Is a cervical biopsy dangerous? Biopsy of the cervix: deciphering the result, that it is impossible after it, preparation. cervical dysplasia

A biopsy of the cervix is a procedure for taking a piece of tissue (or several pieces) that is suspicious for cancer for analysis. Only with the help of this procedure, the doctor will definitely be able to tell if a woman has oncology and prescribe a competent treatment. In a good way, even "cauterization", which are recommended to our women right and left, should be prescribed only after receiving the results of a biopsy. However, even without indications, this procedure is also often prescribed. For example, a biopsy of the cervix with uncomplicated erosion, ectopia, with good results of pap tests and colposcopy is the wrong appointment. But first things first.

Indications and contraindications for biopsy

Before a biopsy, a Pap test and a colposcopy are mandatory. And the main indication for this procedure is the identification of one or more suspicious areas during colposcopy (only with cervical erosion, even true, a biopsy is not done).

These suspicious areas include:

White-colored areas of the epithelium after exposure to acetic acid;

Iodine-negative zones.

Contraindications to the procedure are:

Acute inflammatory diseases;

Blood clotting disorders.

Preparing and performing a biopsy

Before the procedure, you will have to take swabs for various infections. Blood test for RW, hepatitis B and C, HIV.

Since after a biopsy of the cervix, a wound remains on it, which should heal by the beginning of menstruation, the procedure is carried out in the first phase of the menstrual cycle, immediately after the end of menstruation. Although there are often deviations from this rule.

A biopsy can be performed in several ways, but the most reliable is the knife sampling of the material, followed by suturing the cervix. Also, a biopsy can be performed with a radio wave loop (Surgitron apparatus), however, in this case there will be a slight coagulation damage to the material taken, which can interfere with histology. However, in this case, the procedure is less painful and traumatic, but even such a biopsy of the cervix can provoke discharge from the vagina for 1 week or even more.

Preparation for medical intervention also includes obtaining written consent from the patient for a biopsy. If intravenous anesthesia is planned, you should not eat less than 12 hours before the procedure. By the way, about anesthesia. Biopsy of the cervix - painful or tolerable? It all depends on the pain threshold of the woman, on the method of taking the material, as well as the amount of intervention. If there is only one suspicious area on the cervix, anesthesia can be dispensed with (there are no pain receptors on the cervix itself), then a biopsy can be performed even on an outpatient sterile basis. If there are several sites, and the woman is very nervous, local anesthesia is possible - lidocaine spray (sprayed on the cervix) or lidocaine is injected directly into the cervix (more effective). Uterine spasms, cramping pains may appear, in order for this not to happen, you need to relax as much as possible.

If the biopsy was performed on an outpatient basis, she is given 1-2 days of sick leave. If in a hospital - up to 10 days. If a biopsy of the cervix is performed, the results can be expected in 10-14 days. In general, the wording protocol will be very similar to that of the Pap test, but much more reliable (98.6% confidence). 4-6 weeks after the procedure, you should go to an appointment with a gynecologist.

After biopsy

To avoid complications in the next month after the procedure, follow the following rules and recommendations.

1. Do not douche or use vaginal tampons.

2. Sexual abstinence for at least 2 weeks (the duration depends on the volume of the operation, ask your doctor for more details).

3. Don't take a bath, only shower.

4. Do not visit baths, saunas and pools.

5. Do not lift weights (more than 3 kilograms).

Usually, a biopsy of the cervix does not have negative health consequences. However, you need to be prepared for the fact that spotting is possible in the coming days. If they become more abundant than menstruation, you should immediately consult a doctor. An increase in body temperature over 37.5 degrees, severe abdominal pain, the presence of blood clots in the vaginal discharge, and an unpleasant odor should also alert.

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If during the diagnosis a malignant tumor of the uterus was found in the patient, then the next step for the patient is to prescribe a biopsy of the uterine cavity. A uterine biopsy is a medical procedure in which a small amount of mucous is removed from a woman. Further, in the laboratory, it is studied and researched. Based on the results obtained, it is possible to determine oncology, if any, at the very initial stage of formation.

A biopsy of the uterine cavity can be performed for certain indications. In this case, the indications include:

When there is a pathology in the cervical region that needs to be confirmed at the tissue or cellular level.
If a visual examination by a doctor and based on the results of smears failed to obtain the required information, and without a biopsy it is not possible to accurately establish the diagnosis.

A biopsy is performed to establish such ailments:

endocervicitis,
ondylomas,
leukoplakia,
dysplasia of the cervical epithelium,
carcinoma.

All these pathologies are very dangerous, so you need to start treating them as soon as possible.

Contraindications

Any medical procedure will have certain contraindications. In this case, it is forbidden to perform a biopsy under the following conditions:

bearing a child;
inflammation that affected the vagina and cervix;
inflammatory foci present in the pelvis;
blood pathologies: severe anemia, hemophilia, diseases of the hemostasis system;
sexually transmitted pathologies;

Preparatory activities

A uterine biopsy as a procedure is an operative intervention that is allowed to be performed only if the infectious process is completely absent in the reproductive system. To make sure of this, it is necessary to take a smear on the pathological flora. If the results are negative, then a biopsy is allowed. With a positive result, the analysis is prohibited until the fundamental factor in the development of the pathology is clarified.

A biomaterial is taken from a woman immediately after her menstruation has not ended. To do this, the doctor, using a special tool, pinches off a piece of the mucous membrane of the affected organ.

