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When is a cervical biopsy indicated during erosion, how is the biopsy taken and how is the recovery period?

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Uterine biopsy is a medical procedure. This is the name of taking a piece of tissue to make an analysis of cancer cells. The procedure is carried out in cases of suspected oncology and even ordinary erosion (gynecologists often send all patients with erosion to laser burn, but ideally should only do this after a series of tests). In addition, this action is often appointed absolutely without any evidence: for example, a biopsy of the cervix during erosion, which proceeds without complications, colposcopy and ectopia is absolutely not necessary.


Indications for the procedure

Before the gynecologist will write you a referral, you should definitely do a colposcopy. If, according to the results, white-colored epithelium areas were detected (this is checked with acetic acid), a woman is given a biopsy. We repeat once again: a biopsy of the cervix is ​​not done during erosion!


Contraindications

If you suffer from acute inflammatory diseases, a biopsy will be possible only after complete recovery. Women with bleeding disorders are better off, if possible, to avoid such procedures.

How to prepare for the procedure?

First of all, visit a gynecologist and take a smear to make sure there are no infections. In addition, blood tests should be done for RW, hepatitis C and human immunodeficiency virus. After analysis in the cervix will remain a small wound. This is one of the reasons for not performing such an operation as cervical biopsy during erosion. Ideally, the wound should heal before the woman begins critical days. That is why the procedure is usually prescribed in the first phase of the cycle. You should not do it before the onset of menstruation: an infection can get into the wound and the tissue will inflame.

Biopsy Methods

Perhaps the most common method among doctors is to take a piece of tissue with a scalpel, then stitches are applied to the place where the tissue is taken from. Another biopsy method is a radio wave loop (using the Surgitron apparatus). The disadvantage of this option is that a piece of tissue taken may be damaged, which makes histology difficult. In addition, for about ten days after that, the woman may experience vaginal discharge. However, we should not forget that this method is much less painful and completely non-traumatic. Therefore, if you have a high pain threshold, your doctor will prescribe it for you.


Before the procedure, the doctor must obtain written consent from the patient. He is obliged to warn her about contraindications (in particular, that a biopsy of the cervix is ​​not shown during erosion) and possible side effects. Many women are interested in how painful the procedure is. In general, it all depends on personal portability. If there are several areas from which the tissue is taken for analysis, and they are very large, you can ask the gynecologist for local anesthesia (the cervix is ​​sprayed with lidocaine or an injection is given to it). To prevent spasms, the patient should be in the most relaxed state.

What not to do after the procedure?

After taking the tissue for analysis for at least a month, do not use tampons and do not have sexual contacts. You should also refrain from visiting the bath, sauna and hot baths. Do not lift weights and do not overstrain. If the biopsy did not produce results, and the unpleasant symptoms continue to bother you, it is possible that you have nothing but erosion of the cervix after childbirth. In this case, the gynecologist will prescribe the appropriate treatment.

Indications for study

Erosion biopsy should not always be done. Usually, for such a diagnosis it is enough to pass a Pap smear and undergo colposcopy.

The study is appointed only if, along with erosion or pseudo-erosion, the so-called suspicious colposcopic signs were found:

  • the sites which are not painted by iodine after Schiller's test,
  • white areas after exposure to acetic acid solution.

A biopsy of the cervix during erosion confirms or refutes this diagnosis, and is also used to exclude precancer and oncopathology.

Features of the procedure

Biopsy is done on the 5-7 day of the menstrual cycle immediately after the end of menstruation. This is necessary to heal the wound before the next menstrual flow. Otherwise, the risk of infection in the cervix increases, as well as the likelihood of further endometriosis.

Material collection is possible only in the absence of infectious diseases. Therefore, preparation for cervical biopsy involves a smear on the microflora. If an infection is found, the woman is first prescribed the appropriate treatment, and after recovery, a biopsy is performed.

The procedure is performed on an outpatient basis for several minutes.

Does it hurt or not to perform a cervical biopsy in the presence of erosion?

This study is painless, since there are no sensitive nerve endings in the neck, so it is performed without anesthesia. Unpleasant sensation may be associated with the introduction into the vagina gynecological mirrors. In addition, in response to the action of the instruments, the uterus may contract slightly, which causes short-term discomfort in the lower abdomen.

Biopsy should be carried out under the control of colposcopy. The cervix is ​​treated with Lugol's solution, while the pathological areas remain light. For a more accurate material capture, the neck is inspected under magnification with a colposcope.

Preparation for the study

2 days before the biopsy, it is necessary to abandon the use of vaginal tampons and replace them with sanitary pads. It is recommended to wash every evening with warm water and soap, avoiding douches. Suppositories and vaginal tablets can only be used as directed by the doctor. 2 days before the manipulation should refrain from sexual intercourse.

Perineal shaving is usually not required, but this question can be clarified with a gynecologist.

Before a biopsy, tests are taken to exclude the infection process in the vagina and the nearest organs:

  • general blood analysis,
  • smear on flora (gonorrhea, trichomoniasis),
  • tests for mycoplasmosis, ureaplasmosis, chlamydia, HIV infection, syphilis, hepatitis.

Blood coagulability is checked using a coagulation test.

Before biopsy, colposcopy is necessary to clarify the location of the material intake.

The study is not conducted with acute inflammatory diseases of the genital organs, during menstruation, as well as during pregnancy. Erosion is not so dangerous a condition as to risk the health of the unborn child.

