The significance of an 'insufficient' Pipelle sample in the investigation of post-menopausal bleeding.

Background: Out-patient endometrial sampling is a commonly performed procedure in the investigation of post-menopausal bleeding. We hypothesized that an 'insufficient' Pipelle sample reliably reflected the absence of serious endometrial pathology.

Methods And Results: A review of 141 consecutive cases reported as 'insufficient' for diagnostic purposes revealed 29 (20%) cases to have uterine pathology after secondary investigation. These included two cases of endometrial carcinoma and two other cases of uterine malignancy.

Conclusion: These results do not support the initial hypothesis and suggest that in women presenting with post-menopausal bleeding, an 'insufficient' sample is an indication for further investigation.