Endometrial biopsy & bull; hello healthy

Definition

What is an endometrial biopsy?

An endometrial biopsy is a method used by doctors to take a small sample at the border of your uterine wall (endometrium). The sample will be examined in more detail using a microscope to look for abnormal cells. An endometrial biopsy helps your doctor find problems at the lining of your uterus. This examination will also help the doctor to check the balance of the body's hormone levels that affect your endometrium.

There are several ways to perform endometrial biopsy. Your doctor will probably use:

• a soft pipette shaped like a straw to suck a small sample from the lining of the uterus. This method is quick, but may cause cramping
• electronic vacuum (Vabra aspiration). This method is somewhat inconvenient
• a spray that will flush a small sample from the uterine wall. A brush may be used to remove the sample before rinsing is complete

An endometrial biopsy is done to look for the cause of abnormal uterine wall bleeding, to check for thickening of the inner lining of the uterus (endometrial hyperplasia), or to look for possible cancer.

For complaints of difficulty getting pregnant, an endometrial biopsy can be done to check whether your uterine wall can support the pregnancy process.

An endometrial biopsy is sometimes performed in conjunction with other medical tests, namely hysteroscopy, which doctors use to view the uterine wall through a small, lighted tube.

When should I have an endometrial biopsy?

An endometrial biopsy is performed to look for the causes of the following conditions:

• abnormal menstrual periods
• bleeding after menopause
• bleeding after taking hormone therapy drugs
• thickening of the inner lining of the uterus seen on ultrasound

This examination is usually performed on women aged 35 years and over.

A biopsy may also be done to test for endometrial cancer.

Precautions & warnings

What should I know before undergoing an endometrial biopsy?

A biopsy cannot be done during pregnancy. More samples can be taken during the dilation and curettage (D&C) procedure than using a biopsy. Another test, hysteroscopy, is usually done with the D&C so that the doctor can see the boundary of your uterine wall. Endometrial biopsy is not usually done during or after menopause, unless you have abnormal vaginal bleeding.

Process

What should I do before undergoing an endometrial biopsy?

Tell me about all medications you are taking, including blood thinners such as warfariine, clopidigrel, and aspirin. You may be required to have a pregnancy test before the biopsy procedure. Two days before the biopsy, do not apply creams or other medicines to your vagina. Do not use vaginal douches. (Never use vaginal douches. Flushing the vagina using a douche can cause infection of the vagina or uterus.)

Consult your doctor about the need to take painkillers, such as ibuprofen or acetaminophen, before the procedure.

How is the endometrial biopsy process?

The procedure is performed by a hospital obstetrician, your personal doctor, or a specialist nurse who has previously performed biopsy training. Your sample will be examined and tested by a pathologist. A biopsy can be done in your doctor's office. You are required to remove clothes from the waist down, and given a cloth to cover it. You will then be asked to lie down on the examining table, with your legs raised and supported.

The doctor will insert a lubricated device, a speculum camera, into your vagina. The device will slowly separate the vaginal walls so your doctor can see the inside of the vagina and cervix. The cervix will be flushed with a special liquid and will be clamped so that it does not escape with a clamp, called a tenaculum. Your cervix may be numbed with a spray or injection of a local anesthetic. The instrument for taking the sample will be guided through the cervix to the uterus. The tool will be swiped up and down to take a sample. Most women experience stomach cramps during the procedure.

The biopsy procedure takes 5 - 15 minutes.

What should I do after undergoing an endometrial biopsy?

You may feel pain in your vagina for 1-2 days. Vaginal or buttock bleeding is normal for up to 1 week after the biopsy. You can use bandages to treat bleeding. It is not recommended to do strenuous exercise or manual labor the day after the procedure. Nor is it advisable to engage in sexual activity, use tampons, or use douches until the spots run out.

Explanation of the Test Results

What do my test results mean?

Lab test results may be received a few days after the procedure.

Normal result

There were no abnormal cells or cancer. For women who have regular menstrual cycles, the lining of the uterus is at the appropriate stage for the menstrual cycle.

Abnormal results

Non-cancerous polyp growth is detected.

There is thickening of the uterine wall (endometrial hyperplasia).

Detected the presence of cancer or active cancer cells at risk of growing.

For women who have regular menstrual cycles, the lining of the uterus is not at the appropriate stage for the menstrual cycle. It takes a few more tests to be sure.