Endometrial directed biopsy during sonohysterography using the NiGo device: prospective study in women with abnormal uterine bleeding

Objective: To determine the accuracy of sonohysterography (SHG), combined with sonography-guided biopsies that are performed by using the NiGo device, in the diagnosis of endometrial pathologies in women with abnormal uterine bleeding (AUB). Design: Prospective study. Setting: Outpatient clinic. Patient(s): One hundred sixteen women with AUB (55 postmenopausal and 61 premenopausal). Intervention(s): Patients underwent transvaginal sonography and SHG; when an endometrial condition needing a biopsy was diagnosed, the biopsy was performed both by using the NiGo device (ASL 1, Imperia, Italy) and by using Pipelle. Main Outcome Measure(s): Feasibility of SHG and endometrial biopsy by NiGo. Result(s): Sonohysterography was successfully performed by using the NiGo device in 87.4% of the cases (92.6% of premenopausal women and 81.5% of postmenopausal women). Seventy-eight (86.7%) women were judged to require endometrial biopsy; the NiGo device allowed obtaining an adequate biopsy for histological evaluation in 74 cases (94.9%). There was no statistically significant difference in efficacy between the NiGo and Pipelle in providing a specimen that was adequate for histological evaluation. Although no significant difference was observed in the histological diagnosis performed on the specimens obtained by the two techniques, NiGo allowed diagnosis of more focal lesions (simple hyperplasia, endometrial polyps, and myomas). Conclusion(s): The NiGo device allows an adequate biopsy for histological evaluation to be obtained during SHG in an outpatient setting.