In some cases, after a pap test, examination on a gynecological chair or colposcopy, the gynecologist may prescribe a diagnostic procedure such as a cervical biopsy. This study involves taking one or more tissue samples of the cervix and their histological analysis to determine abnormalities, precancerous or cancerous cell degeneration.
In order for such a diagnostic method to give the most reliable results, it is necessary to determine the indications and contraindications for its implementation, select the correct date for its implementation and the type of tissue sampling technique. Before the procedure, a woman must undergo the necessary training, the correctness of which will also determine the reliability of the analysis.
In this article, we will acquaint you with the indications, contraindications, methods of preparing and performing a biopsy of the cervix.
A gynecologist can prescribe the performance of such a diagnostic procedure for any suspected pathological changes in the tissues of the cervix.
Most often, a biopsy is prescribed in the following clinical cases:
- doubtful or negative results of the pap test (smear on cytology),
- the presence of leukoplakia, erosion, genital warts, polyps on the cervix
- detection of suspicious changes during colposcopy (atypical vessels, iodine-negative areas, rough mosaic and punctuation, acetabular epithelium, etc.).
- An analysis of the condition of the uterine mucosa is done to diagnose the likelihood of developing severe disorders or with a comprehensive examination for a malignant tumor,
- A doctor can apply several methods of taking a biopsy,
- Preparation for the study is associated with additional analyzes,
- Usually, in the process of taking a piece of tissue, the subject does not feel pain,
- Limitations after studying a piece of tissue do not bring limitations,
- A biopsy is characterized by a high degree of accuracy of the results.
When is a biopsy needed?
Theoretically, the basis for the study can be any pathological process in the cervix, however, given the invasiveness of the procedure, it is not performed on absolutely all patients. Some diseases do not require detailed morphological confirmation and do not pose a threat to life, therefore, you can do without a biopsy.
In the case of young girls and nulliparous women, the approaches to biopsy are even more stringent, although it is believed that the procedure itself does not cause complications and rarely leads to scarring. In order to avoid possible pregnancy problems in the future, it is worth abandoning unjustified biopsies that somehow injure the surface of the organ.
A cervical biopsy is performed with:
- Identification of suspicious focal changes during colposcopy,
- Bad results of cytological analysis of cervical epithelium,
- Suspicion or diagnosis of carcinoma with colposcopy.
A biopsy is preceded by a colposcopic examination of the cervix and taking a cytological smear, which may give rise to suspicion of carcinoma or a high risk of its occurrence in the near future. With colposcopy, the gynecologist can detect white areas of the epithelium under the action of acetic acid, the absence of a reaction to iodine, eroded red areas. Cytology provides information on the structure of cells, their proliferative activity, the presence of atypia.
Taking a biopsy under the control of a colposcope increases the value of the morphological analysis, because the doctor acts precisely and takes the most altered fragments of the neck.
The most compelling reason for a biopsy is considered a suspicion of cancer or the onset of malignant transformation of existing non-cancerous lesions. A detailed microscopic examination allows you to distinguish between a benign process, severe dysplasia, invasive carcinoma or cancer that has not yet begun to germinate under the epithelial layer. Further treatment tactics will depend on the outcome of the study.
Another reason for a pathomorphological study may be the presence of structural changes in the neck during the infection by highly oncogenic strains of the human papillomavirus proved by PCR. The virus itself is capable of causing lesions visible to the eye, similar to carcinoma, but only histological examination can help distinguish truly cancer from changes caused by the vital activity of the virus in the epithelium.
A biopsy of the cervix with erosion (true) is rarely done because of its fragility and low risk of malignancy, whereas endocervicosis (pseudo-erosion), often denoted by the incorrect term “erosion”, may well cause malignancy. With pseudo-erosion, a morphological study is indicated when there is reason to assume a malignant transformation in the foci of erosion glands.
The absolute indication for biopsy the uterine cervix is a tumor-shaped lesion visible by the eye, exophytic, protruding outwardly of the growth of the epithelium, especially with ulceration, secondary inflammation, and an abundance of bleeding vessels.
Obstacles small in number due to its low invasiveness. They are considered:
- Pathology of hemostasis due to the risk of bleeding,
- Acute inflammatory changes, exacerbated chronic infections in the genital tract (after complete elimination of the inflammatory process, a biopsy can be considered safe).
Pregnancy is considered a relative contraindication to the procedure, with a short period of time it can cause spontaneous abortion, on a large one - premature birth. The safest period for an invasive diagnosis of neck pathology is considered the second trimester of gestation.
If the neck pathology detected during pregnancy does not require an immediate biopsy, the doctor will prefer to postpone it and do it after childbirth. With a very likely growth of a malignant tumor in a pregnant woman, poor results of a cytological examination, the gynecologist may even insist on a biopsy. Sometimes, in order to preserve the patient's life and health, the pregnancy has to be interrupted.
Sometimes a biopsy of the cervix cannot be performed until some contraindications are resolved:
- infectious and inflammatory processes in the genitals,
- disorders in the blood coagulation system,
Another relative contraindication to biopsy can be pregnancy. In such cases, this diagnostic procedure is not always carried out.
Preparation for a planned biopsy of the cervix includes a number of standard examinations that you can go through in your clinic. General and biochemical blood tests, a coagulogram, an examination for syphilis, hepatitis, HIV are prescribed.
Before the procedure, a woman must visit a gynecologist, undergo colposcopy with taking smears for cytology, vaginal microflora. If necessary, an ultrasound of the internal genital organs is performed.
The study is accompanied by trauma to the outer layer of the organ, so it must be prescribed in the first phase of the menstrual cycle (for 5-7 days), so that the defect is epithelized by the next menstruation.
Two days before the manipulation, you need to exclude sexual contact, douching, the use of vaginal suppositories, ointments, capsules, you should also not use tampons, since all this can distort the result of the study. When planning general anesthesia, a woman should not eat or drink liquid from 6 o’clock on the eve of the study.
After passing the examinations and preparatory measures, the patient without fail gives his written consent to take tissues for research.
After an excisional biopsy, the patient is immediately discharged home and on the second day to begin the previous activity. After the procedure with cutting off a piece of tissue, she should be in the hospital for 1 or 2 days. A disability certificate is issued for 10 days.
Sometimes a woman can feel pain, while analgesic medications are allowed. It is recommended to place a non-hot compress on the lower back.
Gynecologists advise wearing underwear made from natural fabrics, using sanitary pads. For washing, you need to use soap without flavorings. The perineum should be well dried.
Wound healing takes place over a month - re-conducts an examination. Menstruation usually occurs on time or with a slight delay.
When can a cervical biopsy be performed during pregnancy?
If pathological changes in the tissues of the cervix uterus are detected during pregnancy, the decision on the need for a biopsy is always taken individually.
In the early (up to 12 weeks) or later periods, this procedure may be unsafe and cause miscarriage or premature delivery. That is why usually gynecologists recommend performing tissue sampling in the second trimester of pregnancy, when the risk of such complications becomes the lowest.
