Women undergo various tests throughout their lives when visiting a gynecologist. Most often they have to do an OMT ultrasound and colposcopy. IN Lately Diagnostic techniques such as hysteroscopy and pipel biopsy have gained popularity. This article will tell you in detail what a pipel biopsy is.
Pipelle endometrial biopsy is a diagnostic surgical intervention performed in gynecology. With its help, the inner lining of the uterus is examined without dilating the cervical canal. Sometimes this technique is included as part of an extensive surgical procedure.
Despite the fact that pipel endometrial biopsy is a diagnostic procedure, it can also be performed for therapeutic procedures that will not only provide necessary information about the organ being diagnosed, but also to improve the patient’s condition. Most often, a woman does not feel pain when collecting material, which allows diagnostics to be carried out without painkillers and narcotics. The technique of performing pipel biopsy is done with a thin tube, the diameter of which is 2.3 mm, 4 mm. The instrument is hollow inside, this is necessary for collecting material for research.
When performing a pipel biopsy, the patient receives the following benefits:
A sample of tissue is taken from the walls of the uterus using a pipel.
Recently, endometrial aspiration biopsy has been increasingly prescribed. The main indications for its implementation:
In addition, this diagnosis is indicated during the preparatory period before surgery, to determine the nature of tumor formations, fibroids, and to identify complications after aspiration. Before IVF, diagnostics eliminates the occurrence of troubles that often appear during the implantation period ovum.
Many women who are scheduled for examination are interested in the question of what day the procedure is carried out, how to prepare for the pipel biopsy. Typically, gynecologists recommend coming for a diagnosis from the 20th to the 25th day from the start of the menstrual cycle. When a woman suffers from heavy bleeding, the biopsy is postponed to the 7th – 10th day after the start of menstruation.
For patients who have started a climatic period, examination can be carried out at any convenient time. Doctors also give the following recommendations to help prepare for a biopsy.
Before the study, you must refrain from drinking alcohol. It is recommended to avoid thermal procedures, visiting a bathhouse, sauna, or taking a bath, as they can lead to complications. Only hygiene procedures in the shower are allowed.
Before the examination, it is important to stop taking hormonal drugs, chemotherapy drugs, and antibiotics the day before, as they can lead to incorrect examination results. 3-4 days before diagnosis, you must abstain from sexual intercourse. You cannot use vaginal suppositories or creams. You should take a smear to check the vaginal microflora. Before IVF, a pipell biopsy of the endometrium is prescribed one cycle before the start of treatment medicines having a hormonal basis.
Before the procedure, you should avoid any physical activity.
Important! If a woman is suspected of having cancer, then an examination of the endometrium with pipell biopsy is carried out any day, even if a blood smear is available.
After the biopsy is performed, the material is placed in a liquid and delivered to the laboratory. Decoding is carried out under a microscope. Typically, the patient receives results 7 days after the procedure. It is worth saying that in private clinics the result comes faster than in public clinics. After receiving the conclusion, the woman needs to come to the gynecologist, who will interpret it correctly and prescribe the necessary treatment.
Many women are interested in what the biopsy shows. Usually this:
To interpret the result, you must contact a doctor who will make a diagnosis. It is prohibited to decipher the result yourself.
Since a biopsy performed with a pipel is a surgical procedure, there are some contraindications for the procedure. These include inflammation of the uterus, infectious diseases, pregnancy, menstruation, bleeding disorders, genital tract infections. In addition, there are individual diseases for which examination is contraindicated. These cases are determined by the doctor based on the patient’s condition.
Complications after pipel biopsy most often occur as a result of erroneous actions during tissue collection for examination. Also, negative developments cannot be avoided if contraindications are not taken into account. The consequences of pipell biopsy of the endometrium are both immediate and delayed. The first case involves the development of pathology due to errors that occur during the collection of material. Usually there are consequences of a delayed type.