At the same time, it is important to observe the woman so that everything heals before the next menstruation. The duration of the tightening of the wound reaches 2 weeks, but not longer.

Does it hurt to do a uterine biopsy?

Very often, before a biopsy in women, the question arises as to whether the procedure is painful. This question is quite interesting, because everything is not so simple here. It is the cervix that refers to those organs that lack nerve endings. Therefore, when taking material that is sent for cancer research, there is no pain syndrome.

However, before the procedure, the patient is very tense, she experiences a certain fear. As a result, all the muscles in the uterus are in tension. During a biopsy, the uterus gives a reaction in the form of spasms. Therefore, the development of painful sensations occurs. Although the resulting pain is not so strong, if you compare it with those sensations when it pulls in the abdomen during menstruation. The more a woman is tense, the stronger the pain and uterine cramps.

In this situation, you can stop the fear and excitement of a lady with the help of the introduction of an anesthetic drug. Most often it is lidocaine, it is used as a local anesthetic, but, sometimes, the operation is performed under general anesthesia.

Before the procedure, the written consent of the woman is required that the test will take place on a voluntary basis.

Biopsy methods

There are many techniques by which a biopsy is performed. The classification is based on the method by which the material was taken.

Colposcopic. This procedure is also called puncture. Its essence lies in the fact that the material is taken with a very thin needle. And then the resulting tissue is examined using a microscope.
. To take a sample, the doctor uses special equipment. Its name is Surgitron.
Laser. This biopsy option is based on the fact that the material will be taken using a laser (laser knife). This biopsy option is considered the most gentle and innovative. Thanks to him, there is no bleeding, as well as pain that worries the girls during the standard procedure.
Conchotomous. This biopsy option is very similar to the colposcopic procedure. The difference between them is that instead of a needle, they use a conchotomy. This is a special surgical instrument that looks like scissors with well-sharpened edges.
Loopback. To take the material, it is necessary to use too thin wire. It is twisted in the form of a loop through which a weak electric current is supplied.
wedge-shaped. This is a variant of the biopsy, with which you can get more advanced data. The bottom line is that a triangular piece is removed from the cervix. Then it is sent for study in order to get a more detailed result.
Circular. This biopsy option refers to the varieties of wedge-shaped surgery. The removal of material is carried out using a laser or a scalpel. At the same time, the resulting material is not only the tissues of the affected organ, but also part of its canal.
Trepanobiopsy. The essence of the procedure is that the material is taken from several affected areas at once.
Curettage of the endocervical canal. The considered option is considered one of the most cardinal. It consists in scraping the cervical canal.

State of the art biopsy techniques

. This method is considered one of the safest and most modern. The material is removed using a special soft tube. It is called paypel. Inside it is a piston, like a syringe. The instrument is inserted into the uterine cavity, and then the piston is pulled out halfway. Thus, a negative pressure is created in the cylinder and the tissue is sucked inward. The duration of the manipulation will be several minutes, while there is no need to expand the cervical canal, because the diameter of the pipel will be 3 mm. During the procedure, the patient does not feel pain and other discomfort. Also, after such a biopsy, there are no complications and negative consequences.
Aspiration biopsy of the uterine cavity. For its implementation, the method of suction of a section of the mucous membrane of the affected organ is used. During the manipulation, the patient may experience discomfort. Do not perform a biopsy if uterine cancer is suspected. The reason is that it is impossible to understand the exact concentration of the neoplasm and the degree of its formation.

How is a uterine biopsy performed?

There are many methods for performing a uterine biopsy, the choice of a specific method is discussed with each patient on an individual basis. For a biopsy, the woman is seated in a gynecological chair. General anesthesia is rarely used. As a rule, the operation is performed under local anesthesia, while the patient herself is conscious.

First, the doctor inserts a speculum into the vagina. Thanks to him, it is possible to examine the cervix. Then a bright light is directed there. Using biopsy instruments, tissue that is suspicious is removed. The resulting material is then sent for further research. All manipulations last an average of half an hour. Although there are situations when the operation is delayed for 1.5 hours. After that, the woman can safely go home.

If, according to the doctor, hospitalization is required, then the patient must follow all the doctor's recommendations, otherwise there is a risk of a number of complications. If necessary, the patient after the biopsy may be left in the hospital for a couple of days so that the doctor can observe her. Deciphering the analysis is a series of activities that require appropriate training from the doctor. Therefore, this should be done by a qualified person.

After instrumental intervention, you can not lift weights that weigh more than 3 kg. Also, for 2 weeks you will have to give up sexual intercourse. And you can start sexual life only after the doctor has performed an examination and given his permission. As a result of the examination, he will be able to understand whether the wound could heal. To protect yourself from bleeding, you can not go to baths, saunas, take baths. It is best to use a contrast shower.

Do not drink aspirin after the procedure. The reason is that it leads to blood thinning and prevents fibrin from falling out. Therefore, a thrombus develops.

Possible consequences of a uterine biopsy

After a biopsy, almost every girl has a discharge. Their duration and abundance depend on a number of factors, such as the method of sampling, as well as the individual characteristics of the organism.

For example, during a radio wave biopsy of the cervix, a woman may experience mild discharge. They can bother you for several days without causing any symptoms. But bleeding after a loop biopsy can go profusely, as if menstruation has come or bleeding has developed. Their duration is 5-7 days.