Before the intervention, the following facts should be reported to the doctor:

  • list of medications taken, especially for blood thinning,
  • allergic to drugs or food,
  • blood diseases in family members or in the patient herself,
  • concomitant diabetes, hypertension or ischemic disease,
  • transferred thrombosis of deep hair dryer, thrombophlebitis, pulmonary thromboembolism.

Variants of the procedure

Material for microscopic examination can be obtained in various ways. How to take a biopsy of the cervix with erosion:

  • most often, special forceps are used (conchote), allowing you to take pieces of tissue from different parts of the cervix - in this case a spray with lidocaine is applied to the surface of the body for pain relief,
  • puncture biopsy is performed with a needle, which gets a portion of the modified tissue,
  • It is possible to obtain a biopsy material during the erosion treatment using the Surgitron device using radio waves (radio wave biopsy), after such a procedure scarring of the neck does not remain, which makes it possible to use radiohead in young women, but the quality of the material obtained is not always good,
  • other options - laser and loop biopsy - are used less often, the laser is well tolerated, but requires intravenous anesthesia, after a loop electroscission, scars may remain on the neck, which further interfere with the child's bearing,
  • The most reliable way to obtain tissue for research is to excise the suspicious area with a scalpel.

In the latter case, the study is assigned to women who have already given birth and do not plan children. Such manipulation is performed under local or intravenous anesthesia, and in some cases carried out in the hospital.

How is a biopsy done?

When erosion biopsy is carried out on an outpatient basis, in the gynecologist's office. The patient is located on the gynecological examination chair. With the help of mirrors, the doctor expands the vagina and examines the neck well. The mucous membrane is cleaned with a cotton swab moistened in sterile saline. At this stage, colposcopy with Schiller's test can be performed.

If necessary, an anesthetic is introduced into the cervical region or sprayed as a spray. Then a small piece of tissue is excised from a suspicious area by any of the methods listed above. It is placed in a sterile solution and sent to the laboratory.

Place a biopsy with a swab is treated with an antiseptic. When the site is bleeding, it is treated with a solution of silver nitrate. Then the area of ​​the external genital organs is disinfected. The wound on the mucous membrane of the cervix is ​​very small, the stitches on it do not impose.

The study lasts no more than half an hour, then the patient receives the recommendations of the doctor and goes home. Repeated reception to assess the state of the genital organs and familiarize the patient with the results of the study is appointed after 2 weeks.

Recovery period

In most cases, the procedure is safe and does not cause complications. Within 3-5 days, there may be scant bleeding from the vagina, gradually ending.

Risk factors for complications after biopsy:

  • excess weight,
  • long experience of smoking
  • elderly age,
  • high blood sugar
  • kidney and liver failure
  • high blood pressure,
  • chronic lung disease
  • malnutrition and anorexia,
  • frequent nosebleeds,
  • autoimmune diseases
  • immunodeficiency.

If a woman has one or more of these factors, she may have such negative effects as a cervical biopsy in diagnosing erosion:

  • bleeding lasting more than a week
  • unpleasant smell of discharge
  • change their colors
  • stomach ache,
  • increase in body temperature to 37.5 degrees or more,
  • feeling unwell.

If these symptoms appear, you need to contact a gynecologist.

These signs do not occur if the woman complies with all the doctor’s prescriptions: it is not recommended to use douching, vaginal tampons. During the same period is not recommended sex.

At this time, you should not lift items weighing more than 3 kg, visit the bath, pool, sauna and take a hot bath.

When a weak aching pain in the abdomen, you can take the usual painkiller, for example, Paracetamol or No-shpu.

The doctor may prescribe some medications that accelerate the process of recovery of the mucous membrane:

  • vaginal suppositories of Terzhinan for the prevention of infection,
  • tablets Metronidazole inside for the same purpose,
  • Rectal suppositories Genferon, which improve local immune protection and accelerate wound healing,
  • vaginal suppositories Betadine, effectively acting not only on bacteria, but also on fungi and viruses.

From the 10th to the 20th day after the procedure, preparations are prescribed that improve tissue regeneration processes and prevent the formation of scars:

  • vaginal suppositories Depantol,
  • vaginal suppositories with immunostimulating action Galavit.

After an erosion biopsy, the woman is usually able to work the next day. Only with the knife removal of a significant part of the neck in a hospital, the period of disability can be several days.

After a knife biopsy, a small scar may remain on the mucous membrane. Sometimes it interferes with fertilization by deforming the cervical canal. In other cases, the scar tissue cannot stretch well during childbirth, making it difficult for them to flow naturally. However, during erosion, the volume of the biopsy material is very small, so gross cicatricial changes do not occur.

results

Why take a biopsy of the cervix with erosion?

The main goal of this study is to exclude concomitant precancer or cervical cancer. According to the microscopic examination of the cells, the doctor can determine the following changes:

  • dysplasia of varying severity,
  • atypical or simple leukoplakia,
  • malignant tumor
  • polyps
  • inflammation,
  • erosion.

The study should be carried out by carriers of oncogenic types of human papillomatosis for the timely recognition of early precancerous changes. Thus, the test results do not normally indicate the presence of cervical intraneoplasia. In case of complications due to ectopia (pseudo-erosion) or true erosion (ectropion), the decoding includes data on CIN I-III degrees. This is already a precancerous condition.

True erosion during biopsy is characterized by the appearance of a defect (damage) in multilayered epithelium lining the surface of the cervix. At the bottom of the eroded surface, granulation (connective tissue) grows and leukocytes accumulate. There is a plethora of arteries and swelling of the surface layers of the mucous membrane. True erosion often heals on its own.

