Cervical ecto-endocervix biopsy (polyps, inflammatory diseases, condylomas, papillomas)

Indications for biopsy

The procedure is prescribed by a gynecologist in cases where it is necessary to clarify the nature of the detected changes. The main indications are:

• Cervical polyps: Benign formations that require confirmation of their nature and exclusion of malignancy (malignant degeneration).
• Inflammatory diseases: Chronic cervicitis or other inflammatory processes that do not respond to standard treatment or have an atypical appearance.
• Condylomas and papillomas: Neoplasms caused by human papillomavirus (HPV), which require assessment of the risk of oncogenicity and the degree of dysplasia.
• Atypical changes: Cytological examination (PAP test) results indicating dysplasia (CIN I, CIN II, CIN III) or suspected cancer.
• Suspicious areas: Areas of atypical epithelium detected during colposcopy that require detailed examination.

Preparing for the procedure

To ensure accurate results and minimize risks, it is necessary to follow several preparation rules:

1. Time: The procedure is most often performed in the first phase of the menstrual cycle (on days 5–10), after the cessation of bleeding, as this promotes better healing.
2. Examination: Before biopsy, it is mandatory to colposcopy, as well as necessary laboratory tests, including a smear for microflora and tests for sexually transmitted infections (STIs).
3. Limitation: For 24-48 hours before the procedure, you should refrain from sexual intercourse, the use of vaginal suppositories, tablets, sprays, and douching.
4. Doctor's message: Be sure to tell your doctor about any medications you are taking, especially those that affect blood clotting (such as aspirin).

Stages of biopsy

The procedure usually takes 10 to 30 minutes and is performed on an outpatient basis.

1. Pain relief: If necessary, the doctor may use local anesthesia, although the procedure is often painless.
2. Review: The gynecologist inserts a speculum to access the cervix.
3. Colposcopic control: A colposcope is used to accurately determine the site of material collection.
4. Sample collection: Depending on the indications, different methods are used:
   • Targeted biopsy: Taking a small piece of tissue using special forceps (conchotome) from a clearly defined atypical area (ectocervix).
   • Endocervical curettage: Sampling of material from the mucous membrane of the cervical canal (endocervix) using a special brush or curette.
5. Hemostasis: The site of sample collection is treated to stop any possible bleeding.
6. Material direction: The resulting sample is placed in a special solution and sent to the laboratory for histological examination.

Post-procedural period and results

After the biopsy, you may experience slight pulling pains in the lower abdomen and slight bloody or mucus-like discharge for a few days.

Tips:

• For 7-10 days after the procedure, it is recommended to avoid:
  • Sexual contact.
  • Using tampons (replace them with pads).
  • Douching.
  • Visiting the sauna, swimming pool, hot tubs (take only warm showers).
  • Significant physical exertion.
• See a doctor immediately. in case of heavy bleeding, fever, or intense pain.

The results of the histological examination are key to making a diagnosis and choosing a treatment strategy. They will allow the doctor to accurately determine the nature of the neoplasm (polyp, condyloma, dysplasia or cancer) and prescribe the most effective treatment plan.