In this situation, it is important to take into account the fact that it is forbidden to use tampons after the operation. In the presence of spotting, it is allowed to use only ordinary pads. You also need to stop douching.

The temperature may also rise slightly, because any instrumental intervention is a huge stress for the body. There is a risk that an infectious process will occur after the operation. If the temperature exceeds 37.5 degrees, then you should immediately consult a doctor.

It is normal when after a biopsy it hurts in the abdomen and in the depths of the vagina. Do not worry, all symptoms will disappear on their own. Painkillers such as Indomethacin or Nurofen can be used to eliminate abdominal pain that occurs due to contraction of the cervix.

During the removal of cervical mucosal tissue for a biopsy, it is forbidden to have sexual intercourse for at least about a week.

A biopsy of the cervix is a very popular procedure with which it is possible to determine the presence of a malignant tumor in time. Therefore, the patient will be able to perform treatment in a timely manner and get rid of the pathology. Biopsy is carried out today by various methods. The choice of the appropriate option is determined by the doctor after examining the patient.

What complications after a uterine biopsy can a woman experience? Why do they appear and is it possible to do without consequences by agreeing to carry out such a manipulation? These and other questions should be addressed to the gynecologist who appointed the procedure.

Collapse

But do not be upset if the conversation with the doctor did not take place for one reason or another. There are a number of complications that are most often diagnosed in women who have undergone a uterine biopsy.

Possible Complications

A biopsy of the cervix is a procedure that is performed as part of a diagnostic study. The procedure allows you to collect biological material, send it to the laboratory for analysis and get the result. The procedure is very laborious, but effective, because it allows:

Diagnose the presence of cancer.
Recognize pathology at an early stage of development.
See erosive changes

Important: Studies are carried out in order to recognize the presence of pathological changes and make the correct diagnosis for the patient.

Signs of pathology

The consequences after a biopsy are different, it is worth noting that they occur quite rarely, among the most common complications are:

the occurrence of discomfort in the lower abdomen;
pain when urinating (occurs rarely);
bloody discharge from the genital tract.

Unpleasant sensations in the lower abdomen occur due to manipulation. Mucous or other tissues are taken for examination, which implies a certain traumatization of the tissues, as a result of which unpleasant sensations appear. Over time (14–21 days), the discomfort will go away, during which time the body will recover.

Sharp pain during urination worries women extremely rarely. It occurs for several reasons. It is not considered a pathological phenomenon and passes quickly enough. If dilators were used in the process of collecting biological material, then this leads to muscle spasm, as a result of which pain appears.

Allocations with an admixture of blood are nominally not considered a sign of pathology. They arise empty, that the tissues are exposed to a certain effect, they are damaged, capillaries and blood vessels suffer from this, blood appears.

Not plentiful.
Without clots and veins.

Attention! The discharge should not have an unpleasant odor, otherwise their appearance is regarded as a sign of a pathological process.

Anxiety symptoms

the temperature has risen;
there was severe pain in the lower abdomen;
there was nausea, weakness;
the discharge is profuse;
clots, streaks, a large amount of mucus come out with the blood;
there was dizziness, weakness.

What can provoke the development of pathology:

Infection.
Inflammatory process.
Excessive tissue trauma.
Increased intrauterine pressure.

To deal with what led to the appearance of pathological symptoms, a timely appeal to the doctor will help.

Otherwise, there is a high risk of developing:

inflammation of the body of the uterus;
inflammation of the fallopian tubes;
inflammation of the cervical canal (cervicosis);
inflammation of the endometrial mucosa.

The appearance of pathological symptoms is certainly associated with inflammation or infection. In this case, it is necessary to visit a doctor as soon as possible and pass all the necessary tests. If the disease is not treated, then after a short period of time it will become chronic, in which case it will be much more difficult to get rid of the unpleasant signs of the disease.

Chronic inflammation of the uterus or fallopian tubes will cause infertility, since the long course of the disease leads to the formation of adhesions.

The most dangerous is severe bleeding. Blood loss must be stopped as soon as possible, otherwise there is a high risk of developing severe anemia, even death.

For this reason, when bleeding occurs, it is worth:

Contact a doctor as soon as possible.
Take hemostatic drugs.
Put ice on the abdomen.

This is the first aid that will help reduce blood loss, but you should not try to cope with the problem yourself, as this is fraught with serious complications.

How to recover after a uterine biopsy?

Recovery after the procedure takes some time. It takes place in 2 stages. A woman can fully recover after the procedure and conceive a child in 6 months. If complications after cervical biopsy are not detected.

Pregnancy after a previous biopsy is possible only after six months, not earlier. Since it takes a certain time to restore the mucous layer. When the endometrium is fully restored, a fruiting egg will be able to attach to it, if this does not happen, the chances of conception are not so high.

To help avoid complications:

compliance with the rules of personal hygiene;
following the recommendations of a specialist;
the use of prescribed drugs in the prescribed mode.

There are a number of tips that will help you recover faster to cope with the consequences of a biopsy:

Refuse to use tampons, give preference to pads.
Do not use the contraceptive nature of the suppository in the treatment of gynecological diseases.
Do not drink aspirin (it thins the blood and can cause bleeding).
Do not have sex (sexual contact increases the risk of complications).

As for sexual contacts, the restriction is imposed for a certain period of time. It all depends on the recommendations of the doctor and the process of cell regeneration.

