Endometrial Biopsy

An endometrial biopsy is probably the most common procedure I perform in the office.  This type of biopsy is performed to remove a very small sample of tissue from the uterine cavity which is sent to a pathologist for evaluation.  Typically done for women with abnormal or heavy uterine bleeding, endometrial biopsy has some application for infertility purposes as well.  THIS PROCEDURE CANNOT BE PERFORMED ON A PREGNANT WOMAN.  IF YOU MAY BE PREGNANT, YOU MUST INFORM YOUR PHYSICIAN.

After signing a consent form, a patient is placed in stirrups, much like when having a pap smear.  A speculum is placed into the vagina, and the cervix is visualized and cleaned with betadine or other cleansing agent.  At times, I need to stabilize the cervix with a tenaculum or grasper.  This will feel like a sharp, quick pinch.  At this point, a very small thin flexible catheter,  a “Pipelle” is placed through the vagina, past the cervix and into the uterine cavity.

This catheter, although very thin, has a smaller, thinner catheter within it.  By slowly withdrawing  the smaller catheter, a suction is created and thereby tissue from the uterus is “vacuumed” into the catheter, ready to be sent to pathology.  This “suction” aspect is much like a straw.  There are no sharp instruments or “scraping” of the cavity that is used for a D&C.  It is performed as “blind” procedure, meaning that there is no visualization of the uterine cavity with this procedure, unlike when a D&C/hysteroscopy is performed.  Because of this, the “sensitivity” or the ability to accurately detect a disease process is lower.  Your physician may still recommend a D&C/hysteroscopy depending on the clinical situation.


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