Pseudo-erosion occurs when the cylindrical epithelium from the cervical canal extends beyond the outer uterine pharynx and forms a circle on the vaginal part of the cervix. Ectopia, or pseudo-erosion, can be of three types:

  1. Ferruginous.
  2. Papillary.
  3. Immature squamous.

The first type is characterized by the presence of glandular formations under the epithelium. The branching glandular passages are lined with high cylindrical epithelium. Microscopic signs of inflammation are expressed around these glands. When papillary ectopia, expanding papillae are formed, formed by the underlying connective tissue and covered with cylindrical epithelium.

The difference in the microscopic picture makes it possible to distinguish between true and false erosion. These conditions have different causes and methods of treatment.

After receiving the results of the biopsy, it is necessary to discuss with your doctor what further steps to treat the detected erosion. If signs of cervical intraneoplasia are found in the material, this will require in-depth diagnosis.

If the colposcopic picture and biopsy in a woman with erosion is within the normal range, the risk of developing cervical cancer is small. This patient is recommended to regularly do Pap smear. If the Pap test, colposcopy and biopsy showed different results, another biopsy is performed with more tissue removed.

The result of a biopsy can be given to another doctor to form a so-called “second opinion”. This will not only reduce the likelihood of a diagnostic error, but will also help the treating gynecologist create the correct treatment plan for the patient. "Second opinion" on the results of the biopsy can be obtained in different clinics, including foreign ones, by sending samples by mail.

What is it and is it necessary to do this procedure?

A cervical biopsy during erosion is not performed on every patient. Why do biopsy?

Histological examination of biological material reveals the pathology and abnormalities of the tissue, confirms or refutes the likelihood of a precancerous condition or cancer of the cervix.

Gynecological diseases that can be detected as a result of cervical biopsy:

  • Cervicitis (endocervicitis) - inflammation of the mucous canal caused by various sexually transmitted infections.

  • Carcinoma - Malignant disease of the cervix.
  • Cervical metaplasia - precancerous disease, in the absence of proper diagnosis and treatment can lead to serious consequences.
  • Dysplasia - a violation of the cellular structure of the cervical epithelium, a frequent form of the precancerous condition of the female organ.

Dysplasia of the second and third stage is precancerous: urgent surgical intervention is required.

Histology and cytogram - what is it and how do they differ from each other?

Histological examination is carried out on the basis of a study of the structure of tissues taken by biopsy.. Histology helps to accurately determine the presence or absence of inflammatory diseases, atypical cells and neoplasms. Usually, the study is performed within two weeks, but in case of emergency, a rapid analysis can be performed in 40 minutes.

A cytogram is a diagnostic procedure. From the surface of the cervix is ​​taken scraping for the study of cells, not tissues. The sample is taken using sterile gynecological instruments. The process is virtually painless, takes only a few seconds.

In any case, these studies can replace and complement each other. Исследования позволяют достоверно поставить диагноз при подозрении на раковую опухоль and other dangerous diseases.

How to prepare for the procedure?

To prepare for the procedure it is necessary:

  1. To hand over all analyzes appointed by the doctor.

  2. Confirm written consent for biopsy.
  3. Give up sex two days before analysis.
  4. Two or three days before the sample is taken, do not douche, do not use tampons and do not inject drugs into the vagina.
  5. Take a shower before the procedure.

How is it done, is it painful to take a piece of cloth or not?

The procedure is most often performed without anesthesia and is rather unpleasant rather than painful.. In some cases, local anesthetics may be used for pain relief.

A cervical biopsy is performed on the 7–13 day of the cycle so that the wound can be delayed before the beginning of the next menstrual period. A doctor using local anesthesia or without it cuts off a small piece of tissue from the mucous membrane.

How to take a biopsy? Material for the study is taken from the most suspicious areas of the mucous. To take a piece of cloth, use special tweezers or a scalpel, with which the affected area is simply pinch off. Next, the cervix is ​​treated with a special solution.

The procedure is a bit unpleasant, but quite tolerable. A tissue sample is sent to the laboratory for detailed examination. and study.

Deciphering test results

The test results are given to the patient in the form of a written opinion. They are not recommended to be decoded independently, and it is unlikely to work: all information is written in Latin using medical terminology.

It is necessary to show them to the gynecologist, who can correctly assess the state of health of the reproductive system, relying not only on the data obtained from the laboratory, but also on the results of colposcopy. In addition to deciphering the tests, the doctor will prescribe a treatment. or give recommendations on how to prevent the development of complications.

Often, women face the conclusion “cytogram corresponds to endocervicosis,” but they do not understand what this means. This conclusion suggests that during the study of the cellular composition of the detected signs of endocervicosis. This pathology, in which there is a violation of the normal location or integrity of the epithelial layer of the cervix.

Endocervicosis occurs in every second woman, this is a pseudo-erosion (or ectopia) of the cervix. It causes hormonal disorders, inflammation or injury, and any other causes of any erosion. The diagnosis of mucosal endocervicosis is considered final only after the conclusion of a cytological study of the cellular composition of the affected area.

The method is effective in the diagnosis of precancerous and cancer diseases of the female reproductive system. But do not be immediately afraid: doctors usually prescribe a biopsy in case of serious suspicion for the purpose of excluding them.

Indications for biopsy

The procedure is often prescribed for dysplasia, erosion and ectopia. Most clinics use the cautery method only after taking the biomaterial. If the results of the pap test and cytology of colposcopy were positive, there is no need to take a puncture. Analysis of oncology is done if there are suspicions of any negative changes in the body. Indications for biopsy can be:

  • hyperkeratosis,
  • condylomas
  • polyps
  • suspicious changes in the organ during colposcopy, for example, iodine-negative zones (areas that did not turn brown after treatment with iodine), acetowhite tissues, atypical vessels, and others,
  • negative cytology smear results.