Preparations

There are a number of medicines that can be used after a biopsy, such drugs include:

Ornidazole- is produced in the form of tablets, is used to treat various diseases of a gynecological nature, is prescribed as part of the prevention of infectious diseases. The drug has antiprotozoal and anti-inflammatory action.
Genferon- these are suppositories that can be used for both vaginal and rectal administration. The composition of the drug includes interferon alpha-2. This substance, once in the body, has an antiviral effect, activates the protective functions of the human immune system, and promotes the production of antibodies.
Terzhinan- these are suppositories-tablets that have a complex effect, have anti-inflammatory, antimicrobial and antifungal effects. Normalize the state of the microflora of the vagina.
Betadine- attributed as an antiseptic and disinfectant, it can be used both before the biopsy and after the completion of all manipulations.
Depantol- is available in the form of a cream and suppositories, the drug contains Chlorhexidine and has a combined effect on the body. Helps to cope with inflammation and eliminate the likelihood of developing an infectious disease. And also the drug speeds up the metabolic processes.
Galavit- Available in the form of tablets and powder, it is considered an immunostimulant. It is used to accelerate the process of tissue regeneration, helps to cope with infections of various origins faster, is part of complex therapy.

Diet

Particular attention should be paid to nutrition, adherence to the regime and the rejection of certain foods will affect the recovery process.

To quickly cope with the consequences of the procedure, you will have to abandon:

Fatty and fried foods.
Salted, pickled and smoked products.
Fast food consumption.
Alcohol use.

Leading a healthy lifestyle, dieting and eating right is necessary in order to reduce the likelihood of edema, avoid high blood pressure, etc.

Healthy food;
Eat only healthy foods.

This will help normalize the metabolic processes in the body and speed up the overall recovery. You should also go in for sports, but heavy physical exertion is recommended to be avoided.

Folk methods

The consequences after a cervical biopsy can be overcome in several ways, in addition to a healthy lifestyle and medicines, there are certain herbs that will significantly reduce the recovery period.

Take baths with chamomile and calendula.
Drink a decoction of echinacea.
Prepare an infusion of St. John's wort.

These herbs will help stabilize the functioning of the body, their use will normalize the duration of the whole organism, improve the effectiveness of general therapy carried out with the use of drugs.

Experts do not consider the use of herbal decoctions a full-fledged treatment, they perceive it only as an addition to conservative medicine.

A biopsy of the cervix is prescribed if the basic diagnostic methods are not enough. The procedure is carried out in order to determine the nature of the origin of various neoplasms. It involves pinching off and examining a sample of living tissue. A biopsy helps to assess the risk of degeneration of the neoplasm into a malignant tumor.

Indications for cervical biopsy

If pathological processes in the pelvis are suspected, diagnostic procedures are prescribed. Initially spend visual inspection genitals, take a swab for flora. In order to make an accurate diagnosis, prescribe Ultrasound monitoring and colposcopy. These procedures help to find the pathological site, but its structure can only be determined with the help of a biopsy. It is usually carried out in the following cases:

cervical erosion;
the formation of genital warts;
hyperkeratosis;
polyps;
pathological changes in the structure of the lower segment of the organ.

One of the most common diagnostic procedures for cervical diseases is a biopsy.

What is a cervical biopsy? This is a surgical intervention, during which a small piece of tissue is taken from the vaginal part of the organ. It is then examined under a microscope.

Purpose of the procedure

Usually it is prescribed after any pathology was found in the cervical region during an external examination or taking a smear. This usually occurs when signs of precancerous changes or cancer are detected, as well as when human papillomavirus is detected, which can cause a malignant tumor of the organ. A biopsy is also prescribed to diagnose genital warts and polyps.

What does this study reveal?

It provides complete information about the structure of the 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 form the correct treatment plan for the patient.

A cervical biopsy is used to confirm a suspected 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 purpose of the procedure is the diagnosis of precancerous conditions and malignant tumors of the cervix.

When is a biopsy performed?

The first stage of diagnosis is to examine the surface of the cervix using a gynecological optical device - a colposcope. During colposcopy, the doctor not only examines the surface, but also conducts some diagnostic tests to help detect pathological foci.

Indications for the study are formulated after receiving the results. The following abnormal signs are found:

areas of white epithelium that appear after treatment with acetic acid (solution) and are an accurate sign of dysplasia;
areas that do not stain after treatment with iodine solution during the Schiller test; usually they are represented by keratinizing cells, under which altered tissues can be hidden; such a picture is observed, in particular, with leukoplakia of the cervix;
punctuation, or red dots on the surface of the mucosa, caused by vascular proliferation;
mosaic, which is areas of branched stromal (submucosal) papillae, separated by small vessels;
atypical transformation zone, combining several of the above features;
an uneven or bumpy surface, which may be a sign of cancer;
warts;
inflammation;
atrophy;
true erosion;
polyp;
endometriosis.

For all the listed conditions and diseases, a histological examination of 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:

Such changes may be an early sign of cervical cancer.

The study is also indicated if the patient has Pap smears of grade 3-5:

single cells with a disturbed structure of the nucleus or cytoplasm (koilocytes);
single cells with clear signs of malignancy;
large numbers of cancer cells.

