An endometrial biopsy is a medical procedure in which a small piece of tissue from the lining of the uterus (the endometrium) is removed for examination under a microscope. The removed tissue is examined for cancer or any other cell abnormalities. An Endometrial Biopsy involves the interior lining of the uterus, cervix, and vagina.
How an endometrial biopsy is performed?
Why an endometrial biopsy is performed?
An endometrial biopsy is done to help your doctor find out the cause of problems leading to heavy or irregular bleeding. It is the most common test done to diagnose endometrial cancer. Though it is a simple office procedure, it needs to be performed by a provider who has experience in performing the test. The biopsy also lets your doctor check to see if your body's endometrial hormone levels are balanced.
What are the indications for an endometrial biopsy?
If you have any of the following, your doctor may recommend an endometrial biopsy:
- The individual is placed in a lithotomy position. The patient lies flat on the back (supine), with feet raised and supported by foot rests, called stirrups
- An instrument called a speculum, is inserted into the vagina
- The speculum gently spreads the vaginal walls following which the vagina and the cervix are exposed
- Various devices (such as a curette, pipette, electronic suction device, jet irrigation device, or a brush) can be used to obtain samples from the inner lining of the uterus
- The device is passed through the cervix into the uterus and may be moved up and down to obtain the sample
Endometrial Biopsy is performed either by an obstetrician, a gynaecologist
, a family physician, or a general surgeon, with assistance from an anaesthesiologist
. The procedure usually takes about 20-30 minutes.
Preparations needed before an endometrial biopsy
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Normally local anaesthesia is not used however, do inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
- Avoid application of any deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
Before an Endometrial Biopsy procedure, the patient has to undergo Pap Smear test
and blood or urine pregnancy tests
Complications during Endometrial Biopsy
There are usually no surgical risks or complications associated with an Endometrial Biopsy. However, there are general factors that increase the risk of getting complications during the procedure, which include:
Complications after Endometrial Biopsy
- Obesity: Generally greater the degree of obesity, greater is the surgical risk
- Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders, chronic infections
- Poor immune system due to a variety of causes
Post Endometrial Biopsy, the following complications may arise:
- Excessive bleeding
- Infection within the lining of the uterine (endometritis)
- In rare cases, unintentional injury of the uterus
The prognosis is usually good with a complete recovery expected in about 3 weeks.