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Fabric-Based Exocervical and Endocervical Biopsy in Comparison With Punch Biopsy and Sharp Curettage

Winter, Marc MD1,2; Cestero, Ramon M. MD3; Burg, Andrew MD4; Felix, Juan C. MD5; Han, Catherine MD1; Raffo, Ann Marie MD1; Vasilev, Steven MD, MBA6

Journal of Lower Genital Tract Disease: April 2012 - Volume 16 - Issue 2 - p 80–87
doi: 10.1097/LGT.0b013e318234262d
Original Articles

Objectives Fabric-based endocervical and exocervical biopsy tools were compared with exocervical punch biopsy and sharp endocervical curettage. We compared the level of pain reported by the patient and the amount of bleeding rated by the physician relative to the type of biopsy used.

Materials and Methods This was a 2-center institutional review board–approved study of patients undergoing colposcopy. One center randomized patients to undergo either conventional (punch biopsy, sharp endocervical curettage) or fabric-based biopsy of the endocervix and exocervix, and a second center enrolled nonrandomized controls. The patient and physician subjectively rated bleeding (exocervical) and pain (endocervical and exocervical) from the biopsy procedure(s), which were compared using the nonparametric Wilcoxon test.

Results Exocervical and endocervical biopsies from 55 patients were compared. Fabric-based biopsies were abundant full-thickness curettage and showed statistically significant less pain and bleeding than the conventional biopsy methods (p < .0001).

Conclusions Fabric-based biopsies are significantly less traumatic than conventional biopsies. The benefits of a less-invasive biopsy could increase the willingness to perform multiple biopsies, increase disease detection, and improve patient satisfaction, which could impact future gynecologic health-seeking behavior and compliance with colposcopy recall.

Fabric-based exocervical and endocervical biopsies were of sufficient number, volume, thickness, and architecture to render a diagnosis but less traumatic than conventional punch biopsy and endocervical curettage.

1Department of Obstetrics and Gynecology, Orange Coast Women’s Medical Group, Laguna Hills; 2Department of Obstetrics and Gynecology, University of California, Irvine School of Medicine, Irvine; 3Department of Obstetrics and Gynecology, Arrowhead Regional Medical Center, Colton; 4Department of Gynecological Pathology, St. Mary Medical Center, Long Beach; 5Department of Gynecological Pathology, University of Southern California Women’s Hospital, Los Angeles; and 6Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA

Reprint requests to: Marc Winter, MD, Orange Coast Women’s Medical Group, 24411 Health Center Dr, Suite 200, Laguna Hills, CA 92653. E-mail:

Presented and abstract published as part of the Pacific Coast Obstetrics and Gynecological Society, October 2010.

Funding and devices for this study were provided by Histologics LLC, Henderson, NV.

©2012The American Society for Colposcopy and Cervical Pathology