology? Am J Obstet Gynecol. 2008 Aug;199(2):115.
  4. Franchini M, Zolfanelli F, Gallorini M, Giarre G, Fimiani R, Florio P. Hysteroscopic polypectomy in an office setting: specimen quality assessment for histopathological evaluation. Eur J Obstet Gynecol Reprod Biol. 2015(189):64–67.
  5. Epstein E, Ramirez A, Skoog L, Valentin L. Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstet Gynecol Scand. 2001;80(12):1131-1136.
  6. The American College of Obstetricians and Gynecologists (ACOG). Practice bulletin no. 149: endometrial cancer. Obstet Gynecol. 2015;125(4):1006-1026.

Important Safety Information

MyoSure Tissue Removal System
The MyoSure® tissue removal system, consisting of the MyoSure tissue removal devices (LITE, REACH, XL) and MyoSure controller, is intended for hysteroscopic intrauterine procedures by trained gynecologists to resect and remove tissue including submucous myomas, endometrial polyps, and retained products of conception. The MyoSure MANUAL hysteroscopic tissue removal device is intended for intrauterine use by a trained gynecologist to hysteroscopically resect and remove tissue, including focal lesions such as endometrial polyps and retained products of conception. MyoSure products are not appropriate for patients who are or may be pregnant, or are exhibiting pelvic infection, cervical malignancies, or previously diagnosed uterine cancer.
For more details on risks and benefits of the MyoSure system, MyoSure MANUAL tissue removal device, MyoSure hysteroscope and the Aquilex® fluid control system, please consult their respective IFUs.

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