Endometrial biopsy is a diagnostic procedure used to sample the lining of the uterus.
Why The Procedure?
- To rule out endometrial cancer or hyperplasia (a potentially precancerous condition) in a woman with abnormal bleeding. This includes bleeding between menstrual periods, excessive bleeding during a menstrual period, or bleeding after menopause.
- As part of an infertility work up to rule out problems with the development of the endometrium.
- To evaluate the problem of repeated early miscarriages.
Procedure
- If checking fertility, the procedure is performed during the last few days prior to onset of the patient's menstrual cycle. This is the best time to identify possible hormonal problems and to determine if ovulation is occurring.
- Usually performed in the health care provider's office with no anesthesia necessary. The woman will lie on her back with knees apart and feet in stirrups.
- A speculum is used to bring the cervix into view just like when you get a pap smear. In some cases, it is necessary to use a tenaculum (a hooklike instrument that holds and helps stabilize the cervix).
- An instrument is inserted through the cervix into the uterus. Often used is a thin, pliable strawlike (pipelle) instrument used to suction out a small amount of tissue.
- The procedure may cause cramping or slight pain, which is minor and temporary.
What To Expect
- We are able to obtain tissue successfully without complications in virtually all cases.
- Recovery time is usually minimal.
- In the first week following the procedure, you should expect vaginal discharge.
- Laboratory testing on the tissue can confirm ovulation has occurred and may identify other causes of infertility, such as infection.
- Pathologic examination will generally determine if there are any abnormal cells found in the uterine lining. A normal (or negative) result shows no cancerous or precancerous cells (however, a small chance of a false negative result is possible).
- Abnormal appearance of the cells forming the uterine tissue could also indicate uterine cancer, or the presence of fibroids or polyps in the uterus. Your health care provider will discuss further testing or treatment options.
Complications
- Excessive bleeding.
- Endometritis (a rare infection of the uterus).
- Inadvertent injury to the uterus or the cervix is torn (rare).
After The Procedure
- Bathe or shower as usual.
- The biopsy may cause a small amount of bleeding (spotting). Wear sanitary pads and avoid tampons until your follow up visit. Your menstrual flow may be heavier than usual.
- Wear cotton underpants and pantyhose with a cotton crotch. Avoid underwear made from nylon, polyester, silk or other nonventilating materials.
- Don't douche!
Do I Need Medications?
- You may use nonprescription drugs, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), for minor pain.
Activity
- Resume normal daily activities and work the same day. You should avoid sexual intercourse for a few days.
Call Us If
- Vaginal discharge increases or begins to have an unpleasant odor.
- You are experiencing cramping or pain that over the counter medications does not relieve.
- You are experiencing unusually heavy vaginal swelling, bleeding or if you develop a fever.