Women often encounter the following negative aspects of a biopsy:
After collecting the material they can a short time slight discharge in the form of a brownish smudge or a few drops of scarlet blood may be observed. Usually these signs go away on their own after 2-3 days.
Brightly colored discharge should be a reason to visit a gynecologist
A video detailing the pipel biopsy can be viewed on the page below.
Article outline
For various pathological changes in the uterus or before the IVF procedure, a pipell biopsy of the endometrium is prescribed, that is, a specific study of the mucous membrane. What is a biopsy? This is a procedure in the form of curettage or tissue collection by other methods for further research, as a result of which pathological factors and causes of many diseases can be accurately determined.
Several methods are used for the procedure; their differences are associated with the characteristics of sample collection. But in any case, microsurgery is usually performed under local anesthesia; it has virtually no complications. Aspiration biopsy, performed on an outpatient basis, is considered the most gentle.
Most often, a pipel biopsy is prescribed for diagnosis - a safe and painless procedure, as a result of which no harm is caused to the body. During the examination, a thin plastic tube is inserted into the uterine cavity, through which a particle of the mucous membrane is taken for examination. Tissues are sucked into the cavity of the tube, that is, scraping or other traumatic actions are not performed. The difference between this method and the aspiration method is that the tissue is collected using a tube rather than a vacuum instrument or syringe.
Indications for a biopsy include:
Let's look at what this procedure shows? Examination of tissues after surgery makes it possible to determine whether there are diagnostic signs of sample polymorphism or structural abnormalities. The procedure can show whether there is hyperplasia of the endometrial layer, the presence of local proliferation of mucosal tissue, malignant tissue overgrowth, discrepancy between the thickness of the mucous membrane and the norm, atrophy of the uterine lining, atypical hyperplasia or hypoplasia.
Preparation for the procedure begins with determining the time, usually these are the days before menstruation. If there is a suspicion of mucosal rejection, then it would be optimal to schedule a biopsy on the 5th day of the cycle, and with hormonal therapy it will be 17-24 days. If the examination is carried out under general anesthesia (for example, during a comprehensive diagnosis or in the form of a scraping), you must prepare for anesthesia - do not drink or eat anything for eight hours, and it is also prohibited to take medications. Tests are usually ordered as with any other surgical procedure.
Otherwise, there are no restrictions or special requirements; the study is carried out in an outpatient setting (with the exception of the classical method).
Can be used for biopsy various methods, including:
This method is also called classical; it is usually carried out under general anesthesia and involves complete curettage of the cavity of the cervical canal and uterus with special instruments. The procedure is painful, it requires the patient to stay in the hospital, before the manipulation you should prepare and undergo tests.
Preparation for a pipel biopsy is very simple:
How exactly the procedure takes place depends on the chosen method, but usually it does not require much time and takes a couple of minutes. The scraping may take approximately 10-15 minutes, after which the patient can go home. A hospital stay is not required unless a biopsy is performed as part of general treatment or there is an indication for it.
A biopsy sample is usually taken on days 21-23 of the cycle, so it is recommended to maintain a personal menstrual schedule. Some types of studies are best done immediately before menstruation, about 5-7 days, but for long cycles this period may be different. If the patient does not know the length of her cycle, the time for the study is approximately scheduled, focusing on the usual duration, that is, between 21-23 days, counting from the date of completion of the last menstruation.
The price of a pipell endometrial biopsy depends on the clinic where the procedure is performed. On average, the cost of this diagnostic procedure ranges from 1,600 to 8,000 rubles. Research is recommended to be carried out only in specialized clinics with appropriate conditions and equipment.
Anastasia N.:
“I had miscarriages several times, and for a long time they could not determine the cause. One of the clinics offered to perform a pipel biopsy. The procedure itself did not take much time, it went well, although it was painful. As a result, hyperplasia was discovered, which was the reason for the impossibility of a normal pregnancy. I completed a course of treatment, now everything is fine, we are expecting our second baby.”