If other studies show that the revealed pathological foci in the tissues of the cervix do not require immediate diagnosis, then a biopsy can be performed already in the postpartum period. In such cases, the study is carried out 6 weeks after delivery.
Radio wave biopsy
The trend in surgery in recent years is the search for the least traumatic and minimally invasive methods of diagnosis and treatment, which are not accompanied by complications, but highly informative. One of them is considered the radio wave method. It has several advantages and is preferred for women of all ages for any pathology of the uterine neck.
radio wave biopsy with Surgitron
Radio wave biopsy is based on the action of high temperature on cells, the liquid part of which evaporates. The main tool in this case is a loop through which high-frequency radio waves pass. The loop does not touch the excised tissue, that is, the method is non-contact. Evaporation of the tissue is accompanied by the formation of steam, which coagulates the vessels, preventing bleeding.
Radio wave biopsy is almost painless, allows you to maintain the integrity of the removed tissue fragment and surrounding tissues, therefore, has a high information content and low invasiveness. The risk of burns, scarring and complications of an infectious-inflammatory nature is extremely low, as well as infection due to the disinfecting effect of radio waves. Healing is much faster than after conventional surgical procedures.
The radio wave technique is preferable for nulliparous women planning a subsequent pregnancy, since it does not leave scar deformity, which means there is no risk of miscarriage or miscarriage.
A radio wave biopsy can be performed on an outpatient basis and without anesthesia, without specific preparation, it is simple to perform and accessible to a wide range of patients. For its implementation, the Surgitron apparatus is used, which is in many women's clinics and gynecological hospitals.
Due to the listed advantages of the method, a radio wave biopsy is practically devoid of contraindications. It cannot be performed for patients with a pacemaker, and this is perhaps the only reason to abandon this diagnostic method in favor of standard surgery.
Puncture (sighting) biopsy
A targeted biopsy remains one of the most common methods for taking cervical tissue for morphological analysis. It is carried out under the control of colposcopy, and the doctor excises those tissue fragments that seem most suspicious during examination. The material in the form of a column is taken using a puncture needle.
A puncture biopsy is carried out in conditions of women's consultations, does not require special preparation and anesthesia. Subjective discomfort is short-lived and limited to those seconds when the needle enters the body.
Loop and laser biopsy
Loop biopsy involves excision of tissue by the action of an electric current passing through a special loop. Electroexcision is painful, therefore, it requires local anesthesia, but there is no need for hospitalization.
The excision of tissue by electric current is rather traumatic, the defect is scarred and epithelized for several weeks, and a woman may complain of spotting from the genital tract.
After the action of the electric loop, there is a risk of the formation of dense scars that deform the cervix, which will interfere with the gestation subsequently, therefore this method of biopsy is extremely undesirable for nulliparous patients planning to have children.
The basis of laser biopsy is the use of a laser beam as a cutting tool. This manipulation is accompanied by pain, therefore, is done under general anesthesia. Advantages - quick healing and low likelihood of cicatricial deformities.
Cervical biopsy. How is it done?
When there are indications for a biopsy, the doctor prescribes it in the period most convenient for the patient. The date will depend on the timing of the menstrual cycle. Tissue sampling is performed in the gynecologist's office when there is no need for anesthesia.
A cervical biopsy is performed under general anesthesia in most cases. If it is required, the procedure is carried out during hospitalization for two days. The doctor must tell the patient how the biopsy will be performed. Detailed recommendations are given for the proper preparation for the procedure. Then you will need to come to your doctor’s appointment again, after about a week will pass after the biopsy.
Types of cervical biopsy
Cervical tissue sampling can be performed using different methods. The choice of this or that method depends on the preliminary diagnosis and a number of other parameters, and some of the biopsy techniques are not only diagnostic, but also medical procedures.
There are such varieties of cervical biopsy:
- Sighting (or puncture). This technique is the most common and performed during colposcopy. The most suspicious tissue sites are taken for analysis. To obtain them, a special biopsy needle is used, which is able to hold a column of tissue. Such a procedure can be performed on an outpatient basis, does not require spinal, epidural anesthesia or general anesthesia. During the procedure, the patient feels only a slight tingling sensation or some pressure, passing in only 5-10 seconds.
- Conchotomy. This type of biopsy is almost no different from a puncture, but for its execution it is used with a conchotome (a tool resembling scissors in its appearance). The procedure can be performed on an outpatient basis, and local anesthesia is used for pain relief. After taking material for analysis, a woman may have spotting for some time.
- Loop (or electrosurgical, electroexcision). During this procedure, the altered portions of the cervical tissue are peeled off with a tool similar in shape to the loop. An electric current passes through it, which ensures the separation of the necessary tissues. The procedure can be performed on an outpatient basis after local anesthesia.It is believed that this type of biopsy is capable of distorting the results of the analysis, since “charred” particles are present in the collected tissues. After taking a sample of the material in this way, healing takes longer and the patient may experience bloody discharge from the vagina for several weeks. In addition, some experts do not recommend carrying out this procedure for women planning a future pregnancy, because after tissue collection on the neck, cicatricial changes may occur that interfere with the normal conception or bearing of the fetus.
- Sphenoid (or knife, expanded, cold-knife, cervical conization). This procedure is carried out using a conventional surgical scalpel. A small piece of a cervical triangular shape is taken as a tissue sample. Cuts are performed so that the most suspicious layers of this part of the uterus are taken for analysis. This method of sampling the material can be not only diagnostic, but also therapeutic. It is always performed in a hospital, because it needs to use sufficient pain relief (general anesthesia, spinal or epidural anesthesia). After the intervention, the woman may be discharged the same or the next day. Over the next few weeks, she can feel mild pain in the lower abdomen and observe bloody discharge of varying degrees of profusion from the vagina.
- Circular (or circular). This method is a type of cervical conization and is performed using a scalpel or radio wave knife. During the intervention, a large area of tissue is taken with a mandatory capture of part of the cervical canal. This method can be prescribed for diagnostic or therapeutic purposes. It is performed under general anesthesia, spinal or epidural anesthesia in a hospital setting. As after cervix conization, a woman can feel pain in the lower abdomen for several weeks after the procedure and observe bloody discharge of varying degrees of profusion from the vagina.
- Radio wave. This technique is performed using a Surgitron radio wave knife and does not leave significant damage to the cervix. After tissue collection, a woman may experience small spotting, but they stop after 2-3 days. Such a procedure rarely causes complications and cicatricial changes do not remain on the organ. Often, this type of biopsy is recommended for women who are still planning a pregnancy.
- Laser. Tissue sampling for analysis is carried out using a laser knife in a hospital setting, since general anesthesia is required to perform such an intervention. This technique rarely causes any complications, is less traumatic and does not need long-term rehabilitation (spotting stops in the first days after the procedure).
- Endocervical curettage. This biopsy technique is slightly different from the previous ones, because it involves curettage of the cervical canal. Thanks to this manipulation, it is possible to obtain tissue directly from the cervical canal to detect atypical cells in them. The procedure can be performed after intravenous anesthesia.
