Vabra aspiration in office gynecology

Four years of clinical experience with 320 vabra aspirations in 271 patients, aged 21 to 84 years, has confirmed our expectation of the procedure, as a quick and easy method, affording reliable diagnosis, causing few complications, and acceptable to patients as a routine method. The procedure was suitable for approximately 80% of patients with menstrual disorders or postmenopausal bleeding. It was also valuable in the follow-up of patients with previous adenomatous hyperplasia of the endometrium and those on long-term estrogen therapy for postmenopausal symptoms. The initial VA specimen was adequate in 95.2% of cases and the quality was excellent. VA supplemented with ECC and uterine size measurement enabled the diagnosis, grading, and staging of all adenocarcinomas accurately. Adenomatous hyperplasia of the endometrium was correctly diagnosed in 96.5% instances but two patients with mild to moderate adenomatous hyperplasia were missed. Endometrial polyps were diagnosed in only 50% of patients. The therapeutic or hemostatic efficacy of VA was just over 50% in this series. The five pregnancy complications (two ectopic pregnancies and three incomplete abortions) in our experience, warrant consideration in all premenopausal females presenting with a menstrual disorder before VA is carried out. Undoubtedly, hospitalization can be avoided, with attendant cost saving, by more widespread use of this technique. We recommend that all obstetric and gynecologic residents be familiar with the procedure.