“An IVF procedure was prescribed, and before it it was recommended to undergo a biopsy to rule out any problems. Everything went quickly in an outpatient clinic, there were no particularly unpleasant sensations, fertilization was scheduled within a month.”
Svetlana D.:
“The observing gynecologist ordered a biopsy because endometriosis was suspected. I was terribly afraid, but in vain - everything took literally five minutes, there were practically no painful sensations. The first couple of days I was bothered by a pulling sensation in the abdomen and light discharge, but everything went away without any consequences.”
Decryption usually takes 10 days, this is done only by a qualified specialist. The results of the study reveal:
Vacuum aspiration of the endometrium is a minimally invasive micro-surgery, almost painless. The operation is performed in an outpatient setting; it does not require a long stay in the clinic or restrictions after a vacuum examination.
The procedure involves taking an aspirate from the uterine cavity using a specially designed syringe. In this case, a long tip or needle is inserted into the uterine cavity, through which the tissue sample is literally sucked inside. This histological examination does not require general anesthesia or serious preparation; it is practically painless and does not cause bleeding.
The price of endometrial aspiration biopsy usually depends on the status of the clinic. The average cost for aspiration research is 1900-8000 rubles.
A CG biopsy is a type of examination during which tissue is removed using line-shaped scrapings. This method is considered the safest; it is not accompanied by bleeding or mucosal rejection. The use of bar biopsy is allowed up to three times during one cycle, without causing injury to the body, and the hormonal levels do not change. This type of study is usually indicated when studying a precancerous condition, in the presence of tumor processes.
Diagnostic hysteroscopy with biopsy is used to accurately identify pathologies, the presence of fibroids, tumor processes, polyposis, and hyperplasia. The material is collected under anesthesia; intravenous anesthesia is usually used for this. The biopsy is taken using a special hysteroscope, after which tissue samples are sent for research.
Endometrial biopsy is a safe and virtually non-traumatic procedure, but there are a number of consequences, including:
Severe bleeding is not observed; this situation is possible only if the procedure was performed incorrectly. But even with a competently performed biopsy, a shift in the menstrual cycle may be observed; the first menstruation usually goes a little differently than always.
Usually a biopsy proceeds quickly and without any special consequences, but it is not prescribed in the following cases:
In addition, a number of restrictions apply intimate relationships, the use of hygienic tampons, pregnancy can only be planned for the next cycle, especially for the IVF procedure.
After a pipel endometrial biopsy, the following actions cannot be performed:
Such actions are prohibited in order to prevent some complications, including inflammatory diseases and heavy bleeding. Such restrictions are in effect for days, after which they are lifted. But, if bleeding continues or purulent discharge from the vagina is observed, you need to contact a supervising specialist.
It is better to postpone intimate relationships after a biopsy until the bleeding has completely passed. Further, sex no longer has restrictions, but if pregnancy is not planned, at first it is better to use barrier contraception, which will also protect the mucous membrane from infectious and bacterial lesions.
Immediately after the procedure, menstrual flow comes on time, there may be slight delays, but no more than 10 days, most often there are no delays at all. The discharge itself will be more scanty than usual; the presence of unpleasant odor discharge, the appearance of clots, the presence of pus, fever.
After a biopsy, some conditions are contraindicated, but pregnancy can be planned for the next cycle, when the endometrium has recovered. There is usually no delay in menstruation, although the discharge may be scanty immediately after the procedure. But over the full cycle, the functionality of the mucous membrane is completely restored, no problems with the arrival of menstruation occur, and the uterus itself will be fully prepared to receive the egg.
Results from an endometrial biopsy, as a rule, have to wait from 7 to 14 days, it all depends on the clinic where the research is carried out and the overall workload of the laboratory. It usually takes no more than 10 days to decipher the results, after which you can contact the supervising doctor to prescribe a therapy regimen or other treatment methods.
