Is Valsalva maneuver an alternative to use tenaculum for endometrial sampling procedure in cases where the cervix cannot be passed spontaneously with pipelle? A randomized study

• Published in: The journal of obstetrics and gynaecology research Vol. 47; no. 2; pp. 529 - 532
• Main Authors: Narin, Raziye, Uysal, Gülsüm, Baş, Sevda, Narin, Mehmet A., Küçükbingöz, Emine G.
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-02-2021; Wiley Subscription Services, Inc
• Subjects: Cervix; endometrial biopsy; Endometrium; Patient satisfaction; pipelle; Sampling; Surgery; tenaculum; Valsalva maneuver; tenaculum; Valsalva maneuver; endometrial biopsy; pipelle
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.14546

Aim
To evaluate the effect of the Valsalva maneuver on ease of the endometrial sampling procedure in cases where the cervix cannot be passed spontaneously.
Methods
A randomized prospective trial was conducted in 84 patients whose cervix could not pass spontaneously with pipelle, and they were randomized for the Valsalva maneuver or tenaculum groups. In 43 of a total of 84 patients, we requested Valsalva maneuver throughout the process to pass the cervical canal, and in 41 patients, we performed tenaculum to pass the cervix.
Results
Valsalva and tenaculum groups did not differ in success rates (P = 0.314). There was no difference between the two groups in the history of the disease, past surgery and education (P > 0.05).
Conclusion
In endometrial sampling procedure with pipelle, when the cervix cannot be passed spontaneously, the transition with the Valsalva maneuver should be tried before using the tenaculum. Thus, a more painful procedure can be avoided and patient satisfaction may increase.