Purpose of the study
A biopsy is performed if absolutely necessary. Moreover, even if it was needed to clarify the diagnosis, but the female representative currently has inflammation, the analysis is not carried out until a complete recovery is achieved. Thus, sufficiently serious reasons and alarming signs are necessary for the analysis to nevertheless take place.
- negative smear results for cytology,
- the presence of any suspicious changes in the cervical region during colposcopy,
- erosion processes in this area,
- leukoplakia, or hyperkeratosis,
- polyps in the cervix, as well as condylomas.
The most suitable period of the menstrual cycle for biopsy should be considered the period from 7 to 13 days. For the correct calculation, it is necessary to recall that the first day of the cycle is the first day of the onset of menstruation. It will be most correct to carry out this analysis immediately after the completion of menstruation. This is done so that the wound in the uterus has time to heal before the next menstruation begins. Otherwise, additional treatment may be necessary, because the likelihood of inflammation and even infection is too high.
How is the preparation for the procedure carried out?
Despite the simplicity of its implementation, a biopsy is still a small surgical intervention, so its implementation should be carried out in the absence of infectious diseases of the female genital area. The patient herself does not take any action - everything is done by the doctor. First, he takes a smear on the pathological flora and, upon receipt of a negative response, a biopsy procedure is prescribed in the near future. If a smear of pathological microflora is found, a woman should undergo the prescribed course of treatment, and only then agree to a biopsy.
The doctor must tell you about how a cervical biopsy is taken, and how important this procedure is in making an accurate diagnosis. Having received the written consent of the patient, the specialist sets the time for taking the material. Typically, a biopsy is performed after the end of menstruation, since by the next menstruation the wound surface should heal completely, and this will take 10 to 14 days. Another important point that worries many women is the pain of the procedure.
Since the cervix does not have nerve endings, there is no need for anesthesia. Taking a biopsy sample does not cause pain, so you should not be afraid and strain. However, some women still experience fear of this procedure, which leads to tension in the muscles and uterus. The result is a reaction to the biopsy process with spasms, comparable to the pulling sensations in the lower abdomen during menstruation. The intensification of unpleasant sensations occurs just at the moment when the woman is tensing, helping the uterine spasms become more noticeable.
An experienced specialist can immediately discern the mood of the patient, so he can offer spraying with lidocaine. In addition, women who are afraid of any medical intervention may themselves ask the doctor for any pain medication. Knowing that there will be no pain, the patients become calmer, so the anesthesia procedure justifies itself.
How to prepare?
In order to reduce the likelihood of complications after passing the analysis, it is recommended to use some recommendations of specialists. Among them: refusal to have sex a few days before the test. It is undesirable to use tampons, as well as douching two days before the biopsy.
Preparation is under the supervision of a physician
You should refuse to introduce medicinal suppositories into the vaginal area, except for those that are necessary and approved for use by a specialist. Immediately before a visit to the gynecologist, you need to take a shower in accordance with all norms of intimate hygiene. If the biopsy is carried out under general anesthesia, then it is advisable not to eat food 8-10 hours before the test itself.
A targeted biopsy of the cervix - we are waiting for the results
After submitting a biopsy for examination, a woman should not pick up objects weighing more than 3 kg. Also, for 2 weeks, it is necessary to abandon sexual life, and the doctor removes the ban only after examination and the belief that the wound has healed. To avoid bleeding, you should not now visit baths and saunas, sitting in a hot bath is also not advisable. For hygiene purposes, you can use a contrast shower. Under no circumstances should a woman take Aspirin after a biopsy, as it dilutes the blood and creates an obstacle to the loss of fibrin, which in turn leads to the formation of a blood clot.
After the biopsy of the cervix, the results are interpreted according to the classification schemes. Today, doctors use such classifications as:
- classification, including all degrees of dysplasia and carcinoma,
- classification of CIN (1 - 3 degrees),
- morphological classification of changes in the uterine neck that are caused by the human papillomatosis virus.
In the absence of cellular changes, histological examination is treated as normal. If they were found in small quantities, then such a result may indicate an inflammatory process or cellular changes of a benign nature.
Actively in the study of biopsy today, the classification of background processes, precancerous conditions and cervical cancer I. Yakovleva and B. G. Kukute is used, according to which they (background processes) are divided into:
- inflammatory (true erosion and cervicitis),
- post-traumatic (ruptures and cicatricial changes, cervical-vaginal fistulas and ectropion),
- hyperplastic, or associated with hormonal disorders (all forms of endocervicosis, polyps of varying complexity, endometriosis, papilloma without signs of atypia, leukoplakia in a simple form).
Precancerous changes are understood as dysplasia, formed on the unchanged uterine neck or in the area of background processes (from weak to pronounced). This also includes adenomatosis and leukoplakia with atypical manifestations. Cervical cancer (cervical cancer) includes preclinical and clinical forms. In the first case, they talk about microcarcinoma or cancer in situ, in the second - about squamous cancer, which can be keratinized and keratinized. Clinical forms of cancer also include its forms, such as:
- low grade
- clear cell mesonephral,
- glandular differentially differentiated.
Judging by the reliability of the biopsy method, it is worth noting its almost 100% effectiveness in the diagnosis of precancerous and cancer of the cervix (up to 98.6%). As for colposcopically oriented biopsy, here the accuracy of diagnosis is increased by 25%. The advantage of the biopsy method can be considered confidence in the recognition of cancerous tumors, especially in the initial stages. As a disadvantage, it is worth noting the impossibility of its multiple conduct in the same patient.
Analyzes before the procedure
Since a cervical biopsy is an invasive procedure, it can be accompanied not only by the likelihood of complications, but even infection. To prevent negative consequences, the analysis field, before the described procedure, the specialist appoints a multi-stage examination. Most often, the doctor says that you need to pass such tests as:
- analysis of the integral state of the blood and coagulogram (makes it possible to determine blood coagulation),
- smear on the state of the flora (determines the presence of such manifestations as gonorrhea and trichomoniasis),
- the presence of latent infections (chlamydia, mycoplasmosis, ureaplasmosis),
- for HIV infection, hepatitis of the viral type, as well as syphilis.
If there are any signs presented in this list, then the implementation of a biopsy is out of the question.
Biopsy, are there any complications?
Most often, the biopsy procedure is complicated by bleeding from the vessels of the cervix, which it is rich in. However, subject to medical recommendations, this problem is resolved independently after 5 to 10 days. In case of violation of the instructions of a specialist or non-observance of personal hygiene, infection of the site from which the biopsy was taken can occur. Symptoms of the infectious process are represented by an increase in body temperature and purulent discharge from the vagina, in which there may be impurities or blood clots. Due to contractions of the cervix in the lower abdomen, pain occurs, which analgesics such as Nurofen and Indomethacin can easily cope with.
In various clinics, biopsy prices are also different. You can find out how much a cervical biopsy costs directly from your doctor. The cost of this procedure varies between 2,000 - 5,000 rubles. And it will be possible to get acquainted with the results of histological examination in 1.5 - 2 weeks.
