Comparison between Karman Cannula and Metal Curette in Uterine Curettage

Abstract

Objectives:

1. To compare severity of pain from endometrial curettage by Karman cannula and metal curette.

2. To compare duration of bleeding after endometrial curettage by Katman cannula and metal curette.

3. To compare adequacy of pathological specimen obtained by Karman cannula and metal curette.

Design: Randomized controlled trail study

Setting: Srinagarind Hospital, Khon Kaen University

Subjects: Women who attended gynecological outpatient clinic with abnormal uterine bleeding which required endometrial curettage from 16 June 1997 to 20 January 1998 were randomly allocated to either Karman cannula or metal curette group.

Intervention: Endometrial curettage by Karman cannula or metal curette

Main outcome measurement:

1. Level of pain by visual analogue scale and descriptive pain evaluation.

2. Duration of bleeding after endometrial curettage in day(s) by postcard questionnaire.

3. Adequacy of pathological specimen.

Results: The number of patients in the metal curette group who suffered from severed from severe pain was more than in the Karman cannula group, with relative risk of 5 (95% confidence interval 2.25-11.13) and 7.25 (95% confidence interval 2.71-19.36) in pain assessment by visual analogue scale and by descriptive pain evaluation, respectively. Duration of bleeding after curettage by Karman cannula was 2.93±2.58 days and by metal curette was 2.50±2.06 days and there was no significant difference in duration of bleeding between the procedures. Adequacy of pathological specimen was 86.67% in metal curette group and 83.33% in Karman cannula group which was not significantly different.

Conclusion: Endometrial curettage by Karman cannula is less painful than curettage by metal curette and there is no significant difference in both duration of bleeding after the procedure and adequacy of pathological specimen.

Key words: Karman cannula, metal curette, endometrial curettage, pain, bleeding