Preparation for IVF often requires a biopsy procedure, which allows you to solve the following problems:
Before in vitro fertilization, careful preparation of the endometrium is necessary. If the results of the study show that the thickness of the mucosa is insufficient, appropriate therapy will be prescribed to quickly bring the endometrium back to normal.
In the field of gynecology, one of the most popular methods for identifying histological problems is endometrial biopsy. The technique is aimed at examining a piece of uterine tissue under a microscope.
Thanks to this, it is possible to accurately determine the presence of morphological changes in the mucosa. To date, certain types of endometrial biopsy have been developed, which have different capabilities, purposes and contraindications.
So, the diagnostic procedure involves taking a sample (during the patient’s lifetime) of mucosal tissue, so that chemical and histological studies can be subsequently carried out.
The event is an important component of minor surgical intervention, carried out as an independent intervention. But in severe cases, an endometrial biopsy is performed intraoperatively, urgently.
This is a procedure performed solely for diagnosis and histology determination. Although, it rarely happens that an endometrial biopsy is a therapeutic procedure.
Before the event, there must be appropriate preparation; this directly determines whether the patient will feel painful and uncomfortable sensations during the process.
Before the biopsy, the patient is asked to administer an anesthetic (this is optional, optional).
It is imperative to refrain from using medications that can affect the endometrium. If one of the rules is violated, you should not be shy - you need to tell the doctor everything.
Despite the simplicity and ease of performing a biopsy, it is nevertheless a surgical intervention, and therefore has a number of contraindications:
Also, the doctor may prohibit the procedure due to personal, individual illnesses that will be determined in advance.
The event is quite simple, so no consequences or side effects are observed. However, in specific, individual situations, slight short-term bleeding may occur, appearing on the day the biopsy is taken. It is worth knowing that in this case no inpatient examination or observation is required, so the woman can immediately go home.
The advantage of the procedure is high level accuracy and information content, compared to the fact that the intervention from a biopsy is minimal. In practice, this activity has not yet had negative reviews or any side effects or deterioration in well-being.
The diagnostic event Pipelle biopsy is a modernized method of examining the endometrium and uterine cavity. The technique is based on the standard method of endometrial aspiration.
The procedure is carried out as follows:
Previously, when standard curettage was carried out, when collecting small quantity diagnostic sample, almost the entire endometrium disappeared, and a large wound appeared on the membrane.
Important, that modern way diagnostics is quite possible for use in case of suspected formation of malignant or benign tumors in the uterine cavity or for metrorrhagia after a miscarriage.
The process of separating the endometrium for diagnosis and analysis is carried out by vacuum separation created in the uterine cavity.
If a more detailed examination and subsequent tests are required, laboratory research, before performing a biopsy, the uterine cavity is sometimes irrigated with a special solution in order to subsequently perform washouts.
Professional experts recommend ensuring sexual rest and abstaining from sexual intercourse as preparation. intimacy, do not do any douching, do not use vaginal tampons for 2-3 days before the biopsy. To exclude STDs and all kinds of acute urogenital diseases, a qualified doctor must prescribe a preliminary examination.
Despite the fact that the procedure is minimally invasive and simple, it is nevertheless associated with a violation of the integrity of the mucous tissues of the uterine cavity. Therefore, it is not uncommon for slight bleeding that does not cause pain to appear during the first 24 hours after an event.
After a diagnostic curettage of Pipel, heavy, menstrual-like discharge may be observed for some time, accompanied by short-term pain in the lower abdomen.
It is worth immediately clarifying that the pain is not prolonged, and the rate of discharge after the procedure is much less than during the menstrual cycle and should not include blood clots, impurities of pus and any unpleasant putrefactive aroma. When any of the above symptoms appear, this is a signal to contact a specialized medical institution for advice.
When the diagnostic procedure is completed, the doctor recommends using a sanitary pad; discharge is possible. But, under no circumstances use tampons, they can irritate the mucous membrane, causing discomfort. Minor pain in the abdomen or lower back is considered normal; this fact is due to spasms in the uterus.
