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Definition

A procedure to remove a tissue sample from the lining of the uterus (called the endometrium)

The Endometrium

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Parts of the Body Involved

  • Vagina
  • Cervix
  • Uterus

Reasons for Procedure

  • Evaluate the cause of bleeding in postmenopausal women
  • Evaluate abnormally heavy vaginal bleeding or bleeding between menstrual periods
  • Obtain a tissue specimen to test for cancerous or precancerous conditions
  • Monitor the uterine lining in women on estrogen replacement therapy
  • Help evaluate the cause of infertility or repeated miscarriages

Risk Factors for Complications During the Procedure

  • If you are pregnant, the test cannot be done
  • If you have a narrow cervical canal, there may not be room to insert the biopsy tools
  • If you had radiation therapy to the area, it may be difficult to get a sample

What to Expect

Prior to Procedure

You may need to schedule the biopsy for a certain time during your menstrual cycle.

Your doctor will likely do the following:

  • Physical and pelvic exam
  • Blood work
  • Urine test

The day of your procedure:

  • Talk to your doctor before taking pain medication before the biopsy. You may be asked to take a pain reliever one hour before the test. Some doctors do not recommend taking a nonsteroidal anti-inflammatory drug (eg, ibuprofen) because it can worsen bleeding.
  • Wear or bring a sanitary pad.

During Procedure

Sedative, anesthesia

Anesthesia

Possibly a mild sedative or local anesthesia

Description of the Procedure

You lie on a table with your feet in stirrups, as you would for a gynecologic exam. A speculum is used to open the vagina. Local anesthetic may be used to numb the cervix. An instrument called a tenaculum is used to grasp the cervix. A flexible, thin, suction instrument is passed through the vagina and inserted into the uterus. Using this tool, the doctor suctions out a small sample of endometrial tissue.

After Procedure

The tissue sample is sent to the lab. If cancer is found, the pathologist will determine the type and grade of cancer. Tests also may be done to check for the presence of progesterone (a female hormone) receptor cells. Endometrial cancers with these cells may grow and spread more slowly than cancers without the receptors.

How Long Will It Take?

10-15 minutes

Will It Hurt?

You may feel some cramping, pain, tugging, and pressure during the biopsy. You may be asked to take pain medication before the test.

Possible Complications

  • Infection
  • Bleeding
  • Hole in the uterus created by the biopsy tool (rare)

Average Hospital Stay

None

Postoperative Care

  • After the biopsy, you may feel lightheaded and dizzy. Lying down for 5-10 minutes should help.
  • You can leave the office shortly after having the biopsy.
  • Expect some cramping and bleeding. Use sanitary napkins, not tampons.
  • Ask your doctor when you can resume douching and having sexual intercourse.

Outcome

In a few days, your doctor will receive the lab report and make a treatment plan based on the results.

In some cases, another kind of tissue sample is needed. Your doctor may recommend that you have a dilation and curettage. Since an endometrial biopsy removes only a small sample, it may miss cancer that is present.

Call Your Doctor If Any of the Following Occurs

  • Excessive bleeding (more than your normal menstrual period or saturating a pad within one hour)
  • Signs of infection, including fever and chills
  • Severe pain
  • Foul-smelling vaginal discharge