Contraindications

The list of reasons for which women may be contraindicated in the analysis is not numerous. Contraindications are due to the presence of pathologies of the reproductive system and the patient's body. The main prohibition on biopsy is poor blood clotting. Taking tissue from the cervix is ​​a minor surgical procedure, but the procedure can cause severe uterine bleeding. This body reaction is due to the presence in the body of a large number of small vessels, as features of the endometrium (uterine mucosa). Biopsy do not:

  • in the presence of acute inflammation in the body of a woman,
  • patients with venereal diseases (gonorrhea, trichomoniasis, chlamydia, HPV, others),
  • during pregnancy.

Biopsy Types

The best outcome of the procedure is complete removal of suspicious cervical tissue (if the lesion occupies a small area of ​​the organ). In other cases, it is required to take puncture from different parts of the organ, which implies cutting out 2-3 samples in one procedure. Depending on the individual characteristics of the patient's body, the doctor uses one of the existing types of biopsy:

  1. Sighting (colposcopic). Through a special tool of the colposcope, which is a tweezers, a small piece of cloth is taken. The wound heals completely within 4-5 days after the procedure.
  2. Loop (radio wave). A painless method of taking analysis, which is carried out using a special apparatus. The patient does not need further rehabilitation.
  3. Knife (cononization). The tissue is taken through a hardware wedge-shaped excision of a piece of tissue. The method is used not only for diagnostics, but also for the treatment of pathological areas (their removal).

Erosion Test

The greatest number of diseases of the cervix uterus - the erosion of this organ. However, the doctor must ensure the accuracy of the diagnosis, excluding the possibility of simple focal inflammation, often found on the surface of the uterine cervix. Patients should remember two basic rules: an examination (initial examination) should be carried out exclusively by means of a colposcope, and a wrong diagnosis and inappropriate treatment leads to the development of cancer.

Erosion biopsy is the only method that allows you to verify the accuracy of the diagnosis. The study will help eliminate the pre-and actual cancer changes in the damaged areas of the cervix, to choose the right treatment tactics. Statistics show that in 90% of cases the diagnosis of cervical erosion is confirmed, and the remaining 10% are due to other diseases such as chronic cervicitis, dysplasia or metaplasia.

Biopsy target

The procedure is the selection of a small piece of tissue from the area of ​​the cervix on which damage was detected during colposcopy. After the biopsy is done, the sample is examined under a microscope and it is ascertained whether cells of an atypical structure are present (that is, a precancerous condition is observed), or whether the pathology is malignant.

Features of the biopsy

A biopsy is performed the next day after the end of the menstrual period (approximately on the 7th day of the cycle) so that by the beginning of the next menstruation, the wound in the sampling site is delayed. In this case, the risk of infection falling into it during the following periods is reduced. In addition, penetration of menstrual blood into an unhealed wound on the cervix can lead to the development of genital endometriosis.

The duration of the procedure is usually a few minutes. Depending on the technique used, the biopsy is performed on an outpatient basis (if local anesthesia is used) or in the hospital (when tissue is taken under general anesthesia).

The procedure is controlled by a colposcope - a device that makes it possible to produce optical magnification and illumination of the surface of the vagina. The selected material is placed in a formalin solution and sent to a laboratory for histological examination.

Is the biopsy procedure painful?

Since the nerve endings in the cervix are absent, strong pain during the selection of material during erosion does not occur. Depending on the method of biopsy and the vastness of the site of erosion from which the sample is taken, the procedure is performed without anesthesia or with local anesthesia (lidocaine is injected). Contractions of the uterus, which reflex occur when exposed to the cervix, can cause a slight discomfort in the lower abdomen.

Preparing for a biopsy

Before the appointment of the procedure, studies are conducted to determine blood clotting, as well as blood tests, urine and mucus from the vagina and cervix to detect infections and inflammatory processes. In this case:

  • general blood and urine analysis
  • biochemical analysis of blood sugar, urea, liver enzymes,
  • coagulogram (blood test for clotting),
  • smear for microscopic examination of the composition of the vaginal microflora,
  • blood tests for syphilis and other sexually transmitted infections, as well as for HIV and hepatitis viruses.

In the absence of contraindications for biopsy, the day of the procedure is appointed. In this case, a week before its implementation, it is necessary to abandon the use of blood thinning medications (aspirin, warfarin, ibuprofen). The day before the procedure it is necessary to stop using tampons, douching, use of vaginal tablets and suppositories for erosion.

Before the start of the manipulation, the woman should warn the doctor about the presence of any drug or food allergies, hypertension, heart disease, diabetes mellitus, vascular pathologies. It is also necessary to report on previous operations to remove the appendix, gallbladder and, in particular, the complications that have arisen.

In some cases, at the request of the patient or if the area of ​​the cervix uteri is too large, the biopsy is performed under general anesthesia in the hospital. At the same time, it is necessary to stop the ingestion of food, liquids and any medications 12 hours before it starts.

Biopsy and possible complications

Before the procedure, the neck is irrigated with lidocaine spray or an injection of lidocaine into her muscle. The expander is installed into the vagina, through which the tools for manipulation are inserted. In the case of suspected erosion, the test surface is treated with acetic acid or iodine and a sample is taken. After that, a suture is imposed or vascular coagulation is performed using various methods.

