Cervical Biopsy

A cervical biopsy is the removal of a small sample of tissue from the cervix. The cervix is the lowest part of the womb (uterus). The womb contains the opening of the uterus into the vagina (birth canal). A cervical biopsy is usually done to detect cancer of the cervix. A cervical biopsy is also done following an abnormal pap smear, or when an abnormality is seen on the cervix during a pelvic examination.

A pap smear is a test of your cervix and cervical canal. During a pap smear, your caregiver uses a small spatula and a brush. He/she uses these tools to gently scrape cells from inside the canal of the cervix and from the surface of your cervix. These cells are sent to a lab for testing. The pap smear is a screening test to detect early changes in cells which suggest cancer will develop. Abnormal pap smears often lead to a colposcopy.

A colposcopy is an examination of the surface of the cervix through a magnifying scope. It is usually done if:

  • You have an abnormal pap smear.

  • You have a lesion on the cervix, vulva, or vagina, with or without an abnormal pap smear.

  • Your pap smear suggests the presence of the herpes virus or the human papilloma virus (HPV). This virus can cause genital warts. Several HPV types are linked to the development of cervical cancer.

  • You have extensive genital warts on the vulva. These are the lips at the opening of the vagina.

  • You were exposed to DES, or diethylstilbestrol during your mother's pregnancy. This medicine has been linked with abnormal changes in the cervix of women exposed to DES as fetuses.

  • Your caregiver can safely perform a cervical biopsy while you are pregnant. Your caregiver will often wait until a time after delivery, if the pap smear does not indicate cancer cells.

PROCEDURE

Do not douche or have sexual intercourse for at least 24 hours before doing the biopsy. A cervical biopsy is done with the woman lying on her back. Her feet will be placed in stirrups (foot rests). The biopsy is done when a woman does not have her menstrual period. The caregiver places a speculum inside the woman's vagina. This instrument helps hold open the opening of the vagina. This allows the caregiver to see the cervix and inside of the vagina.

The caregiver uses a colposcope to magnify the cervix, vulva, and vagina if necessary. Your caregiver will put a mild solution of vinegar on the area. This solution makes abnormal cells more visible. The caregiver may also use a solution of weak iodine to help see any abnormal cells.

The caregiver takes small pieces of tissue from suspicious areas. When using the colposcope, the technique is called directed cervical punch biopsy. A small amount of paste is placed on the biopsy site to prevent bleeding. You may feel mild discomfort during the biopsy. Your caregiver will record the location of the abnormal areas. Tissue samples will be sent to the lab to a specialist, to see if there are any abnormal cells. The specialist will examine your biopsy under a microscope.

HOME CARE INSTRUCTIONS

  • Cramping usually goes away within minutes of the cervical biopsy.

  • Lying down for a few minutes usually prevents light headedness.

  • Cramping may be treated with over-the-counter medicines. Only take over-the-counter or prescription medicines for pain or discomfort as directed by your caregiver.

  • Your caregiver will discuss the cervical biopsy test results with you. Problems can range from normal to mild or slightly abnormal changes in the cells, to cancer of the cervix. Treatments and follow-up depend upon what is found on the biopsy.

  • You may have a small amount of minor bleeding from the vagina for 1 or 2 days.

  • For a week (or as instructed) avoid:

  • Sexual intercourse.

  • Douches.

  • Tampons.

  • Complications may include:

  • Heavier vaginal bleeding.

  • Infection.

  • Allergic reaction to the iodine used.

SEEK MEDICAL CARE IF:

  • You develop a rash.

  • You develop abnormal vaginal discharge.

  • You develop itching or irritation of the vagina or vulva.

  • You become dizzy or lightheaded.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop heavy vaginal bleeding.

  • You develop a temperature of 100° F (37.9° C) or higher.

  • You pass out.

  • Any new problems develop.