📍 The information is provided solely for popular educational purposes, does not claim to reference and medical accuracy, is not a guide to action. Do not self-medicate. Consult with specialist.
Another name for this method is targeted biopsy of the cervix uteri and it is performed as part of colposcopy. For the test, only those areas of the cervix that are considered suspicious by a specialist are taken. A special needle is used to take the genetic material. It makes it possible to take a certain amount of uterine tissue, which contains all the layers of cells required for the examination.
For this biopsy method, there is no need for hospitalization, it is quite possible to carry out it in the gynecologist's office. Another advantage is that during the analysis, general anesthesia is not required. Most often, colposcopic analysis is performed without any pain medication.
During the procedure, the patient:
- may feel uncomfortable
However, this will last no more than 5-10 seconds. After analysis of the type presented, spotting from the vaginal area may occur. Normally, they will last from two to three days. If the discharge lasts longer, you need to contact a gynecologist.
In the case of laser biopsy, the cervical region is removed using a special laser knife. Unlike colposcopy, this method should be carried out in a hospital setting. This is relevant due to the fact that for this procedure, even short-term, but still general anesthesia is necessary.
The described method is the least traumatic and rarely provokes any deterioration. At the same time, within a few days after the analysis, a woman may be diagnosed with minor spotting. Their color can range from red to pink.
Radio wave method
A biopsy of this type does not provoke any damage and is associated with a relatively low risk of complications. This test does not require general anesthesia, and therefore can be carried out even in the office of the attending physician. After a biopsy, any discharge is either absent or not abundant and lasts no more than two to three days.
The risk of scar formation in the cervical region after an radio wave biopsy is extremely small. That is why it is recommended to those female representatives who are going to have a baby in the future.
What does it show?
If the results of the analysis were poor, it is necessary to immediately begin treatment. This will require not only the advice of a gynecologist, but also an oncologist. Today, doctors are able to cure not only cervical dysplasia, but also cancer. Because it is important to carry out this test once a year and more often if any deviations and other signs are observed.
Thus, the results of a cervical biopsy are recognized by all gynecologists as the only ones that indicate pre- and cancerous changes in the female reproductive system. They are considered the most reliable and help to prescribe the right treatment.
Before carrying out a biopsy of the cervix, it is necessary to find out from the doctor all the possible consequences in order to avoid further misunderstandings. Women should know that after the procedure, you need to follow some rules. For the most part they are not complicated and some inconvenience can be suffered. For instance:
- if you can’t bathe in a hot bath, you can take a warm shower,
- some women prefer to use only tampons during menstrual flow, but one month you can postpone them in favor of pads,
- lovers of saunas, baths and pools should find other preferences for the healing time of the postoperative wound,
- not to lift weights - but it is desirable to exclude it altogether, and not only for the recovery period,
- vaginal ointments or suppositories are completely replaced by tablets and capsules,
- the biggest inconvenience is the prohibition of sexual activity, but the idea that health, first of all, can be somewhat comforting.
Observance of all these indications will contribute to a quick recovery, recovery and return to a normal, healthy and full life.
This method of tissue collection is far from the safest, most effective. Although it is used often enough, because it does not require the use of special sophisticated equipment.
In the process of conducting a wedge-shaped biopsy of the cervix, the doctor uses a scalpel. This is a full-fledged operation that can be carried out exclusively in stationary conditions. A surgical scalpel is used. It is with the use of a scalpel that a specialist excises a wedge-shaped area directly on the cervix. In this case, not only diseased areas in the tissues are taken. Healthy particles are also needed: this is necessary for an adequate analysis.
After surgery, be sure to stitch. Such surgery occurs only under general anesthesia. The healing process takes a long time. Unfortunately, during the rehabilitation period there will be discharge, probably, and plentiful. Pain also accompanies healing.
Loop fabric fence
A loop biopsy is associated with the use of electric current. A special loop is applied to a specific area on the cervix. Then, an electric current starts looping. It provokes necrosis of cells. This technique is used not only as part of the biopsy procedure. It is in demand in the complex treatment of cervical diseases. The so-called cauterization is still used quite often. Experts note that the technique is not quite modern, sometimes it provokes complications. Unfortunately, often after a loop biopsy of the cervix, scars remain on the tissues.
A circular biopsy technique is also known. It differs from all the methods of tissue collection that we examined earlier. During a circular biopsy, tissue is also taken from the cervical canal. This is an extended biopsy. Usually, specialists use radio knives and a scalpel to remove tissue. General anesthesia is necessarily given, the procedure is allowed only in stationary conditions. Over the course of several days of the recovery period, discharge usually occurs, patients are concerned about pain.
After the procedure
Experts say that after performing a biopsy, you need to behave correctly so that complications do not arise. Here are a few important recommendations that you must follow.
- It is forbidden to douche.
- Do not lift weights.
- It is forbidden to take a bath, go to the bath.
- The use of vaginal tampons is also prohibited.
- Intimacy is prohibited.
All these precautions must be taken for a minimum of two weeks. Further, everything will depend on the specific recommendations of the attending physician, the patient's condition.
Classification of biopsy types by sampling method
Only a specialist will be able to accurately determine the best method for cervical biopsy. Also, the doctor will prescribe the period when it is better to take tissue samples for further analysis.
There are several basic analysis methods:
- radio wave biopsy,
The procedure is shown for erosion, when detecting changes in the tissues of the organ, as well as for polyps. Hyperkeratosis of the cervix is quite common, and a biopsy procedure is also performed with it. A biopsy is also necessary if abnormalities are determined during a laboratory smear analysis for cytology.
The analysis of tissues helps to identify the oncological diseases themselves, as well as the various ailments preceding them. Unfortunately, the study is forbidden to conduct with poor blood coagulation, as well as during the development of inflammatory processes.
Preparation for the procedure
It is important to know exactly how to prepare for the biopsy. It is necessary to follow all the recommendations and advice of a doctor so that the procedure goes well and does not cause negative consequences.
The patient passes a certain range of tests before the biopsy. Assign smears for various infections, blood tests for HIV, for hepatitis, as well as for RW. What state will have the neck of the organ at the beginning of critical days is also essential. That is why a biopsy is performed immediately after menstruation. Then, by the next critical day, the neck manages to heal, is no longer damaged.
Here are a few more important tips that necessarily must be respected.
- It is important to carefully carry out all hygiene procedures immediately before taking the tissue.
- You should take a shower.
- Food should not be taken in the evening.
- Intimacy is prohibited two days before the biopsy.
- Do not use medicines or vaginal care products.
Only with proper preparation for the analysis will it be possible to conduct it effectively.
First of all, it is important to find out all the possible symptoms of complications arising after a biopsy of the cervix. Here are some signs that should immediately alert:
- pain in the lower abdomen,
- vaginal discharge
- itching in the perineum,
- yellow, dark discharge,
- secretion of darkened blood clots,
- the reappearance of discharge in large quantities when they were already ending,
- general weakness, dizziness, poor health.