Important symptoms that you should be concerned about are the following characteristics:
If symptoms do not go away even after taking painkillers, you should immediately consult a doctor.
In order to prevent serious consequences and various complications, it is necessary to observe following rules after biopsy:
In addition, to prevent the development of infections and pathogens in the uterine cavity, it is recommended to take a course of antibiotics. If necessary, the leading doctor may prescribe hormonal medications.
The recovery period lasts no more than 3-4 days, depending on the individual characteristics woman's body.
When used for diagnostic purposes possible pathologies uterus using the gentle Peipel biopsy method, menstruation may begin with a slight delay of 8-10 days. The meager volume and period of menstruation also differs somewhat from standard indicators. This is not a reason to worry, there is nothing wrong with it.
If the delay continues for more than 10 days, you should take a pregnancy test and then consult a specialist.
Planning to conceive a child is recommended only in the next menstrual cycle after the Pipel biopsy.
This is done so that the uterus rests and the mucous membrane undergoes a full course of restoration of functionality. It is worth knowing that the diagnostic procedure does not affect the functioning of the ovaries.
Considering that the Peipel biopsy is a gentle method for diagnosing diseases of the female organs, the remaining layer of the endometrium is quite enough to undergo the IVF fertilization procedure in the next ovulation cycle.
Often, leading experts advise women not to resort to intimacy with their spouse during the period while spotting appears. In the subsequent menstrual cycle, it is recommended to use barrier method contraception.
Before the day for the procedure is set, specialists together with the patient will choose the most appropriate diagnostic method, based on the woman’s personal testimony, body characteristics, etc. Depending on this, preparation requirements and various risks after the event are regulated.
Despite the fact that bleeding and minor pain are possible after a pipel biopsy, you should not immediately say “No” to this event, because no other methodology will provide such an accurate histological analysis.
Possible complications:
As a standard, the diagnostic process and subsequent interpretation of the results takes at least 14 days. This should be performed exclusively by a pathologist or histologist. If the leading specialist made an appropriate note in the direction for analysis, it is possible additional analysis immunohistochemical.
How long the results will be made depends on the capabilities of the laboratory and the experience of the specialist, as well as on the volume of research and additional analyzes performed.
Another important aspect today is the cost of the manipulation. Most clinics have already included this procedure in their list of services.
The price will vary depending on the region, level of the clinic and other circumstances. In Moscow average price for this procedure is 3,000 rubles. In the regions, the price for Pipelle endometrial biopsy is lower.
When a Paypel endometrial biopsy is performed, the price includes payment for histological or cytological examination. On average it fluctuates from 4,000 to 5,000 rubles. So the final cost of the entire survey will be in the area 7,000-8,000 rubles.
In the field of gynecology, one of the most popular methods for identifying histological problems is endometrial biopsy. The technique is aimed at examining a piece of uterine tissue under a microscope.
Thanks to this, it is possible to accurately determine the presence of morphological changes in the mucosa. To date, certain types of endometrial biopsy have been developed, which have different capabilities, purposes and contraindications.
So, the diagnostic procedure involves taking a sample (during the patient’s lifetime) of mucosal tissue, so that chemical and histological studies can be subsequently carried out.
The event is an important component of minor surgical intervention, carried out as an independent intervention. But in severe cases, an endometrial biopsy is performed intraoperatively, urgently.
This is a procedure performed solely for diagnosis and histology determination. Although, it rarely happens that an endometrial biopsy is a therapeutic procedure.
Before the event, there must be appropriate preparation; this directly determines whether the patient will feel painful and uncomfortable sensations during the process.
Before the biopsy, the patient is asked to administer an anesthetic (this is optional, optional).
It is imperative to refrain from using medications that can affect the endometrium. If one of the rules is violated, you should not be shy - you need to tell the doctor everything.
Despite the simplicity and ease of performing a biopsy, it is nevertheless a surgical intervention, and therefore has a number of contraindications:
Also, the doctor may prohibit the procedure due to personal, individual illnesses that will be determined in advance.
