Endometrial sampling: brush less painful than curette. (Equivalent Quality).

LOS ANGELES -- The endocervical brush is less painful than a metal curette for endocervical sampling at colposcopy in patients with abnormal Pap smears, Dr. Shelly W. Holmstrom said at the annual meeting of the American College of Obstetricians and Gynecologists.

In a prospective, randomized comparison of the two tools in 148 women, mean pain scores as rated by the patients were significantly lower for the brush than the curette. Moreover, sample quality was similar for both methods when compared with pathology results in 41 patients who underwent cervical conization, she reported. The study won first prize at the meeting for papers by junior fellows.

Study participants were referred for evaluation after an abnormal Pap smear result during a 2-year period at Dr. Holmstrom's institution, Mercer University in Savannah, Ga. All women underwent colposcopy, and endocervical samples were taken twice. To obtain the samples, clinicians used the curette and then the brush in 77 women. In the remaining 71 women, they used the brush before the curette. Patients were randomized to the two groups and not told the order in which the instruments were used. The study excluded patients with a history of cervical cancer.

Patients rated the pain associated with each technique on a visual analog scale immediately after each sampling. On a pain ...