If such symptoms appear, you should immediately consult a doctor. For any irregularities in the menstrual cycle, it is also necessary to go to a gynecologist.
Doctors say: in some cases, complications begin due to allergic reactions to the drug, acting as anesthesia. The optimal solution is to make appropriate tests in advance to find out which anesthesia is more suitable.
Deciphering the results
When conducting such a histological analysis, specialists determine whether there are cells with changes on the surface of the uterus. Such violations are almost safe, but can be cardinal, characteristic of the presence of a malignant tumor, precancerous condition. There are mild, severe and moderate dysplasia, as well as carcinoma - an early stage of cancer.
Analyzes are decrypted. All identified changes referring to one of three groups:
According to these data, the doctor makes an accurate diagnosis, forms a program for the complex treatment of cervical biopsy
Purpose of the procedure
What is a biopsy for?
Usually it is prescribed after any pathology was found in the neck area during an external examination or smear taking. This usually occurs when signs of precancerous changes or cancer are detected, and also when a human papilloma virus is detected that can cause a malignant tumor of the organ. A biopsy is also indicated for the diagnosis of genital warts and polyps.
What does this study reveal?
It provides complete information about the structure of cervical cells and allows you to determine the morphological (structural) signs of diseases. The histological conclusion after microscopic diagnosis gives the doctor the opportunity to make a diagnosis, determine the prognosis of the disease and formulate the correct treatment plan for the patient.
A neck biopsy is used to confirm the alleged diagnosis. This is a very important part of the diagnosis of cervical diseases, without which it is impossible to effectively help a woman. The main goal of the procedure is the diagnosis of precancerous conditions and malignant tumors of the neck.
When is a biopsy performed?
The first stage of diagnosis is the examination of the surface of the neck using a gynecological optical apparatus - a colposcope. During colposcopy, the doctor not only examines the surface, but also performs some diagnostic tests to help detect pathological lesions.
Indications for the study are formulated after obtaining the results. The following abnormal signs are detected:
- white areas of the epithelium that appear after treatment with acetic acid (solution) and are an accurate sign of dysplasia,
- areas that are not stained after treatment with iodine solution during Schiller’s test, they are usually represented by keratinizing cells, under which altered tissues can be hidden, this picture is observed, in particular, with cervical leukoplakia,
- punctuation, or red dots on the surface of the mucosa caused by proliferation of blood vessels,
- a mosaic representing sections of branched stromal (submucosal) papillae, separated by small vessels,
- atypical transformation zone, combining several of the above signs,
- uneven or bumpy surfaces that may be a sign of cancer,
- true erosion
For all these conditions and diseases, a histological examination of the altered tissues is necessary.
In addition, a biopsy is performed with a combination of colposcopic signs of papillomavirus infection in combination with the detection of this virus of high oncogenicity:
- mosaic and punctuation.
Such changes may be an early sign of cervical cancer.
The study is also shown if Pap smears of class 3-5 are found in the patient:
- single cells with a disturbed structure of the nucleus or cytoplasm (coil cells),
- single cells with clear signs of malignancy,
- cancer cells in large numbers.
In the decoding of the Pap smear, at which a biopsy is necessary, the following designations may occur:
- ASC-US - altered epithelial cells that appear for some reason,
- ASC-H - altered cells indicating a precancer or tumor,
- AGC - altered cells of the cylindrical epithelium characteristic of the cervical canal,
- HSIL - precancerous epithelium,
- AIS is a precancer of the cervical canal.
It is necessary to question the doctor in detail what the detected changes mean. This will help the woman make the right decision on further treatment.
The study is contraindicated during inflammatory diseases of the genital and other organs, in particular, with colpitis or acute respiratory infection. It is not carried out for blood diseases accompanied by a pronounced violation of blood coagulation (thrombocytopenia, hemophilia).
The main reason that a biopsy is postponed for a while is infectious diseases of the genital organs. In addition, if general anesthesia is necessary, restrictions may arise associated with drug allergies, severe heart diseases, epilepsy, and diabetes.
Types of manipulation
Types of cervical biopsy:
- Excision (puncture). A small piece of tissue is taken using a special tool - biopsy forceps. To determine the place of analysis, the doctor can pre-treat the neck with acetic acid or iodine.
- Wedge-shaped, or conization, involves the removal of a cone-shaped portion of the neck with a scalpel, laser beam, or other physical factors. General anesthesia is used for this procedure.
- Curettage of the cervical canal - removal of cells from the cervical canal using a curette.
The choice of the method of intervention depends on the alleged disease, its severity and the general condition of the patient.
An endocervical curettage is considered to be a radically different method of cervical biopsy. Its purpose is the diagnosis of cervical canal pathology by curettage of its mucous membrane, carried out under local anesthesia. The resulting tissue is placed in formalin and sent to the laboratory.
The technique of taking a biopsy is not difficult for an experienced specialist. If an outpatient procedure is planned, then the woman should come to the clinic at the appointed time with the results of the examinations. The patient is in a gynecological chair, a special mirror is placed in the vagina in order to improve visibility, colposcopic control is possible.
If the study can cause pain, then the cervix is punctured with a local anesthetic, and then the affected area is excised by means of a scalpel, radio knife, conchotome, electric loop, which is immediately placed in a container with formalin and sent to a histopathological laboratory.
During a biopsy under general anesthesia, an anesthetist talks to a woman before the procedure, and during tissue collection, the patient sleeps and does not feel pain. With spinal anesthesia, the subject does not sleep, but does not feel discomfort from manipulations on the neck.
Taking the material for the study lasts an average of about half an hour, in case of general anesthesia, the operation lasts up to one and a half hours. After an outpatient biopsy, the patient can go home immediately, and during the study under anesthesia, she remains in the clinic for up to 10 days, depending on the condition.
Most women who have a biopsy of the cervix are worried about the possible pain of the study. Sensations will depend on the type of manipulation: with a puncture and radio wave biopsy, the woman will not be hurt, in some cases there is no need even for local anesthesia. A biopsy with a scalpel, loop, laser technique is quite painful, but painkillers and anesthesia help to survive the pain.
Postoperative period and possible complications
In most cases, after a biopsy of the cervix, women feel satisfactory, possible pain is relieved by analgesics, and work capacity is not impaired. Regardless of the method of taking tissue, after its excision appears bleeding of different intensity and duration.
Discharge after a biopsy is not too plentiful, lasting several days. In the case of minimally invasive tissue sampling methods, they are disturbing for the next 2-3 days, while loop biopsy, electroconization, or knife technique give a fairly pronounced bleeding within a week, and then the discharge becomes smeared and may be present for another 2-3 weeks.
After a biopsy, doctors strongly discourage the use of tampons, douching, and resume sexual activity until the bleeding stops completely. You should exclude visiting the pool, baths, saunas, lifting weights of more than 3 kg in the next 2 weeks after the study, or longer if the discharge has not stopped.