In deciphering the Pap smear, which requires a biopsy, the following designations may occur:

ASC-US - altered epithelial cells that appeared for an unknown reason;
ASC-H - altered cells indicating a precancer or tumor;
AGC - altered cells of the columnar epithelium, characteristic of the cervical canal;
HSIL, epithelial precancer;
AIS is a precancer of the cervical canal.

It is necessary to ask the doctor in detail what the detected changes mean. This will help the woman make the right decision about 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 in case of blood diseases accompanied by a pronounced violation of blood clotting (thrombocytopenia, hemophilia).

The main reason why a biopsy is postponed for a while is infectious diseases of the genital organs. In addition, if general anesthesia is required, there may be restrictions associated with drug allergies, severe heart disease, epilepsy, and diabetes.

Varieties of manipulation

Types of cervical biopsy:

Excision (puncture). A small piece of tissue is taken using a special tool - biopsy forceps. To determine the location of the analysis, the doctor may pre-treat the neck with acetic acid or iodine.
Wedge-shaped, or conization, involves the removal of a conical section 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 method of intervention depends on the suspected disease, its severity and the general condition of the patient.

Preparation

The procedure is planned in accordance with the menstrual cycle. On what day of the cycle do the manipulation? Usually 5-7 days after the first day of menstruation. This is necessary for the healing of the wound before the onset of the next menstruation, which reduces the likelihood of subsequent inflammation. In addition, endometrial cells that enter an unhealed wound during menstruation can gain a foothold there and further cause endometriosis.

The following studies are assigned:

blood and urine analysis;
if indicated, determination of the level of bilirubin in the blood, liver tests, creatinine, urea and sugar;
coagulogram (blood clotting test);
smear for detection of microflora;
Pap smear;
tests for viral hepatitis, HIV, syphilis;
tests for chlamydia, ureaplasmosis, mycoplasmosis;
colposcopy.

If an infectious process is detected, a biopsy can be performed only after it has been eliminated.

You should first tell your doctor about the medications you are taking. It is necessary to stop drugs that increase the risk of bleeding, for example:

In addition to the list of medications taken, the doctor must provide the following information:

allergies to medicines or food;
recurrent abnormal bleeding in the patient or her family members;
the presence of diabetes, high blood pressure, heart disease;
previous deep vein thrombosis or pulmonary embolism;
previous surgical interventions (removal of the appendix, gallbladder, and so on) and features of recovery after them.

At least one day before the procedure, it is necessary to stop vaginal douching, do not use tampons, do not use therapeutic vaginal creams or suppositories.

Before manipulation, you do not need to use intimate hygiene products, smoke and drink alcohol. Persons with diabetes should first consult with an endocrinologist: a temporary change in the dose of insulin or hypoglycemic medications may be needed.

Before the biopsy, a routine examination of the patient and a gynecological examination are performed. After talking with the doctor about the need for the procedure, the procedure for its implementation, possible complications, the woman signs the consent to perform the manipulation.

If anesthesia is planned, preparation for a cervical biopsy is accompanied by a refusal to take food, fluids and drugs for 12 hours before the procedure.

It is possible that a woman will experience some bleeding after the biopsy. Therefore, you should take a pack of gaskets with you. After anesthesia, the patient will experience some drowsiness, so she needs to be taken home by relatives. It is extremely undesirable for her to sit behind the wheel.

According to modern requirements, the procedure should always be carried out under the control of colposcopy - targeted biopsy of the cervix.

Manipulation order

How is a cervical biopsy performed?

Depending on the amount of tissue to be removed, it can be performed in a antenatal clinic using local anesthesia or in a hospital under general anesthesia.

The procedure starts like a regular gynecological examination. For pain relief, irrigation of the cervix with a spray of lidocaine or the introduction of this drug directly into the tissue of the organ is used. If a circular biopsy of the cervix is to be performed, spinal, epidural or intravenous anesthesia is necessary, which is used only in a hospital setting.

A dilator is inserted into the vagina, the neck is grasped 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 anesthesia, 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.

Does it hurt to do a cervical biopsy?

Under conditions of appropriate anesthesia, the woman does not feel any discomfort. 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 found during colposcopy. If there are several such foci, and they look heterogeneous, several samples are taken. The doctor cuts out with a scalpel a wedge-shaped area on the border of a healthy and altered part of the cervix. 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.

Device Surgitron for radio wave biopsy, the so-called. "radio knife"

When using a special conchotome tool resembling forceps, the structure of the tissue can be damaged, which makes diagnosis difficult. Diathermic or loop biopsy of the cervix may 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 a radioknife surgical device, with the help of which biopsy material is taken quickly, bloodlessly and accurately.

After the procedure, separate catgut sutures are applied to the wound in the neck area, which will subsequently dissolve. If a knife biopsy was performed, a hemostatic sponge or swab moistened with fibrin or aminocaproic acid is inserted into the vagina. This is necessary to stop bleeding. With diathermocoagulation or radio wave biopsy, these manipulations are not needed, since the heat “solders” the damaged vessels, and the blood stops immediately.

Taking a biopsy of the cervix should always be accompanied by an examination of the cervical canal to exclude its precancerous changes.

The resulting tissue sample is fixed in a formaldehyde solution and sent to the laboratory for examination under a microscope.

Conization, or a circular biopsy, is accompanied by the removal of more tissue. A circular excision of the cervix is performed in the form of a cone, with 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 radioknife, or an ultrasound biopsy of the cervix is \u200b\u200bperformed.

