Surgery Overview
A cervical biopsy removes part of the cervix
so the tissue can be examined under a microscope. The amount of cervical tissue
removed depends on the method used:
- A simple cervical biopsy
removes a small piece of tissue from the surface of the cervix.
- An
endocervical biopsy (endocervical curettage) removes
tissue from high in the cervix by scraping with a scoop-shaped instrument
(curette).
How it is done
A cervical biopsy can be done in
your doctor's office, a clinic, or a hospital as an outpatient procedure (you
do not have to spend the night in the hospital).
You will need to
take off your clothes below the waist and drape a paper or cloth covering
around your waist. You will then lie on your back on an exam table with your
feet raised and supported by footrests (stirrups). Your doctor will insert an
instrument with curved blades (speculum) into your vagina. The speculum gently
spreads apart the vaginal walls, allowing the inside of the vagina and the
cervix to be examined. A vinegar solution (acetic acid) may be applied to the
cervix to show the abnormal areas.
A cervical or endocervical
biopsy may be done with an oral pain medicine but without an injection of
numbing medicine (
anesthetic
) in the cervix (cervical
block). Alternately, these procedures may be done with a cervical block along
with oral pain medicine. An anesthetic ointment may be applied to your cervix
before a biopsy. After the biopsy, a liquid (Monsel's solution) may be applied
to stop bleeding.
A cone biopsy (conization) is a more extensive form of a cervical biopsy. It is called
a cone biopsy because a cone-shaped wedge of tissue is removed from the cervix.
Both normal and abnormal cervical tissues are removed. For more information,
see
cone biopsy.
A colposcope is used to
magnify the tissues during these procedures.
What To Expect After Surgery
Most women are able to return to normal
activity the day of or within 1 day after the biopsy.
After cervical biopsy
- Some vaginal bleeding and a small amount of
dark brown discharge are normal for about 1 to 2 weeks.
- Pads should
be used instead of tampons for 1 week.
- Sexual intercourse should
be avoided for about 1 week. But your doctor will let you know exactly how long
to wait.
- Douching should not be done.
When to call your doctor
Call your doctor for any
of these symptoms:
- A fever
- Moderate to heavy
bleeding (more than you would usually have during a menstrual
period)
- Increasing pelvic pain
- Bad-smelling or
yellowish vaginal discharge, which may point to an infection
Why It Is Done
A cervical biopsy should always be
done before surgical treatment is considered when abnormal tissue is seen on
the
vulva
, vagina, or cervix, or if abnormal tissue is
seen during
colposcopy
.
How Well It Works
Results of the
abnormal Pap test
, colposcopy, and cervical biopsy are
compared and evaluated.
-
Normal. No abnormal
tissue is found on the biopsy. Monitoring with Pap tests is done at regular
intervals as recommended by your doctor. If the initial abnormal Pap test
showed moderate to severe cell changes, additional testing, such as a cone
biopsy, may be done to explain the different results found in the cervical
biopsy.
-
Abnormal. Abnormal tissue is found.
Results may indicate:
- Infection. The infection may be treated
with medicine if it is caused by bacteria or yeast. Repeat Pap tests may be
done to monitor the success of the treatment.
-
Minor cell changes.
Abnormal tissue may be monitored without treating it, or treatment may be done
to destroy or remove the abnormal cells. Over half of minor cell changes become
normal again on their own in 6 to 18 months.
-
Moderate to severe cell changes. Treatment is done to destroy or remove the abnormal cervical
cells.
- Cancer. Treatment is done to destroy or remove the tissue
affected by invasive cancer.
If the results of the initial abnormal Pap test,
colposcopy, and cervical biopsy do not agree:
- Repeat Pap testing, with or without colposcopy,
may be done to monitor the progression of the cell changes.
- A cone
biopsy to destroy or remove the abnormal cells may be done if moderate to
severe cell changes are indicated in the Pap test.
Risks
Vaginal bleeding can occur for up to 2 weeks
after the cervical biopsy.
What To Think About
You should ask your doctor when
and how the results of the biopsy will be reported to you. Depending on the
results of the biopsy, treatment may or may not be recommended. The timing of
follow-up tests can be discussed with your doctor.
If the Pap
tests and cervical biopsy results do not agree, further evaluation and a cone
biopsy may be needed before any type of treatment is recommended so that an
invasive cancer is not missed.
Complete the
surgery information form (PDF)
(What is a
PDF
document?)
to help you prepare for this surgery.