Among the complaints made by patients who underwent a biopsy of the cervix, there may be pain in the lower abdomen and in the genital tract. They are associated with a neck injury and, as a rule, go away quickly.In some cases, gynecologists advise taking analgesics in the first few days after the procedure.
Negative consequences after a biopsy of the cervix are very rare, but still not excluded. Among them, bleeding and infection, as well as cicatricial deformity in the distant period after resection with a scalpel, conchotome or exposure to electric shock, are considered the most probable.
The woman should be alert for heavy bleeding, discharge for more than 2-3 weeks, fever, cloudy and foul-smelling discharge from the genital tract. These symptoms are a reason to urgently see a doctor.
Cervical biopsy - what is it
With a biopsy of the cervix, a sampling of cellular material (Pap smear) or tissue of the cervix (tissue tissue sampling is performed if necessary, histological examination).
A cervical biopsy is performed to:
- differential diagnosis of tumors of benign and malignant etiology,
- risk assessment of malignant degeneration of polyps, cervical erosion, etc.,
- assessment of the risk of developing cervical cancer with HPV (assessment of the oncogenicity of the strain of the human papilloma virus with which the patient is infected),
- determining the stage of malignant neoplasm and the cellular composition of the tumor,
- prognosis of cervical cancer,
- determine the degree of tumor differentiation,
- assessing the sensitivity of cervical cancer to various treatment methods,
- assessment of the risk of development and early detection of tumor relapse.
What day of the menstrual cycle does a biopsy take
The most favorable days for tissue collection are the first days of the menstrual cycle - 5-7 days from the first day of menstruation, immediately after their completion. Experts recommend performing a biopsy on these days in order for the tissue damage formed after the procedure to heal completely before the next monthly bleeding begins.
How is a cervical biopsy performed?
In accordance with the volume of tissue removed, it can be performed in a antenatal clinic using local anesthesia or in a hospital under general anesthesia.
The procedure begins as a routine examination by a gynecologist. For analgesia, irrigation of the neck with a spray with lidocaine or the introduction of this drug directly into the tissue of an organ is used. If a circular biopsy of the cervix is performed, spinal, epidural or intravenous anesthesia is needed, which is used only in a hospital setting.
An expander is inserted into the vagina, the neck is grabbed with forceps and lowered closer to the entrance to the vagina and treated with acetic acid or iodine to detect suspicious areas. If the manipulation is performed without analgesia, at this time the patient may feel a slight burning sensation. The doctor removes the abnormal tissue using biopsy forceps, a scalpel, or other instrument.
Is it painful to do a cervical biopsy?
In conditions of appropriate pain relief, a woman does not feel any unpleasant sensations. There are few pain receptors in the neck, so manipulations on it can bring discomfort, but do not cause pain. If intravenous, spinal or epidural anesthesia is used, the examination is completely painless.
How is a biopsy done depending on the method of intervention?
A piece of tissue is taken from the pathological site detected by colposcopy. If there are several such foci, and they look heterogeneous, several samples are taken. The doctor cuts a wedge-shaped area with a scalpel on the border of a healthy and altered part of the neck. It should be large enough: 5 mm wide and up to 5 mm deep to capture the underlying tissue. This is necessary to assess the degree of penetration of altered cells under the epithelium.
Surgitron apparatus for radio wave biopsy, the so-called "Radio knife"
When using a special conchotome instrument that resembles forceps, the structure of the tissue may be damaged, which will complicate the diagnosis. A diathermic or loop biopsy of the cervix can be accompanied by charring of the edges of the sample, which also reduces the quality. Therefore, it is better to use a scalpel. But the best option for the procedure is with the help of radio waves, that is, a biopsy of the cervix with Surgitron. This is the surgical device "radio knife", with the help of which biopsy material is quickly, bloodless and accurately taken.
After the procedure, individual catgut sutures are placed on the wound in the neck area, which subsequently dissolve. If a knife biopsy was performed, a hemostatic sponge or swab moistened with fibrin or aminocaproic acid is injected into the vagina. This is necessary to stop bleeding. During diathermocoagulation or radio wave biopsy, these manipulations are not necessary, since the heat “seals” the damaged vessels, and the blood stops immediately.
A cervical biopsy should always be followed by an examination of the cervical canal to rule out precancerous lesions.
The resulting tissue sample is fixed in formaldehyde solution and sent to a laboratory for examination under a microscope.
Conization, or circular biopsy, is accompanied by the removal of more tissue. Circular excision of the neck is carried out in the form of a cone, the base directed towards the vagina, and the apex into the cervical canal. It is necessary to capture at least a third of the channel. For this, a special scalpel, a Rogovenko tip, a radio knife are used, or an ultrasound biopsy of the cervix is performed.
Circular biopsy is not only diagnostic, but also medical manipulation. Tissue removal should be carried out so that all changed cells and part of a healthy neck get into the biopsy.
This study is carried out in such cases:
- damage to the cervical canal, which spreads from the neck,
- channel precancer according to diagnostic curettage,
- suspected tumor invasion into the underlying tissue by colposcopy, which was not confirmed by a routine biopsy.
Indications for the procedure in the hospital:
- laser biopsy
- the need for intravenous anesthesia.
The structure of the cervix
The cervix is the lower uterine segment connecting the vagina to the uterus. The length of the cervix is from three to four centimeters.
The vaginal part of the cervix connects to the vaults of the vagina and can be examined using gynecological mirrors. The supravaginal part of the cervix opens into the uterine cavity.
Inside the cervix is the cervical canal (cervical canal), clogged by cervical mucus produced by the tubular glands. Normally, mucus forms a mucus plug that is impervious to pathogens and sperm.
During ovulation, the mucus physiologically liquefies and becomes permeable to sperm (during a gynecological examination, this symptom is visualized as a “pupil symptom”).
What tests must be done before biopsy
Cervical tissue sampling is an invasive procedure, and after its execution, damage remains on the surface of the organ, which can become the entrance gate for infection or a source of bleeding. To exclude such complications of a biopsy, a woman is assigned a number of diagnostic studies:
- clinical blood test,
- tests for detecting infections: a smear on the microflora, analysis for a latent infection, blood tests for hepatitis, syphilis and HIV,
- smear on cytology.
Histological features of the cervix
Normally, the cervix contains a large amount of connective tissue penetrated by collagen fibers. This provides high elasticity and the ability of the cervix to stretch during labor.
Due to the content of smooth muscle fibers, the cervix is capable of compression and relaxation. Relaxation of the cervix promotes the secretion of cervical glands in the vagina, and its reduction - the retraction of sperm after sexual intercourse.
Histologically, the cervical epithelium consists of the following layers:
- basal - formed by large prismatic cells attached to the surface of the basement membrane,
- spinous (prickly) - formed by large cells with spiky processes. The spinous and basal layers are also called the germ layer, which provides regeneration and physiological renewal of the cervical epithelium,
- surface - formed by flat cells having a short lifespan (constantly updated layer).
The cell structure of squamous epithelium of the cervix is determined by the phase of the menstrual cycle.