Circular biopsy of the cervix

A circular biopsy is not only a diagnostic, but also a therapeutic manipulation. Removal of tissues should be carried out so that all the altered cells and part of a healthy cervix are included in the biopsy.

This study is carried out in such cases:

damage to the cervical canal, which spreads from the neck;
canal precancer according to diagnostic curettage;
suspicion of tumor invasion into the underlying tissues during colposcopy, which was not confirmed during a conventional biopsy.

Indications for performing the procedure in a hospital:

conization;
laser biopsy;
the need for intravenous anesthesia.

Recovery period

An excisional biopsy of the cervix is performed on an outpatient basis, after which the patient can go home. The next day she can go to work, or she is given a sick leave for 1-2 days.

After conization, the woman remains under the supervision of doctors for 1-2 days. A sick leave is issued to her for up to 10 days.

In the early days, mild pain in the lower abdomen and slight spotting may disturb. Sometimes they have a greenish tint due to the treatment of the neck with an iodine solution. These signs persist for no more than a week. If the pain after the biopsy is uncomfortable, you can use regular painkillers. You can put a warm compress on your lower back or wrap yourself in a woolen scarf.

To prevent infectious complications, the doctor may prescribe certain medications, for example, Terzhinan vaginal tablets. They need to be administered at night for 6 days.

Other medicines that a doctor may prescribe in the first days after a biopsy:

antimicrobial drugs Metronidazole or Ornidazole in the form of tablets;
rectal suppositories Genferon to stimulate local immunity;
vaginal suppositories Betadine.

Suppositories can be prescribed that accelerate healing and prevent scar formation, for example, Depantol.

Women are advised to wear cotton underwear and use absorbent pads. It is necessary to wash daily with soap without fragrances and dry the perineal area well. You can drive a car only after a day.

What not to do after a biopsy: lift objects heavier than 3 kg, use vaginal swabs or douche for a week during an excisional biopsy or a month after conization. Sexual intercourse is not allowed for 4 weeks after the usual procedure and 6-8 weeks after conization. According to foreign recommendations, the restriction of sexual life after a puncture biopsy lasts only for a week. Within 2-4 weeks you do not need to take a bath, visit the sauna, swimming pool.

Wound healing occurs after 4-6 weeks, depending on the amount of tissue removed. After this period, the woman visits a gynecologist who examines the cervix using mirrors.

Menstruation after a biopsy occurs at the usual time, since the procedure does not affect the hormonal status and the state of the endometrium. There may be a slight shift in the cycle associated with the emotional reaction of the patient or with the characteristics of the recovery period.

Possible Complications

Risk factors that increase the likelihood of complications:

obesity;
smoking;
elderly age;
high sugar and/or glycosylated hemoglobin levels in people with diabetes;
impaired renal function with increased levels of urea and creatinine in the blood;
violation of the liver with an increase in the level of bilirubin, transaminases and other liver tests;
chronic lung diseases;
coagulation disorders;
autoimmune diseases and other chronic diseases;
weakened immunity.

Unpleasant consequences of a cervical biopsy usually occur with the development of an infection and are manifested by conditions such as:

pain in the lower abdomen;
vaginal discharge with an unpleasant odor and itching in the perineum;
high body temperature;
the appearance of abundant secretions after they have almost disappeared;
secretion of dark blood clots;
yellow discharge;
deterioration in general condition.

You should go to the hospital if there is bleeding from the vagina, and this is not menstrual bleeding. A delay in menstruation after a biopsy for more than a week may be a sign of an onset pregnancy, which arose when the restrictions on sexual life were not observed. In any case, if the menstrual cycle fails, you need to visit a gynecologist.

Sometimes complications can arise due to an allergy to an anesthetic drug. In this case, a reaction in the form of urticaria, angioedema, or even anaphylactic shock is possible. These effects develop almost immediately after the administration of the drug, so doctors can provide immediate assistance to the patient.

During spinal or epidural anesthesia, a woman may feel weakness in her legs and back pain for some time. If these symptoms do not go away within 2 days, you should consult a doctor.

If the doctor performs the procedure technically correctly, and the woman follows all his further recommendations, then complications after a cervical biopsy develop very rarely. With extensive conization or high removal of the cervical canal, cicatricial narrowing of the neck is possible, which further prevents conception and the normal course of pregnancy. With a large amount of tissue removed, a cylindrical epithelium from its canal can grow on the surface of the neck, and ectopia (pseudo-erosion) will occur.

results

What does a cervical biopsy show?

With the help of a histological examination of the material obtained, the doctor determines whether there are altered cells on the surface of the organ. These violations may not threaten serious consequences or be a sign of precancer and malignant tumors.

According to the WHO classification, there are mild, moderate or severe dysplasia and carcinoma in situ - an early stage of cancer. Also determine the degree of cervical intraneoplasia (CIN). This division is carried out according to the depth of penetration of the changed cells into the thickness of the epithelium and underlying tissues. In addition, changes in the cervix caused by the papillomatosis virus are determined.

Deciphering the results of the analyzes allows us to attribute the detected changes to one of the following groups:

Which do not turn into precancer, but can serve as the basis for the development of the disease:

dishormonal hyperplastic (endocervicosis, polyp, papilloma without signs of atypia, simple leukoplakia and endometriosis);
inflammatory (true erosion, cervicitis);
post-traumatic (cervical rupture, ectropion, scars, cervical-vaginal fistula).

