What is endometrial biopsy?

Endometrial biopsy is a safe and effective method for evaluating the tissue lining the inside of the uterus (or womb). A plastic catheter is slipped into the uterus, and a small amount of the endometrial lining is suctioned into the catheter. This technique has been demonstrated to provide a tissue sample equal to or superior to the older dilatation and curettage (D&C) procedure.

Why is endometrial biopsy performed?

Endometrial biopsy is performed to evaluate the uterus lining for the presence of cancer or precancerous cells. Most women who have this procedure done have abnormal uterine bleeding or prolonged absence of their periods (amenorrhea). Other women who undergo this procedure include those on hormones (taking estrogen but not progesterone) or those at high risk for endometrial cancer (hereditary nonpolyposis colorectal cancer).

Is endometrial biopsy painful?

It can be uncomfortable. The placement of the thin plastic catheter inside the uterus can produce cramping. Take four 200-mg tablets of ibuprofen (brand names: Advil, Motrin, Nuprin) with some food about an hour before coming to the office for the procedure. To reduce the discomfort from instruments used during the procedure, the cervix can be sprayed with a numbing medicine. The numbing spray may sting for a few seconds. The entire procedure takes just a few minutes, and most women tolerate the procedure well.

What complications may develop after endometrial biopsy?

You may experience vaginal bleeding for a few days following the procedure. If you are pregnant at the time of the procedure, the pregnancy can be damaged, so before the procedure tell your doctor if there is a possibility that you are pregnant. Some women may develop infection in the uterus or fallopian tubes any time an instrument is placed into the uterus, but this is rare following endometrial biopsy. Rarely, a hole can be made in the wall of the uterus by the thin plastic catheter, especially if the uterus is angled up or down.

What happens to the sample that is removed from the lining of my uterus?

The sample is sent to the hospital for examination by a subspecialist physician called a pathologist. The cells from the tissue are examined under the microscope, and the pathologist can determine if cancerous or precancerous cells are present. Your doctor's office will contact you once the report of the tissue examination is completed.

Following Endometrial Biopsy

1. If you have any discomfort after the procedure, you may take ibuprofen, three 200-mg tablets three times a day with food. Acetaminophen (brand name: Tylenol) can also be taken but is not as effective in reducing the uterine cramping.

2. You may drive home following the procedure, unless additional medications have to be given in the office to complete your procedure.

3. Some vaginal bleeding or spotting is common following the procedure. If you experience heavy bleeding, please call your doctor.

4. Infection following the procedure is uncommon but report any complaints that would suggest an infection, such as pain in the lower abdomen or vagina, or a foul-smelling vaginal discharge. Your doctor may prescribe an antibiotic for a few days following the procedure to prevent infection.

5. Please do not place anything in your vagina and avoid sex (intercourse) for one week following the procedure.

6. A nurse will call you with the report of the tests done on the tissue removed from your uterus. You may be asked to take hormones if abnormal cells are detected. Your doctor will talk to you about the best treatment strategy for you when you return to the office for a follow-up visit in a few weeks.