The cylindrical epithelium of the cervix consists of cylindrical (rectangular) epithelial cells. The main function of this layer is the secretion of mucus.
The structure of this layer is little dependent on the phases of the menstrual cycle, however, a change in the hormonal background at a different phase significantly affects the composition and structure of secreted mucus.
The metaplastic cervical epithelium located in the transition zone (the place of transition of the multilayer epithelium to the cylindrical) is formed by a transformed cylindrical epithelium. In most women, the transition zone is located in the external pharynx.
The metaplastic epithelial layer contains small nabot glands and cystic formations (their ducts are closed by squamous cells). According to statistics from the WHO (World Health Organization), it is in this zone that the formation of precancerous and cancerous tumors is most often observed.
The basement membrane of the cervix is represented by a strong thin layer formed by collagen fibers. This layer separates the epithelial and connective tissue, and also supports the multilayer and cylindrical epithelial layers.
How to prepare for a biopsy
To obtain the most reliable results of the study and the prevention of complications in preparation for a biopsy, a woman should observe a number of rules:
- 2 days before the procedure, refuse sex.
- 2-3 days before the study, stop douching, do not use tampons and do not inject drugs into the vagina.
- If it is necessary to perform local anesthesia, conduct a test to identify a possible allergic reaction to the anesthetic used.
- If it is necessary to perform general anesthesia, consult an anesthesiologist and, if necessary, carry out his recommendations (additional studies, taking a sedative drug the day before the procedure, etc.).
- Before the procedure, take a hygienic shower.
- If it is planned to perform general anesthesia, then the last meal and liquid should take place 8-12 hours before the procedure.
- Sign consent documents for biopsy.
What does a cervical biopsy show?
Using a histological examination of the material obtained, the doctor determines whether there are altered cells on the surface of the organ. These disorders may not threaten severe consequences or be a sign of precancer and a malignant tumor.
According to the WHO classification, mild, moderate or severe dysplasia is distinguished and in situ carcinoma is an early stage of cancer. The degree of cervical intraneoplasia (CIN) is also determined. This division is carried out according to the depth of penetration of the altered cells into the thickness of the epithelium and underlying tissue. In addition, neck changes caused by the papillomatosis virus are determined.
Deciphering the analysis results allows you to attribute the detected changes to one of the following groups:
Which do not pass into precancer, but can serve as the basis for the development of the disease:
- dyshormonal hyperplastic (endocervicosis, polyp, papilloma without signs of atypia, simple leukoplakia and endometriosis),
- inflammatory (true erosion, cervicitis),
- post-traumatic (rupture of the neck, ectropion, scars, cervical-vaginal fistula).
Which are not yet malignant, but with a certain probability (about 50%), if untreated, can transform into a tumor:
- dysplasia on a healthy neck or in background processes,
- leukoplakia with atypia,
3. Cervical cancer
Directly malignant tumors:
- preclinical - an early stage of the disease, asymptomatic (cancer in situ, with initial invasion, microcarcinoma),
- clinically pronounced (squamous, glandular, clear cell, low-grade).
Depending on what kind of changes are found in the patient, the doctor makes a diagnosis and prescribes various treatments. Therefore, a biopsy is an indispensable method that allows in many cases to recognize cancer at an early stage and to help the patient in time.
The reliability of biopsy data for the detection of precancerous diseases and cancer is 98.6%. This means that if such results are obtained, in the vast majority of cases, a diagnostic error is excluded.
A biopsy performed under biopsy control improves the quality of diagnosis by 25%. Therefore, colposcopic monitoring should be a mandatory part of the procedure.
The only drawback of the method is the limited ability to use it several times in the same woman. Therefore, the question of how often a biopsy can be done, the answer is this: a re-examination is prescribed only in case of emergency. Injury to the neck can lead to cicatricial changes, which makes it difficult to bear pregnancy and childbirth. Repeated conization is most often carried out for the purpose of treatment, rather than diagnosis.
A biopsy sample is sent to the laboratory. There it is processed and slices are prepared, which the pathomorphologist examines under a microscope. The test result is usually ready 2 weeks after the biopsy, but in some institutions this period is reduced to 3 days.
Many women, after receiving biopsy data, feel confused and do not understand what this information means. If the doctor’s explanations do not seem clear enough to the patient, she may turn to another specialist to find out a “second opinion” and dispel her doubts about the diagnosis and treatment tactics.
What types of anesthesia are used to perform the procedure?
The intensity of pain during a biopsy of the cervix depends on the following parameters:
- method for performing tissue sampling,
- the level of pain sensitivity of the patient,
- volume of invasive intervention.
If there is only one small focus for tissue collection, anesthesia may not be performed, since there are no pain receptors on the cervix. If a larger invasive intervention is planned or the patient is very sensitive to pain, worried or nervous, then local anesthetics can be used to eliminate the pain. Such drugs are applied to the cervix in the form of a spray or injected into its tissue. In addition, a woman is recommended to relax during tissue collection. This condition reduces the likelihood of cramping uterine contractions and makes the pain less noticeable.
For some types of biopsies, general anesthesia, epidural or spinal anesthesia may be recommended. In such cases, the woman should be consulted by an anesthetist. If necessary, this specialist can prescribe additional diagnostic tests (ECG, tests, etc.) that will allow him to assess the general state of health and choose the most suitable drugs for safe pain relief.
Biopsy and pregnancy
Removing a piece of tissue from the neck subsequently causes the formation of a small scar consisting of connective tissue. It is inelastic and does not stretch during childbirth. Therefore, at birth, the risk of neck rupture increases.
Large scars can deform the neck, as a result of which the walls of the cervical canal are not tightly closed. This can lead to a threat of abortion and other complications.
Therefore, a biopsy of the cervix by nulliparous should be carried out as accurately as possible. Such women should not use electroexcision or diathermocoagulation (removal of tissue using an electrically heated loop), since with this procedure a small burn of the surrounding mucous membrane occurs. This increases the likelihood of scarring. The best option for women planning a future pregnancy is a radio wave biopsy.
Pregnancy after a biopsy proceeds normally if the procedure was performed using a laser, ultrasound, radio knife. In other cases, the resulting scar can cause neck failure.
A cervical biopsy during pregnancy is prescribed only in exceptional cases, for example, for the diagnosis of cancer, in which you can not bear a baby. Usually it is not performed in the first trimester, as it increases the risk of miscarriage. In the II trimester, this procedure is safer. In the third trimester, a biopsy is also usually not used, so as not to provoke a premature birth.
Conization is carried out only with justifiable suspicion of cancer. Curettage of the cervical canal during pregnancy is not used.
When can I get pregnant?
Sexual life is allowed after complete healing of the neck, that is, 4-8 weeks after manipulation, depending on its type. The degree of recovery is determined by the doctor upon repeated examination. If the wound has healed without complications, you can have sex and become pregnant.
Cervical biopsy - how is it done
Preparation for a biopsy of the cervix includes examination by a gynecologist (colposcopy), testing, and treatment of inflammatory processes (if any).
