Endometrial Screening of Asymptomatic Women by Irrigation Technique in the Private Gynecology Office

A study was made of 201 asymptomatic women over age 40 (range, 40-74 years) who underwent uterine sounding and endometrial screening by the negative pressure jet irrigation technique, without anesthesia, in private gynecologists' offices. Introduction of the irrigator was accomplished in 88% of these patients. In 97% of the successful irrigations, the specimens obtained were satisfactory for cytologic and histologic diagnosis of neoplasia. No occult endometrial carcinomas were discovered. The factors which interfered with endometrial screening by these methods are analyzed. Cervical stenosis prevented endometrial irrigation in 13 of the 24 unsuccessful attempts. Acceptance by the patients was high, in that 74.2% reported light or no discomfort and only 4.7% complained of severe discomfort. Although 12.5% experienced pelvic cramping after irrigation, no other significant side effects were observed. The results of this investigation indicate the feasibility of using the endometrial irrigation technique for massive screening studies of asymptomatic women who are at risk for the development of endometrial carcinoma.