Complications after the procedure

As a rule, complications after the manipulation does not occur. Within a few days, a woman may have small amounts of blood in the discharge, then the condition returns to normal. In rare cases, there are more prolonged bleeding and abdominal pain, indicating poor healing.

It is possible to change the color of the discharge and the appearance of an unpleasant odor (which indicates infection of the wound and the occurrence of the inflammatory process). After the procedure, a slight increase in body temperature is possible.

The occurrence of complications can be triggered by a decrease in immunity as a result of previous diseases, poor nutrition, stress. A woman must inform the doctor about all such ailments.

May be prescribed the use of vaginal suppositories with antibacterial drugs (terzhinan, metronidazole), antiviral agents (betadine). To improve the immune defense and speed up the healing process of tissues, rectal suppositories Genferon are prescribed.

Recommendations after the procedure

In order for the healing to take place as quickly as possible and no complications arise, the doctors recommend the woman to follow certain rules after a neck biopsy. It is necessary in the next 4 weeks to avoid nervous and physical fatigue, stay in the sauna, under the rays of the sun. You can swim only under a warm shower.

Gaskets should be used as hygienic products; tampons should not be used. You can not hold douching, use any ointments and suppositories not prescribed by a doctor. During the recovery period, sexual intercourse should be avoided.

What is it, is it necessary and why do

By itself, erosion of the cervix is ​​asymptomatic. As long as the lesion is small, the presence of a hidden problem does not affect the functioning of the reproductive system.

However, the site of erosion is nothing but a center of chronic low-intensity inflammation, which can lead to very serious complications.

Erosion is almost an ideal entrance gate for various infections.which can penetrate the uterine cavity, reach the tubes and infect the ovaries, thereby questioning the ability to bear children.

Among the possible complications:

  • leukoplakia, epithelium keratinization,
  • transition to the bleeding stage.

Both conditions are prone to malignancy. Biopsy - the most informative method, giving the opportunity to assess the risks for the patient as accurately as possible in time and prescribe appropriate treatment for the case.

Cytology and Histology

Cytological studies - The easiest, fastest and most affordable way to early diagnosis of cancer.

In gynecological practice Papanicolaou method, PAP test is widely used.

For women who have sex, this test should be carried out annually, if there are suspicions of certain gynecological pathologies every six months.

To study the doctor takes a smear from the mucous membrane of the cervix, vaginal walls and urethra.

Samples of epithelial cells are fixed on a glass slide and sent to the laboratory.

After staining with a special technique, the laboratory technician examines the smear under a microscope and compares what he saw with the standard table for assessing the risk of the oncological process. Preliminary preparation for the selection of material is not required.

Histological examination appointed with more severe symptoms. Indications for histological analysis are irregularities on the mucous membrane of the cervix uterus, leukoplakia, erosion bleeding, neoplasms.

In contrast to cytological analysis, tissue fragments are examined, and depending on the characteristics of their structure, a conclusion is made about the nature of the neoplasms and treatment tactics are developed.

Histological analysis is one of the most accurate. methods of early diagnosis of cancer.

Features of cytological and histological studies:

How to prepare for the event

The optimal period for biopsy sampling is the second week of the menstrual cycle.. The date is calculated by the gynecologist, given the need for a preliminary examination of the patient.

The standard scheme of diagnostic measures includes:

  • blood tests (general, blood clotting, the presence of viral infections),
  • smear on flora,
  • Wasserman reaction,
  • Pap test.

If inflammatory diseases are found in the patient, treatment is prescribed, the duration of the biopsy changes.

Within two days before the procedure abstinence is recommended, the procedure is performed on an empty stomach.

Biopsy of the cervix and its types

Biopsy is one of the most informative diagnostics, allowing to detect the presence of cancer cells and serious inflammatory diseases in a timely manner. The accuracy of the results of histological examination is 99%. Other examinations and confirmations of the diagnosis after a biopsy are not required.

To determine the nature of pathogenic tumors and the state of the epithelial layer, a sample is taken from the damaged areas of the cervix. Pathology is detected at the tissue and cellular level. A piece of cloth pinch off or cut with special tools. Different methods are used for sampling biological samples:

  1. Puncture biopsy. The sampling is done with a biopsy needle capable of holding a column of cells. For the study take the most suspicious areas of tissue. General anesthesia and anesthesia is not required.
  2. The radio wave procedure is based on the use of the Surgitron apparatus. The operation is done with a radio wave knife, which leaves no serious damage. Complications are minimal, in very rare cases, scarring remains on the neck. This method is most often applied to unborn women.
  3. Laser biopsy is performed using a laser beam. This method is low-impact, has no complications and does not cause unpleasant painful sensations to the patient.
  4. Loop or electrosurgical operation is performed using a special loop through which electrical impulses pass.
  5. A knife or wedge biopsy is done with a surgical scalpel. Tissue samples are triangular. The cuts make it so that they take the most suspicious layers.

When choosing a type of biopsy study, doctors are guided by a preliminary diagnosis, indications and general state of health of the patient.

Indications and Contraindications

A cervical erosion biopsy is done to differentiate benign and malignant tumors. The procedure is prescribed for any suspicion of pathological abnormalities in the structure of the cervix. As indications most often are:

  • dysplasia (detection of atypical epithelial cells, a precancerous condition),
  • poor (doubtful) cytology smear results,
  • polyps
  • the appearance of ectopia (pathological changes in the vaginal mucosa of the cervix),
  • leukoplakia (thickening and coarsening of the squamous epithelium),
  • mucosal changes identified during gynecological examination: acetowhite epithelium, atypical blood vessels, iodine-negative areas.

