by Puzanov I

Endometrial Biopsy

(Biopsy, Endometrial)

Click here to view an animated version of this procedure.

Definition

This is a procedure to remove a tissue sample from the lining of the uterus (womb).
The Endometrium
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Reasons for Procedure

Some reasons for an endometrial biopsy include:
  • Evaluate the cause of bleeding in postmenopausal women
  • Evaluate heavy menstrual bleeding or bleeding between menstrual periods
  • Obtain a tissue sample to test for cancer or precancerous conditions
  • Monitor the uterine lining in women on estrogen replacement therapy
  • Help evaluate the cause of infertility or repeated miscarriages

Possible Complications

If you are planning to have an endometrial biopsy, your doctor will review a list of possible complications, which may include:
  • Infection
  • Bleeding
  • Damage to the uterus (rare)
Factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the procedure. If you are pregnant, the test cannot be done.

What to Expect

Prior to Procedure

You may need to schedule the biopsy for a certain time during your menstrual cycle.
Your doctor may do the following:
  • Physical and pelvic exam
  • Blood tests
  • Urine test
Leading up to your procedure, you may be advised to:
  • Take a pain reliever one hour before the procedure.
  • Wear or bring a sanitary pad to the health clinic.

Anesthesia

Usually none is needed. Sometimes local anesthesia is used to numb the cervix.

Description of the Procedure

You will lie on a table with your feet in footrests. The doctor will use a speculum to look into the vagina. An instrument called a tenaculum will be used to grasp the cervix. A flexible, thin, suction tube will be passed through the vagina and into the uterus. The doctor will suction out a small sample of endometrial tissue.

Immediately After Procedure

After the biopsy, you may feel lightheaded. Lying down for 5-10 minutes will help. Once you feel better, you will be able to go home.

How Long Will It Take?

About 10-15 minutes

Will It Hurt?

You may feel some cramping and pressure during the biopsy. Your doctor may give you pain medicine after the procedure.

Post-procedure Care

When you return home after the procedure, do the following to help ensure a smooth recovery:
  • Expect some cramping and bleeding. Use sanitary napkins. Do not use tampons.
  • Ask your doctor when you can resume:
    • Using tampons
    • Having sex
  • Be sure to follow your doctor's instructions .
Your doctor will receive results in about a week. She will work with you to create a treatment plan.

Call Your Doctor

After arriving home, contact 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
  • Nausea and/or vomiting
In case of an emergency, call for medical help right away.

RESOURCES

American Cancer Society http://www.cancer.org

The American Congress of Obstetricians and Gynecologists http://www.acog.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca/index%5Fe.html

Women's Health Matters http://www.womenshealthmatters.ca

References

Abnormal uterine bleeding. Family Doctor.org. Available at: http://familydoctor.org/online/famdocen/home/women/reproductive/menstrual/470.html . Updated September 2006. Accessed June 4, 2008.

How is endometrial cancer diagnosed? American Cancer Society website. Available at: http://www.cancer.org/ . Updated November 2006. Accessed June 4, 2008.

6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med . 2011;124(2):144-154.e8.

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