Which are not yet malignant, but with a certain probability (about 50%), if left untreated, can transform into a tumor:

dysplasia on a healthy neck or with background processes;
leukoplakia with atypia;
adenomatosis.

Directly malignant formations:

preclinical - an early stage of the disease that is asymptomatic (cancer in situ, with initial invasion, microcarcinoma);
clinically pronounced (squamous, glandular, clear cell, poorly differentiated).

Depending on what 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 help the patient in time.

The reliability of biopsy data for the detection of precancerous lesions and cancer is 98.6%. This means that if such results are obtained, in the vast majority of cases, an error in diagnosis is excluded.

A biopsy guided by biopsy improves the quality of diagnosis by 25%. Therefore, colposcopic control 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, to the question of how often a biopsy can be done, the answer is this: a second study is prescribed only in case of emergency. Injury to the cervix can lead to its cicatricial changes, which will make it difficult to bear pregnancy and childbirth. Re-conization is most often performed for the purpose of treatment, not diagnosis.

The biopsy sample is sent to the laboratory. There it is processed and sections are prepared, which the pathologist examines under a microscope. The result of the study 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 seem not clear enough to the patient, she can turn to another specialist to get a "second opinion" and dispel her doubts about the diagnosis and treatment tactics.

Biopsy and pregnancy

The removal of a piece of tissue from the neck further causes the formation of a small scar, consisting of connective tissue. It is inelastic and does not stretch during childbirth. Therefore, at the birth of a child, the risk of cervical rupture increases.

Large scars can deform the cervix, as a result of which the walls of the cervical canal do not close tightly. This can lead to threatened miscarriage and other complications.

Therefore, a biopsy of the cervix of the nulliparous should be carried out as carefully as possible. In such women, electroexcision or diathermocoagulation (removal of tissue with an electrically heated loop) should not be used, as this procedure causes a small burn of the surrounding mucosa. This increases the likelihood of a scar. The best option for women planning a pregnancy in the future is a radio wave biopsy.

Pregnancy after a biopsy proceeds normally if the procedure was performed using a laser, ultrasound, radioknife. In other cases, the resulting scar can cause cervical incompetence.

A biopsy of the cervix during pregnancy is prescribed only in exceptional cases, for example, for the diagnosis of cancer, in which it is impossible to bear a child. Usually it is not carried out in the first trimester, as it increases the risk of miscarriage. In the second trimester, this procedure is safer. In the third trimester, a biopsy is also usually not used, so as not to provoke premature birth.

Conization is performed only when there is a justified suspicion of cancer. Curettage of the cervical canal during pregnancy is not used.

Sexual life is allowed after complete healing of the cervix, that is, 4-8 weeks after the manipulation, depending on its type. The degree of recovery is determined by the doctor during a second examination. If the wound healed without complications, you can have sex and become pregnant.

Gynecologist, gynecology

Make an appointment with Dr. Borisova

Biography of gynecologist Borisova

Gynecology - information for patients

Selected issues of gynecology

Gynecologist - about the specialty

Gynecology - clinics

Biopsy of the cervix

A cervical biopsy is the plucking/cutting off of a piece of tissue from the surface of the cervix, with or without scraping the cervical canal.

Biopsy of the cervix - indications. The indication for a biopsy is the identification of a pathological site / sites on the cervix / vagina during colposcopy.

Biopsies are usually performed on:

Areas of white epithelium that appear after the use of acetic acid;

Iodine-negative zones on the surface of the cervix.

A cervical biopsy is a painless procedure that usually does not require anesthesia. However, if the patient has a low threshold of pain sensitivity or a biopsy is planned from several areas of the cervix, then the procedure is performed using local anesthesia. To do this, either Lidocaine spray (may cause vaginal tingling) is used, which is sprayed onto the surface of the cervix, and / or an injection of Lidocaine solution directly into the cervix.

A biopsy of the cervix is always performed under the control of colposcopy:

Or with the help of special tweezers, then a piece of epithelium is plucked from the surface of the cervix;

Or with the help of the Surgidron apparatus; then a piece of cervical epithelium is cut out.

A cervical biopsy may be performed immediately after a colposcopy. The doctor may also schedule the biopsy for another day. In most cases, a biopsy is performed in the first phase of the menstrual cycle, i.e. 3-5 days after the end of menstruation. Why is it so? Because the biopsy site usually heals within 2 weeks and it is necessary for this healing to occur by the beginning of the next menstruation.

The result of a cervical biopsy (histological examination) is usually ready in a day.

Cervical biopsy - possible complications:

Bleeding from the vessels of the cervix (sometimes suturing the cervix is required to stop it);

The development of infection / inflammation at the biopsy site (sometimes a course of antibiotic treatment is required).

These complications occur in less than 0.5% of all cervical biopsy procedures.

Biopsy of the cervix - instructions after the biopsy.

After a cervical biopsy, you may have:

Moderate pulling pains in the lower abdomen, sometimes cramping - an average of 3-5 days;

Minor/moderate bleeding from the genital tract - an average of 5-10 days

You should call the clinic/your gynecologist immediately if:

Bloody discharge from the genital tract is more abundant than your normal period;

You have copious bloody discharge from the genital tract or many clots;

You have severe pain in the lower abdomen;

Body temperature above 37.5;

You notice unusual, foul-smelling discharge

Cervical biopsy what you should not do:

Lift weights over 3kg

Have intimacy for the next 2 weeks

Go to the bath, sauna, take a bath for the next 2 weeks (you can wash in the shower).

