Endometrial Biopsy
Definition |
Body Parts Involved |
Reasons for Procedure |
Complications |
What to Expect |
Outcome |
Call Doctor If
Definition
A procedure to remove a tissue sample from the lining of the uterus, which is called the endometrium.
Parts of the Body Involved
Vagina, cervix, uterus
Reasons for Procedure
- Evaluate the cause of resumed bleeding in post-menopausal women
- Evaluate abnormally heavy vaginal bleeding or bleeding between menstrual periods in pre-menopausal women
- Obtain a tissue specimen to test for cancerous or pre-cancerous conditions
- Monitor the uterine lining in women on estrogen replacement therapy
- Help evaluate the cause of infertility or repeated miscarriage
Risk Factors for Complications during the Procedure
- Pregnancy - You should not have an endometrial biopsy if you are pregnant.
- A narrow cervical canal, which may not allow insertion of the biopsy tool.
- Prior radiation treatment to the area, which makes obtaining the sample more difficult.
What to Expect
Prior to Procedure - You may be advised to schedule the biopsy for a particular 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:
- Take any pain medication as ordered by your doctor; a mild pain reliever or anti-inflammatory medication (ibuprofen) one hour before the procedure may be recommended
- Wear or bring a sanitary pad to the doctor's office
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 biopsy tool, the doctor suctions out a small sample of endometrial tissue.
After Procedure - Laboratory examination of removed tissue. If cancer is found, the pathologist will determine the type and grade of cancer. Tests also may be conducted to check for the presence of progesterone (a female hormone) receptor cells. Endometrial cancers with progesterone receptor cells grow and spread more slowly than cancers without the receptors.
How Long Will It Take? 10-15 minutes
Will It Hurt? Most patients report some cramping, pain, tugging, and/or pressure during the biopsy. Your doctor may order pain medication to be taken one hour before the procedure to minimize this pain.
Possible Complications:
- Infection
- Bleeding
- The biopsy instrument may poke a hole in the uterus (rare)
Average Hospital Stay - None
Postoperative Care:
- Some women feel lightheaded or dizzy immediately after the biopsy. You'll be advised to lie still for 5-10 minutes until this passes.
- You may leave the office shortly after the biopsy is finished.
- Expect some cramping and bleeding after the biopsy. Use sanitary napkins, not tampons.
- Ask your physician when you may resume douching and having sexual intercourse.
Outcome
In a few days your doctor will receive the report showing the laboratory analysis of the removed tissue. Your doctor will make treatment recommendations based on these results.
If an inadequate sample was obtained or the results were inconclusive, a dilation and curettage (D&C) is usually recommended to obtain another tissue specimen. An endometrial biopsy removes only a small sample of the uterine lining and, therefore, 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
SOURCES:
American Academy of Family Physicians
American Cancer Society
Last reviewed March 2001 by Medical Review Board