Любой из способов лечения эрозии шейки направлен на разъедание пораженных (больных) клеток. The results of the biopsy show how justified certain methods of influence on the damaged area. In some cases, this procedure is contraindicated. Cell sampling is not carried out if the woman is menstruating, there are problems with blood clotting, infectious and inflammatory diseases of the genital organs are diagnosed, heart failure and vascular pathologies are found.

Pregnancy is considered a relative contraindication. Immediately after conception, the procedure is undesirable.

In the early stages, a biopsy can lead to miscarriage, and in the later stages cause premature labor. The most safe for the collection of cells is considered 2 trimester. Gynecologists explain the need for biopsy in carrying a child by the fact that when cancer cells are detected, pregnancy is interrupted in some cases. This is done to save the woman’s life.

How is the procedure

The procedure is carried out in a gynecological chair. Sampling is done with special tools. During a biopsy, cervical erosion of the woman feels unpleasant slander. Short-term discomfort provokes uterine contraction. There are no pain receptors on the surface of the cervical mucosa, so the patient does not feel any painful sensations.

Biopsy test under local anesthesia is carried out on an outpatient basis. After the procedure, the woman can go home and do the usual things. If general anesthesia is planned, the patient is placed in the hospital.

Trepanobiopsy

Sighting trepanobiopsy is one of the most common ways to take a sample. The fabric is collected using a special needle. For the study taken small pieces of tissue from different erosion sites. This is done to identify differences in the structure of the layers of the epithelium. This method of biopsy of erosion is resorted to in cases where colposcopy showed the presence of a large lesion of the uterine mucosa.

The method of conization is used to detect visible pathological epithelium areas. The sample is taken from the neck with a scalpel, laser and other medical devices. A piece of tissue cut out in the shape of a cone is sent to a laboratory for histological examination.

Biopsy: what is it?

What is a cervical biopsy? This is a diagnostic procedure, in the process of which the doctor takes a sample from the affected area, for a histological examination. The purpose of this type of analysis is to identify the presence of oncological formations and other, no less negative pathologies. It is worth noting that the accuracy of such a survey technique is 99%.

Important: Material sampling for histological examination is performed only before the planned cauterization.

A biopsy during erosion is indicated for treatment, if the doctor during the examination reveals atypical lesions on the organ. This type of study allows you to identify all the negative processes that the cervix has undergone and promptly eliminate them.

When biopsy is indicated

A biopsy of cervical erosion is prescribed if, during routine inspection, the patient has an inflammation of the organ and areas with dead and keratinized tissue are found on its surface. A similar condition can signal the development of the following pathologies:

  • leukoplakia,
  • dysplasia of varying degrees
  • the formation of polyps
  • malignant neoplasms.

Important: Material sampling for the study of pathological conditions should be carried out only under the control of colcoscopy. Using a kolkoskop body inspect for more accurate sampling.

The feasibility of the procedure is established after an extended colcoscopy. In parallel, the reaction of the damaged zone to treatment with certain solutions, such as acetic acid or lugol solution, is checked. If the zones are not stained with iodine or are converted to a white color after the application of acetic acid, this is a signal for the mandatory biopsy. Material intake is taken in order to confirm or deny the presence of dangerous pathologies.

Preparation for the survey

To obtain reliable data, a woman should be properly prepared to perform such a survey:

  • 2 days before the biopsy, you should stop using tampons, replacing them with gaskets,
  • 2 days before the examination in question exclude intimate contacts,
  • per day stop douching,
  • It is recommended to wash only with warm water and soapy water,
  • not to eat food 12 hours before the planned procedure,
  • reduce the amount of fluid consumed per day,
  • use vaginal suppositories should only be if they are prescribed by a doctor.

Important: If the patient has poor blood clotting, this procedure is contraindicated.

In addition, before collecting a biomaterial, a woman will need to be tested to exclude an infection process:

  • general analysis
  • swabs on the flora,
  • blood tests for HIV, hepatitis and syphilis.

Before the material is collected for examination, the gynecologist performs a colcoscopy in order to clarify the point from which the fragment of the neck is to be collected.

Important: They refuse to carry out such a manipulation, if a woman has an acute inflammation of the reproductive system, during menstruation, during the waiting period of the child.

Before the procedure, the patient should provide information to the doctor about the following points, if any:

  • list of drugs used
  • Are there any allergies to products or dosage forms?
  • whether the patient suffers from blood disorders
  • whether a woman is subject to such illnesses as hypertension, ischemic disease or diabetes.

In addition, the specialist should be informed about pulmonary embolism and transferred thrombosis, if any.

Methods of material sampling

How to take a biopsy of the cervix with erosion? There are several techniques for performing this procedure. Consider the most popular:

  1. The first, most popular, material sampling is performed with the help of special tongs. With this technique, the surface is pretreated with lidocaine for pain relief,
  2. The second, equally common method, needle biopsy. The fence is performed with a thin needle,
  3. You can get the material for the study and the radio wave method. But the quality of the fabric obtained will not always be satisfactory. Moreover, this method is the most gentle for young patients planning a child in the future,
  4. Loopback and laser material sampling method. Such methods are well tolerated by patients. However, they are rarely used, since there is a high probability of scar formation,
  5. And the last most reliable way is to excise the part with a scalpel.

Important: Choosing a method of biopsy, the doctor takes into account the age category of women and the degree of development of the wound area.