The event is quite simple, so no consequences or side effects are observed. However, in specific, individual situations, slight short-term bleeding may occur, appearing on the day the biopsy is taken. It is worth knowing that in this case no inpatient examination or observation is required, so the woman can immediately go home.
The advantage of the procedure is a high level of accuracy and information content, compared to the fact that the intervention from a biopsy is minimal. In practice, this activity has not yet had negative reviews or any side effects or deterioration in well-being.
The diagnostic event Pipelle biopsy is a modernized method of examining the endometrium and uterine cavity. The technique is based on the standard method of endometrial aspiration.
The procedure is carried out as follows:
Previously, when standard curettage was performed, when a small amount of a diagnostic sample was taken, almost the entire endometrium disappeared, and a large wound appeared on the membrane.
It is important that the modern diagnostic method is quite possible for use in cases of suspected formation of malignant or benign tumors in the uterine cavity or in case of metrorrhagia after a miscarriage.
The process of separating the endometrium for diagnosis and analysis is carried out by vacuum separation created in the uterine cavity.
If a more detailed examination and subsequent tests, laboratory tests are required, before performing a biopsy, the uterine cavity is sometimes irrigated with a special solution in order to subsequently perform washouts.
Professional experts recommend that before the procedure, as a preparation, ensure sexual rest and abstain from intimacy, do not do any douching, and do not use vaginal tampons for 2-3 days before the biopsy. To exclude STDs and all kinds of acute urogenital diseases, a qualified doctor must prescribe a preliminary examination.
Despite the fact that the procedure is minimally invasive and simple, it is nevertheless associated with a violation of the integrity of the mucous tissues of the uterine cavity. Therefore, it is not uncommon for slight bleeding that does not cause pain to appear during the first 24 hours after an event.
After a diagnostic curettage of Pipel, heavy, menstrual-like discharge may be observed for some time, accompanied by short-term pain in the lower abdomen.
It is worth immediately clarifying that the pain is not prolonged, and the rate of discharge after the procedure is much less than during the menstrual cycle and should not include blood clots, impurities of pus and any unpleasant putrefactive aroma. When any of the above symptoms appear, this is a signal to contact a specialized medical institution for advice.
When the diagnostic procedure is completed, the doctor recommends using a sanitary pad; discharge is possible. But, under no circumstances use tampons, they can irritate the mucous membrane, causing discomfort. Minor pain in the abdomen or lower back is considered normal; this fact is due to spasms in the uterus.
Important symptoms that you should be concerned about are the following characteristics:
If symptoms do not go away even after taking painkillers, you should immediately consult a doctor.
In order to prevent serious consequences and various complications, the following rules must be followed after a biopsy:
In addition, to prevent the development of infections and pathogens in the uterine cavity, it is recommended to take a course of antibiotics. If necessary, the leading doctor may prescribe hormonal medications.
The recovery period lasts no more than 3-4 days, depending on the individual characteristics of the woman’s body.
When using the gentle Pipel biopsy method to diagnose possible pathologies of the uterus, menstruation may begin with a slight delay of 8-10 days. The meager volume and period of menstruation also differs somewhat from standard indicators. This is not a reason to worry, there is nothing wrong with it.
If the delay continues for more than 10 days, you should take a pregnancy test and then consult a specialist.
Planning to conceive a child is recommended only in the next menstrual cycle after the Pipel biopsy.
This is done so that the uterus rests and the mucous membrane undergoes a full course of restoration of functionality. It is worth knowing that the diagnostic procedure does not affect the functioning of the ovaries.
Considering that the Peipel biopsy is a gentle method for diagnosing diseases of the female organs, the remaining layer of the endometrium is quite enough to undergo the IVF fertilization procedure in the next ovulation cycle.
Often, leading experts advise women not to resort to intimacy with their spouse during the period while spotting appears. In the subsequent menstrual cycle, it is recommended to use barrier method contraception.
