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Cervical biopsy

Definition

A cervical biopsy is a test in which tissue samples are taken from the cervix and examined for disease or other problems.

See also: Colposcopy-directed biopsy

Alternative Names

Cervical punch biopsy; Biopsy - cervical punch; Biopsy of the cervix

How the Test is Performed

You will lie on your back with your feet in stirrups. As in a regular pelvic examination, an instrument (speculum) will hold the vaginal canal open for the doctor to look inside. It will be inserted into the vagina and opened slightly so that the cervix is visible.

The health care provider will place a small low-power microscope (colposcope) at the opening of the vagina and cervix to examine the area. The colposcope magnifies the surface of the vagina and cervix.

The cervix is swabbed with a vinegar solution (acetic acid), which removes the mucus to help highlight abnormal areas. Photographs may be taken.

Another method is the Schiller's test, which uses an iodine solution to stain the cervix. The stain is inserted through the speculum. The iodine solution stains the normal portions of the cervix, but does not stain abnormal tissues.

If the health care provider finds abnormal tissue, a sample (biopsy) may be taken using a small biopsy forceps or large needle. More than one sample may be taken.

Cells from the cervical canal may be used as samples as well. This is called an endocervical curettage or biopsy (ECC), and it may further help find abnormal cervical cells. When the procedure is done, the health care provider will remove all of the instruments.

How to Prepare for the Test

There is no special preparation. Before the procedure, you should empty your bladder and bowel for your comfort. Do not douche or have sexual intercourse for 24 hours before the exam.

How the Test Will Feel

A colposcopy is painless. The biopsy may feel like a pinch each time a tissue sample is taken. You may have some cramping after the biopsy.

Many women tend to hold their breath during pelvic procedures because they expect pain. Taking a few slow, deep breaths can help you relax and reduce pain or cramping during the biopsy.

Why the Test is Performed

A cervical biopsy is usually done when the health care provider sees an abnormal area on the cervix during a routine pelvic examination. The biopsy can be done if the abnormal area is big enough for the health care provider to see. A colposcopy may be needed for small abnormal areas, or if a Pap smear is abnormal.

Normal Results

A specialist called a pathologist will examine the tissue sample from the cervical biopsy and will report to your doctor whether the cells appear normal or abnormal.

What Abnormal Results Mean

Abnormal biopsy results may indicate problems, such as:

  • Abnormal tissue or cell growth in the cervix (cervical intraepithelial neoplasia)
  • Cancer

Colposcopy may be used to keep track of precancerous cells and look for abnormalities that come back after treatment. Problems that may be biopsied or monitored include:

  • Abnormal patterns in the blood vessels
  • Areas that are swollen, worn away, or wasted away (atrophic)
  • Whitish patches on the cervix

Other findings may be signs of cervical polyps.

Risks

You may have some bleeding after the biopsy for up to 1 week. If bleeding is very heavy or lasts for longer than 2 weeks, or if you notice any signs of infection (fever, foul odor, or discharge), call your health care provider.

Considerations

If the examination or biopsy does not show why the Pap smear was abnormal, your health care provider may suggest that you have a more extensive biopsy.

To allow the cervix to heal, for 1 week after the biopsy avoid:

  • Douching
  • Sexual intercourse
  • Using tampons

Review Date: 2/19/2008
Reviewed By: Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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