Loop and knife biopsy is not suitable for those representatives who want to endure and give birth to a baby in the future. After such techniques, scars are formed on the neck, which impede conception or may complicate labor activity in the future.

Possible complications

Basically, after carrying out the survey methodology, negative effects do not occur. Initially, there may be blood discharge in a small amount, which within a week will completely disappear. More rarely, but the following phenomena are possible:

  • bleeding for a long time and severe discomfort in the lower abdomen indicates that the wound heals poorly,
  • if the discharge has changed color and an unpleasant putrid odor has appeared - this is a signal that the wound was infected,
  • An increase in body temperature also signals inflammation.

Often, complications provoke a weakening of the protective functions of the immune system due to previously suffered pathologies, malnutrition or due to frequent stresses. If the patient has similar ailments, you should immediately visit a doctor.

Recovery period

To heal the wound area, the patient should follow a number of specific rules:

  • the first month after the biopsy is contraindicated for severity, nervous exhaustion and visiting the bath,
  • exclude during the month bathing. You should wash under a warm shower
  • the first 3 months is desirable to use pads instead of tampons,
  • it is categorically contraindicated douching and the use of any ointment without the appointment of a gynecologist,
  • for the period of recovery intimate contacts are contraindicated,
  • if weak pains of a whine character bother you, you can take No-shpu or paracetamol.

For the rehabilitation period, the doctor prescribes a number of medicines that promote rapid healing. These include the following:

  • vaginal suppositories of Terzhinan and metronidazole tablets are shown to prevent infection;
  • for intensive healing and immunity, suppositories for rectal administration are Genferon,
  • Betadine vaginal suppositories are shown to prevent the occurrence of fungi, bacteria and viruses.

This therapy is followed the first 10 days. Then, starting from the 11th day, they use agents that improve the processes of cell renewal and prevent the formation of scars on the organ. The most effective are the following:

After the manipulation the next day, the patient can begin her daily duties. An exception is the method of excision of tissue sites by the knife method. This variant of the procedure is performed only in the hospital. After that, the woman remains under the supervision of a doctor for two more days.

After excision of a fragment using a knife, a scar often forms on the mucous membrane, which can cause difficulties in conceiving a baby.

The feasibility of biopsy in pathologies of the cervix uterus

What is erosion? Under this term hides a lot of dangerous states, including ectopia itself. Due to numerous studies it was possible to identify, erosion is quite common. But this condition does not always require treatment.

Modern gynecologists say ectopia - this is not a defective condition of the epithelium, and not even an ulcer, transforming into a malignant neoplasm. Such a pathology is asymptomatic and it is often possible to identify it only during routine examination. But at the same time, the ectopic zone is very vulnerable to infections. Any virus or bacterium, entering the vaginal environment, infects erosion, as a result of which the wound site is transformed into a complicated course. Then the pathology requires additional examination and observation.

Important: Cells from the dislocation area of ​​erosion should be examined for cancer.

A biopsy is not assigned to all representatives of the beautiful half of humanity. As a rule, this type of diagnosis is assigned only to those who are at risk of the formation of malignant tumors. This group includes women with:

  • promiscuity,
  • early start of intimate life,
  • papillomavirus,
  • endured abortions in large numbers
  • HIV infection,
  • hormonal failure,
  • there are frequent inflammations of the genitals.

If erosion is diagnosed in patients at risk, an examination is mandatory:

  • conducting colcoscopy,
  • taking a smear on the definition of atypical cells,
  • advanced analysis of oncogenic types,
  • other examinations by appointment of the attending gynecologist.

After receiving the data, the woman should discuss her steps regarding the elimination of erosion. If the material reveals signs of cervical pathology, this condition requires further detailed examination. In the case when the data obtained indicate acceptable limits and the likelihood of developing cancer education is negligible, a woman is recommended to undergo a regular check-up with a Pap smear.

Summarizing the above, it should be emphasized that biopsy is one of the most informative types of examination, which the patient should not refuse when erosion is detected with suspected severe pathology. Material is being sampled for research with virtually no pain. At the same time, laboratory tests of bi + optata help to get an accurate picture of the state of the tissues.

The essence of the problem

Erosion of the cervix is ​​a damage to the vaginal section of the mucous membrane of the organ. It can be expressed in the form of ulceration or other defects that violate the integrity of the layer.

The worst complication is the risk of transformation into an oncological neoplasm.

The etiological mechanism of the appearance of uterine erosions is triggered by such factors, as:

  • hormonal imbalance
  • weakened immunity
  • menstrual disorders,
  • excessively early sexual intercourse and early childbirth,
  • promiscuity in sexual intercourse and frequent changes of partners,
  • violation of the elementary hygiene of the intimate zone,
  • mechanical injury - abortion, improper douching and use of contraceptives, disturbances during medical procedures, perverted sex,
  • frequent inflammatory processes and infectious lesions of the urogenital system and improper treatment,
  • viral and bacterial diseases,
  • genetic predisposition.

By etiological nature, there are 3 main types of erosion:

The most dangerous is the last species, which is prone to malignancy.

Symptoms of pathology

The disease often develops without obvious manifestations and has uncontrolled flow for a long time. Only periodic gynecological prophylactic examinations help to reveal it.

As the pathology progresses, such the symptoms:

  • vaginal discharge with blood or purulent impurities (often after sexual intercourse),
  • unpleasant smell of discharge
  • the emergence of longer and more intense periods,
  • pain in the lower abdomen during urination and during sexual intercourse.

Gynecological examination reveals such obvious signs as spots on the bright red epithelium. If you click on them, then the bleeding begins.

What is a biopsy

Biopsy is a diagnostic procedure based on the selection of a mucous membrane sample for in-depth laboratory studies.

Take a biopsy in several ways:

  • simple or puncture biopsy. The most commonly used special forceps (conchote) or puncture needle. The essence of the procedure is to cut a small piece of tissue in 3-4 points. The procedure can be carried out without anesthesia or with the use of an anesthetic spray,
  • endocervical curettage. The technology involves the scraping of secretions from the surface of the endocervix using a special tool - curette,
  • loop electroscission. It is carried out by trapping a small loop of epithelium with a wire loop and cutting it off by passing an electric current through the wire,
  • radio wave and laser technology. These are modern ways of cutting a fabric with a laser beam or “radio knife”,
  • wedge biopsy (conization). This type of procedure is the most extensive and consists of cutting out a wedge-shaped tissue sample. The most reliable tool is used - the scalpel. The procedure is performed with local anesthesia.

What does the study

The main task of the biopsy is to establish the presence of pre-cancerous premises or developing oncology. It allows you to identify a cancer at an early stage, to clarify the diagnosis, to differentiate the pathology.

Laboratory studies of samples (biopsy) allows to identify such violations as:

  • malignant formation,
  • dysplasia and its degree,
  • leukoplakia (typical or atypical type),
  • polyps
  • zrozii,
  • inflammatory process.

The biopsy results help to clarify the type of erosion, which allows you to properly establish a treatment scheme.

In particular, the congenital species does not require special treatment. With pseudo-erosion, there is a high likelihood of palpitations, and, therefore, urgent measures are necessary.

In addition, the biopsy allows to identify papillomas and their carcinogenicity. Thus, the presence of oncological prerequisites is assessed.

When the procedure is assigned

In all cases, if erosion prescribe a biopsy?

In principle, a biopsy can be considered a small, minimally invasive surgery, and therefore it is not done to all women who have cervical erosion.

To clarify the diagnosis, it is often sufficient to use non-damaging techniques - Pap smear or colposcopy.

Additional studies directly on samples of affected tissues are needed when suspicious signs are found indicating serious pathology.

The indications for biopsy are the following colposcopic manifestations:

  • the presence of mucous membrane sites is not stained with iodine during the Schiller test,
  • the appearance of whitish zones after treatment with vinegar.

The reason for the procedure may be the identification of pseudo-erosion in neglected condition. Characteristic signs are established during gynecological examinations - the exit of the cylindrical epithelium from the cervical canal beyond the borders of the external uterine pharynx with the formation of a circle in the vaginal area of ​​the cervix.

Наиболее опасна папиллярная разновидность, при которой разрастаются сосочки из соединительной ткани.

Biopsy is also important to do before cauterization.

Preparatory activities

The biopsy selection procedure should be carried out on the 5-6 day of the menstrual cycle, i.e. immediately after the cessation of menstruation. This will allow you to go through the full recovery cycle until the next menstruation.

Biopsy preparation includes the following conditions:

  • Vaginal tampons should be stopped for 2 days before the procedure. You can use gaskets. Douching should not be done, but washing with warm water is necessary daily. Within 3-4 days before the biopsy, you should refuse sex,
  • crotch shaving is not necessary but desirable
  • biopsy can not be performed with infectious lesions. For this, tests are necessarily performed - a general blood test, a smear for gonorrhea and trichomoniasis, tests for the presence of other infections of the urogenital system, hepatitis, HIV,
  • blood is checked for clotting,
  • Colposcopy is required to clarify the need for biopsy,
  • It is impossible to carry out the procedure during pregnancy.

How is the analysis taken

Most often, a biopsy is performed on an outpatient basis, in a gynecological office, and the wedge-shaped variety is inpatient.

The whole procedure is carried out in a gynecological chair, after a thorough examination by a doctor using mirrors. To begin, the test area is cleaned with a swab soaked in saline. It is advisable to pre-test Schiller.

Depending on the biopsy method used, local anesthesia is administered or aerosol anesthesia is provided. The mucosa is treated with Lugol’s solution, and then a small piece of tissue is cut off with an appropriate tool. The site of exposure is disinfected with an antiseptic.

If the damaged area bleeds, then silver nitrate solution is used. Antiseptic treatment and exposed external surfaces of the penis. The seams at the sampling point usually do not overlap.

The resulting biopsy is sent for laboratory research. The whole procedure takes only a few minutes. At the end of her assessment of the patient's condition.

Repeated examinations are carried out in 10-12 days.

Pain sensations

There are practically no nerve endings in the uterine cervix, and therefore the biopsy procedure is considered painless.

It can be painful in violation of the technology of sampling, damage to other tissues, as well as an extensive biopsy. That is why in the latter case local or general anesthesia is provided.

Certain inconvenience causes the introduction of mirrors. Some sensitive patients may have a reflexive uterine contraction, which can cause slight pain in the lower abdomen.

Features of decoding results

The biopsy specimen is sent for complex histological studies.

Results are divided into the following categories:

  • negative result - absence of pathology. It is set if no altered or atypical cells are detected,
  • minor changes. In this case, only a change in shape is detected in a few cells, which usually indicates the consequences of an inflammatory reaction,
  • benign changes. Such a result is possible with the detection of diseases such as endometriosis, endocervicitis, polyps and other benign changes,
  • cancerous conditions, precancerous condition,
  • cervical cancer.

Detection of atypical cells and oncological markers enables early diagnosis of oncology. In this case, an effective treatment is able to completely defeat the disease.

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