Before the day for the procedure is set, specialists together with the patient will choose the most appropriate diagnostic method, based on the woman’s personal testimony, body characteristics, etc. Depending on this, preparation requirements and various risks after the event are regulated.
Despite the fact that bleeding and minor pain are possible after a pipel biopsy, you should not immediately say “No” to this event, because no other methodology will provide such an accurate histological analysis.
Possible complications:
As a standard, the diagnostic process and subsequent interpretation of the results takes at least 14 days. This should be performed exclusively by a pathologist or histologist. If the leading specialist has made an appropriate note in the referral for analysis, an additional immunohistochemical analysis is possible.
How long the results will be made depends on the capabilities of the laboratory and the experience of the specialist, as well as on the volume of research and additional analyzes performed.
Another important aspect today is the cost of the manipulation. Most clinics have already included this procedure in their list of services.
The price will vary depending on the region, level of the clinic and other circumstances. In Moscow, the average price for this procedure is 3,000 rubles. In the regions, the price for Pipelle endometrial biopsy is lower.
When a Paypel endometrial biopsy is performed, the price includes payment for histological or cytological examination. On average it fluctuates from 4,000 to 5,000 rubles. So the final cost of the entire survey will be in the area 7,000-8,000 rubles.
Previously, with some gynecological diseases To collect endometrial samples, only traumatic biopsy techniques of the uterine mucosa were used, which involved curettage (i.e., a procedure similar to a classic surgical abortion). However, thanks to the advent of aspiration biopsy (or Pipelle biopsy), such an examination has become more painless and safe.
This minimally invasive surgical technique for collecting endometrial tissue is carried out using a special plastic tube - pipel. The thickness of this device is 3 mm, and its operating principle is similar to the syringe mechanism. There is a piston inside the tube, and at one end there is a side hole for entry by aspiration of the endometrium into the tip of the pipel.
In this article we will introduce you to the indications, contraindications, how to prepare the patient for the procedure, the advantages and methods of performing endometrial aspiration biopsy. This information will help you understand the essence of this diagnostic technique, and you can ask your doctor any questions you have.
Unlike the classical surgical method of collecting endometrial tissue, aspiration biopsy does not require dilation of the cervical canal. The tip of a disposable tube is inserted into the uterine cavity without the use of additional devices. The doctor pulls the piston towards himself, creating negative pressure for the necessary aspiration small area endometrium. At the same time, on inner layer the uterus does not form extensive wound surfaces, the cervix does not suffer from mechanical impact, and the patient does not experience significant discomfort.
An aspiration biopsy is prescribed in cases where, after a gynecological examination and ultrasound, the doctor suspects that the patient has pathological changes in the condition of the inner layer of the uterus - the endometrium. The obtained tissue samples make it possible to conduct a histological analysis of the mucous layer of the uterus and make a correct diagnosis.
Endometrial aspiration biopsy is prescribed in the following clinical cases:
Pipelle biopsy can be performed not only to diagnose endometrial pathologies, but also to evaluate the effectiveness of hormone therapy.
Endometrial aspiration biopsy cannot be performed in the following cases:
Possible limitations for performing Pipelle biopsy include the following clinical cases:
If such conditions are detected, aspiration biopsy can be performed after special preparation of the patient or replaced with another study.
Although aspiration biopsy of the endometrium is a minimally invasive procedure, during it, instruments are inserted into the uterine cavity and damage to the integrity of the inner layer of this organ occurs, albeit minor. That is why to exclude possible complications For such a study, the patient needs to properly prepare for the collection of material.
To exclude possible contraindications to endometrial aspiration biopsy, the following must be performed: diagnostic studies:
When prescribing a Pipelle biopsy, the doctor must obtain from the patient all information about the medications she is taking. medicines. Special attention is given to taking blood thinners (Clopidogrel, Aspirin, Warfarin, etc.). If necessary, the doctor can change the order in which they are taken a few days before the procedure.