Also, on the eve of a biopsy, it is necessary to refrain from sexual intercourse and the introduction of drugs into the vagina (with the exception of suppositories with an antibiotic or antiseptic, if they are prescribed by a gynecologist).
What types of anesthesia are used
When performing a biopsy, general or limited anesthesia is used. General anesthesia is more preferable because the surgeon cuts a sufficiently large piece of tissue.
In order to introduce the patient into a state of anesthesia, he is given epidural, general, spinal anesthesia. With epidural anesthesia, the drug is injected into the epidural space of the spine through a catheter.
With spinal anesthesia, the same substance is introduced into the subaranchnoid space using lumbar puncture.
On an outpatient basis
A biopsy has much in common with a gynecological examination. In order to anesthetize the cervix is irrigated with lidocaine (it is possible to inject the drug into the tissue).
An expander is inserted into the vagina, the neck is captured by forceps and treated with iodine solution or acetic acid. Next, the specialist takes part of the tissue with forceps, a scalpel or other tool.
A piece of tissue is taken from the site detected during colposcopy. If there are several, then a sample is taken from each of them. The area of the fabric should be large - not less than 5 mm in length and thickness.
How to prepare for a cervical biopsy
The procedure is carried out on the 5-7th day of menstruation. Compliance with this time period is associated with the need to heal wounds after bleeding. Before a biopsy is prescribed:
- general examination of blood and urine,
- determination of indicators of bilirubin, liver enzymes, creatinine sugar and urea (according to indications),
- blood coagulation examination,
- PAP test
- analysis for HIV, syphilis and hepatitis,
- screening for ureaplasmosis, toxoplasmosis, chlamydia,
- colposcopic examination.
If an infectious process is detected, a biopsy is done only after complete recovery. The examination should be canceled when taking Aspirin, Ibuprofen or Warfarin. The doctor needs to be informed about:
- allergic to medications or certain foods,
- possible pathological bleeding,
- high blood pressure
- a history of venous thrombosis or a risk of obstruction of the pulmonary artery,
- transferred surgical interventions.
Before a biopsy, it is unacceptable to douche, drink alcoholic beverages and smoke.
What diseases can be detected?
A biopsy can detect these types of diseases.
- Dyshormonal (endocervicosis, endometriosis, simple leukoplakia).
- Inflammation of the cervical canal.
- Cervical erosion.
- Post-traumatic (scars, rupture, fistula).
- Precancerous pathologies - dysplasia, leukoplakia, adenomatosis.
- Preclinical carcinoma of the cervix (pathology progresses without any manifestations). These conditions include microcarcinoma.
- Clinically expressed carcinoma of the uterus or cervix.
Depending on the identified changes, the gynecologist prescribes a therapeutic course of uterine diseases.
Cervical biopsy on an outpatient basis
If the procedure will be performed in the clinic, then spinal, epidural anesthesia or general anesthesia will not be used for it.
A biopsy will be performed as follows:
- The patient lies on a gynecological chair, as for a routine examination.
- A mirror is inserted into the vagina and bright light is sent to the cervix.
- If necessary, local anesthesia is performed (cervical irrigation with a solution of local anesthetic or its injection).
- A sample of suspicious tissue sites is collected and the resulting material is sent to the laboratory for histological analysis.
- After completing the procedure, the patient can go home.
The duration of such a procedure is no more than half an hour. After its completion, the specialist sets the date of the next examination, gives the patient recommendations on some restrictions and introduces the symptoms, in the event of which she should consult a doctor.
Cervical biopsy in a hospital
If a woman is prescribed a type of biopsy, which should be performed after spinal, epidural anesthesia or intravenous anesthesia, then she will need hospitalization for 1-2 days. The procedure is performed in the operating room on a gynecological chair.
After performing spinal or epidural anesthesia, the woman is conscious, but does not feel the lower half of the body, and after general anesthesia she falls asleep. Depending on the clinical case, the duration of such an intervention can be from 40 minutes to 1.5 hours.
After the biopsy is completed, the patient should remain under medical supervision for several hours or until the next morning. After that, in the absence of complications, she is discharged and will have to follow a number of medical recommendations. At discharge, the doctor sets the date for the next examination.
Discharge after cervical biopsy
Sometimes at first a small red discharge may appear from a biopsy. At times, they turn green because the neck was treated with iodine.
You need to visit a medical institution if blood comes from the uterus. Sometimes pus appears, indicating the development of an infectious phenomenon.
When to contact a doctor immediately
In some cases, after a biopsy, a woman may start bleeding or develop an infectious complication. The reason for immediately contacting a doctor should be the appearance of the following symptoms:
- heavy bleeding (red or dark blood with clots),
- discharge is similar in profusion to menstruation, lasts more than 7 days,
- mild, but prolonged, bloody discharge of more than 2-3 weeks,
- the appearance of yellowish discharge with an unpleasant odor,
- temperature increase above 37.5 ° C,
- intense pain in the lower abdomen or in the vagina.
What can not be done after the procedure
After a biopsy is prohibited:
- work with goods (over three kilograms),
- introduce tampons into the vagina (from a week to a month, depending on the type of biopsy),
- do not practice intimate contacts for one month,
- up to a month do not go to the steam room, pool, do not wash in the bathroom.
How to accelerate cervical healing
A few days after the examination, medications are prescribed to improve healing:
- Terzhinan drug for resorption in the vagina (six-day course of administration),
- Metronidazole in tablet form,
- straight candles Genferon,
- vaginal suppositories Betadine,
- Depantol in the form of vaginal suppositories.
What diseases can the study identify
The formulation of the obtained cervical biopsy analyzes is in many ways similar to the pap test, but the results of such a study are more reliable (approximately 98%). Only the attending physician can correctly decrypt laboratory data.
After performing a biopsy of the cervix and analysis of the tissues obtained, the specialist will be able to identify the following diseases:
After making a diagnosis, the doctor will prescribe a treatment for the disease. In most cases, all detected pathological changes in the cervix respond well to therapy. The only exceptions are advanced stages of cervical cancer.
“Colposcopy revealed a suspicion of precancerous mucosa. During the biopsy, it was found that I did not have such a disease. "
“A cervical biopsy helped determine the cause of the discharge. Now I am undergoing treatment, which gives results. "
Ekaterina, 44 years old:
“The analysis made in the district clinic turned out to be inaccurate. After examination in a private clinic, a biopsy revealed the presence of a precancerous disease. ”
Which doctor to contact
A gynecologist or oncologist can prescribe a cervical biopsy. The reason for carrying out such a diagnostic procedure can be various cases: suspected cancer, leukoplakia, polyps, erosion, condylomas, negative or doubtful results of a pap test or colposcopy.
A cervical biopsy is an invasive study, but its diagnostic value justifies the completion of such a procedure. Depending on the clinical case, women may be advised of various varieties of this examination method. Some of them can be performed without painkillers, while others require local, spinal, epidural or general anesthesia.
Specialists of the Moscow Doctor Clinic talk about a cervical biopsy: