Endometrial biopsy

WHY this test is done

An endometrial biopsy (sometimes known as a "pipelle") is a sample of tissue taken from the lining of the uterus. An endometrial biopsy is usually recommended when someone has experienced abnormal bleeding. Heavy bleeding, spotting, or irregular bleeding may indicate a hormonal imbalance or non-cancerous growths such as polyps or fibroids. Sometimes abnormal bleeding is an indication of abnormal cells, precancer, or uterine cancer. The best way to determine the cause of abnormal bleeding is to take a sample of tissue from the lining of the uterus.

WHAT you should do to prepare

No special preparation is needed. Ibuprofen 400-600 mg 1 hour prior to the procedure will reduce cramping. DO NOT FAST.

WHAT to expect during the procedure

After you are brought to the examination room you will be asked to undress from the waist down. Your doctor will insert a speculum (just like for a Pap smear) and cleanse the cervix with a betadyne soap solution. A thin catheter (tube) will then be introduced through your cervical canal to enter the uterine cavity. Some women feel a slight cramp during this part of the procedure. Once the catheter is in the uterus the physician will obtain the sample. This generally takes about ten seconds and may cause some additional cramping. Once the catheter is removed, the cramping will quickly subside.

WHAT to expect after the procedure

Most women feel fine, but some women will continue to have mild cramping for a short time after the procedure. There may be slight bleeding. You may use a pad or a tampon. All activities can be resumed following the procedure including exercise and intercourse.

RESULTS

The tissue will be sent to Northwestern Memorial Hospital to be evaluated by a pathologist. Results are generally available in five workdays. At the time of the procedure your physician will let you know if you should call for results, if we will call you, or if the results are to be discussed at a subsequent appointment. If you have not discussed your results with anyone one week after the procedure, be sure to call.

FAQ

How long does the procedure take?
The procedure usually takes only a few minutes.

How bad is the cramping?
Some women experience no cramping or very mild cramping. On occasion, if the cervix is very tight (sometimes the case if a woman has never had a vaginal birth) the catheter may not thread easily and cramping may be more severe. If that is the case, it is rare for a severe run to last more than about ten seconds. If, at any time, the cramping is so severe that you would like the procedure to stop, tell your doctor.

Are results ever inconclusive?
Sometimes the pathologist is not able to make a definitive diagnosis. This can occur if there is an inadequate amount of tissue due to heavy bleeding or if minimal tissue is present in the uterus. In that case, you may need a repeat sample or further testing such as a dilattion and curretage.

Are there circumstances in which the test cannot be completed?
Sometimes the test is not completed if someone is unable to tolerate the procedure. Sometimes the catheter cannot be inserted if the cervix is very tight or if there is an obstruction due to a fibroid. In that case a full dilatation and curretage) may be scheduled at another time.

What if I am bleeding at the time of the procedure?
Do not cancel. Many women have this test because of unpredictable or continuous bleeding and it is perfectly fine to have the procedure while bleeding. Please remove your tampon prior to entering the room. If your bleeding is very heavy, tell the medical assistant and she will make sure that there is extra protective padding on the exam table.

What if I have a tendency to pass out?
Some women do get light headed or pass out during any gynecologic procedure. If that is the case, please be sure to EAT PRIOR TO YOUR ARRIVAL. Inform your doctor that you have a tendency to faint. If, during the procedure, you feel light headed, nauseated, or ill, tell your doctor immediately.