When prescribing endometrial aspiration biopsy, special attention is paid to choosing the date of the study. If a woman has not yet entered menopause, the timing of the procedure depends on the day of the menstrual cycle. If the patient is no longer menstruating, tissue sampling is performed depending on the onset of abnormal uterine bleeding.
Typically, endometrial aspiration biopsy is performed on the following days:
Direct preparation for Pipelle biopsy is carried out 3 days before the study. During these days, a woman must follow the following doctor’s recommendations:
The endometrial aspiration biopsy procedure can be performed in a specially equipped office in a clinic. As a rule, it does not require the use of local anesthesia, but sometimes this method of pain relief is performed for particularly sensitive patients. In such cases, before conducting the study, the doctor must make sure that there is no allergic reaction on the drug used (based on medical history or test performed).
During the procedure, the patient is on a gynecological chair. On the appointed day, the patient with a referral comes to the office for an aspiration biopsy. The procedure for collecting endometrial tissue is performed as follows:
The results of histological analysis of endometrial tissue are obtained 7-14 days after the biopsy. After assessing them, the gynecologist makes a diagnosis and draws up a plan for further examination and treatment.
After performing an aspiration biopsy of the endometrium, the patient feels satisfactory and can go home. Her performance is not impaired in any way, and there is no need for hospitalization.
In the next 1-2 days, the patient may feel minor painful pulling sensations in the lower abdomen. To eliminate cramping pain, which causes significant inconvenience, a woman can take antispasmodics (No-shpa, Papaverine, Spazmalgon). As a rule, such discomfort does not last more than 1 day.
In the first few days after the aspiration biopsy procedure, women experience light, bloody discharge from the genital tract. Most experts recommend that their patients abstain from sexual intercourse during these days. After the bleeding stops, a woman can resume sexual activity and use barrier contraception to prevent pregnancy.
After the study, menstruation may occur on time or with some delay (up to 10 days). In such cases, the woman is advised to take a pregnancy test and visit a doctor.
After an aspiration biopsy, pregnancy can occur in the current or subsequent cycle. This method of endometrial sampling does not affect the functioning of the ovaries and the remaining area of the uterine mucosa is sufficient for implantation of the fertilized egg.
The endometrial aspiration biopsy procedure is minimally invasive and in rare cases leads to complications. After the examination, the gynecologist must familiarize the patient with the symptoms, when they appear, she should immediately consult a doctor:
Pipelle biopsy has a number of significant advantages:
In the absence of pathological abnormalities in the structure of the mucous layer of the uterus, the analysis will indicate that the endometrium corresponds to the age norm and the phase of the menstrual cycle, and no signs of atypia were identified.
If deviations in the structure of the mucous layer of the uterus are detected, the following pathological changes may be indicated in the analysis results:
Endometrial aspiration biopsy is often used as a screening method for examining patients with questionable ultrasound results. However, this method of collecting tissue from the inner layer of the uterus does not always allow obtaining a sufficient amount of material to completely exclude the presence of malignant tumors. That is why, if a cancerous process is suspected, the examination of the patient is supplemented with a more informative diagnostic curettage.
After performing a Pipelle biopsy, the doctor sets a date for the patient’s next visit. Typically, histological examination tests are ready 7-14 days after the procedure, and based on their results, the gynecologist can determine further tactics for diagnostic and therapeutic measures.
If signs of atypia or cancerous processes are detected, the doctor decides on the need for additional research and surgical treatment. If the results of histological analysis indicate the presence of inflammation, then the patient is prescribed antibiotic therapy and anti-inflammatory drugs.
When determining signs of hyperplasia or insufficient response of the endometrium to hormonal changes during the menstrual cycle, the doctor conducts additional diagnostic tests to identify endocrine disorders. After this, the patient may be prescribed hormone therapy, which improves the condition of the endometrium and restores reproductive function, taking other medications and physiotherapeutic procedures.
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