Take aspirin; this drug thins the blood and prevents blood clots in the biopsy area, which can lead to prolonged/heavy bleeding.

You can take Indomethacin/Nurofen 200 mg per os to reduce the pulling sensations in the lower abdomen.

Consulting obstetrician-gynecologist, Ph.D. Borisova Alexandra Viktorovna

Discharge after cervical biopsy - normal or abnormal

An impressive fear in women causes such a phenomenon as discharge after a cervical biopsy, bleeding after a cervical biopsy. How disturbing these symptoms are, whether it is worth worrying about this, what results of a cervical biopsy are normal - these issues should be dealt with in detail.

A biopsy of the cervix is a gynecological procedure, the purpose of which is to take one or more pieces of mucosal tissue for histological examination. At its core, such manipulation can be regarded as a minor surgical intervention, which does not exclude complications during this period. Every woman who has been assigned such an analysis should be informed about this. Discharge after a cervical biopsy and moderate bleeding after a cervical biopsy are present in every woman, so you should not be afraid of this.

Discharge after cervical biopsy

Bleeding after a cervical biopsy is a fairly common occurrence and is not regarded as a complication, but rather as a natural healing process. During this period, a woman may experience unexpressed pulling pains in the lower abdomen, as during menstruation. As it heals, the spotting after a cervical biopsy gradually becomes more scarce, the wound scars, and after five to six days the patient can return to normal. After a biopsy of the cervix is performed, the discharge can persist for quite a long time. To avoid complications, it is enough to follow the rules of personal hygiene and medical recommendations:

use sanitary napkins;
do not use a syringe;
do not visit the pool, bath, sauna;
exclude heavy physical exertion;
refuse intimate relationships (the term will be indicated by the doctor);
do not take drugs that contain aspirin (aspirin thins the blood and bleeding may increase).

Each doctor is obliged to warn his patient: when a cervical biopsy was performed, the discharge may be bloody, scanty and not last for a long time. Although the discharge after a cervical biopsy may have a different character depending on the type of biopsy: for example, the discharge after a biopsy of the cervix by conization is more abundant and prolonged. But the discharge after a biopsy of the cervix by the radio wave method can be extremely scarce and short-lived. Bleeding after a biopsy of the cervix with more gentle techniques is always less pronounced.

After a biopsy of the cervix has been performed, the discharge should not cause concern to the patient. Usually, a biopsy of the cervix does not carry any consequences, and it is better to carry it out in the first half of the cycle. It is known that during this period the highest tissue regeneration. After a biopsy of the cervix is performed, discharge is an indicator of health. The likelihood of complications increases if the patient does not follow medical recommendations. The consequences obtained after the manipulation of the cervical biopsy can be if the biopsy was performed during menstruation. If a cervical biopsy is planned, menstrual bleeding requires a delay in this procedure.

Dangerous symptoms after the procedure

bleeding of bright scarlet or dark color with clots;
an increase in body temperature above 37C;
unpleasant odor of discharge;
severe cramping pain in the lower abdomen;
slight nausea.

If a biopsy of the cervix was performed, bleeding was complicated by the listed complaints - urgent medical attention is required, since there is an infection. As treatment, intensive antibiotic therapy is prescribed. When bleeding after a cervical biopsy is severe, measures are taken to stop it. After the biopsy of the cervix, the discharge is normally only scanty bloody, any other is a reason to visit the clinic. It should be noted that bleeding after a cervical biopsy can be provoked by a poor blood clotting system in women, therefore, before writing a referral, the doctor must prescribe the necessary tests. It is also necessary to screen for viral infections (hepatitis), HIV infection, AIDS.

The presence of a disease such as cervical erosion is in itself an indication for a biopsy. A cervical biopsy is prescribed for erosion at the discretion of the doctor. Before the procedure, it is desirable to obtain the results of a PAP test (a smear of the flora from the genital tract for the presence of malignant cells), colposcopy. It is this examination that allows, under magnification, to identify altered areas - iodine-negative zones, which appear when using Lugol's solution. However, a biopsy of the cervix with erosion is not a prerequisite, and the decision to prescribe this procedure is made after a comprehensive examination. A biopsy of the cervix during erosion allows you to exclude or detect cervical cancer at the earliest stages, which will allow you to start treatment on time and completely get rid of this terrible diagnosis.

As a rule, the results of a biopsy of the cervix indicate various pathologies. With their help, a final and accurate diagnosis is established. A presumptive diagnosis can also be removed (a biopsy of the cervix with erosion can rule out cancer).

Cellular changes are divided by severity, there are three of them:

cervical dysplasia of the first degree (one third of the modified cells);
cervical dysplasia of the second and third degree (indicates the presence of a large number of abnormal cells).

For cervical dysplasia of the first degree, treatment is prescribed at the discretion of the doctor based on the results of smears on the flora and colposcopy. The second and third degrees require mandatory treatment.

Thus, a biopsy of the cervix is a medical manipulation, the results of which determine the exact diagnosis. And remember: if you develop heavy bleeding after a cervical biopsy, or after an extended cervical biopsy was performed, the discharge became fetid, changed color - immediately contact the clinic, because only an early start of treatment will ensure its success!

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