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Sexual contact after biopsy. Essential knowledge about cervical biopsy. Prohibition of sexual activity during pregnancy
The cervical biopsy procedure is prescribed by the attending gynecologist, based on the patient's complaints and the problems found with the female reproductive system. A biopsy is a small and painless surgical intervention, which is performed without anesthesia, anesthesia and takes no more than 15 minutes. The main indicators for this procedure are conization, the presence of erosion, suspicion of cervical cancer.
A biopsy requires the woman to comply with certain conditions a few days before the scheduled procedure, and also for some time after it. One of the mandatory prescriptions is complete rest.
Can I have sex before the biopsy?
Since during the biopsy tissue is taken from the cervical area, the procedure is prescribed 2-3 days after the end of menstruation. Sex a few days before the biopsy is strictly contraindicated.
Such preventive measures help to avoid complications that are possible during the procedure itself. Sexual intercourse should be completely excluded, regardless of whether you are protected by a barrier method or not.
Sex after cervical biopsy
During a biopsy, the integrity of the tissue covers is violated. This is typical for any type of procedure, including radio wave and laser tissue sampling. In the latter case, the tissues are injured a little less, since the capillaries and vessels are “washed down” with the laser immediately, due to which the amount of bleeding is minimized.
When tissue is taken with forceps or a scalpel, the resulting small wound can still bleed for 1-2 days.
On the video - talks about radio wave biopsy:
Despite the fact that spotting during this period is scarce, the very presence of a wound is the main reason why you should not have sex after a cervical biopsy.
Despite the fact that the tissues of the cervix are treated with drugs and antiseptics before and after the sampling, sexual intercourse is fraught with the introduction of various infections into the woman's vagina.
In addition to the latter, fungal cells can enter the habitual microflora through the penis, to which a healthy woman's body normally might not have reacted. But, since there is a microtrauma, they become dangerous.
Sex is unacceptable after a biopsy and subject to the use of condoms. Despite, it would seem, the option of the absence of infections, there are a number of other risks that can also result in a subsequent protracted treatment for a woman. The head of the penis can cause even more trauma to already wounded tissues due to mechanical effects during intercourse. The area of the wound will increase, and with it the risk of infections getting into it will increase.
The time period for which it is worth completely eliminating sexual activity is 2 weeks. During this time, the wound will completely heal, and the discharge of the genitourinary system will normalize. This period of abstinence is relevant for those women in whom the biopsy procedure was completed without complications.
Consequences of violation of sexual abstinence
If during the biopsy of the cervix, other vessels were affected, bleeding began, or there were increased, uncharacteristic discharges for a healthy body, you should definitely consult a doctor. Only after examination and taking smears, the doctor will be able to make a verdict. He also needs to be asked: is additional treatment needed and for how long will sex be excluded?
Usually, if complications arise, the period of abstinence from intimate relationships increases by another 2 weeks.
The consequences of having an intimate life after tissue sampling from the cervix during the period of the prohibition indicated by the doctor are:
- Increased wound healing time;
- Bleeding;
- Inflammatory process;
- Drawing pains.
Before returning to a full sexual life after a biopsy, it is necessary to go for an examination to your doctor. During it, the doctor will be able to reliably say whether the wound surface has healed and whether this procedure has passed for the body without consequences.
The article will describe the reasons for various restrictions on intimate life.
In intimate life, some restrictions are necessary if the female body undergoes changes. You should abstain from sex when:
- monthly
- pregnancy (on certain terms or individual inadmissibility)
- after an abortion
- after a miscarriage
- after surgery
- after spiral
- after cauterization erosion or biopsy
- with special treatment
Each type of restriction has its own deadlines. Best Option it will be if the gynecologist himself gives recommendations on the timing of abstinence from intimate life.
At what stage of pregnancy should you not have sex?
- At normal course pregnancy sex is not a hindrance
- Moreover, according to experts, sperm has a positive effect on the condition of the uterus, preparing it for childbirth.
- Naturally, sometimes a personal condition (dizziness, toxicosis, pain in the body) does not make it possible to have sex. In this case, forcibly living an intimate life is not worth it.
- Contraindications in sex do not always depend on the term. It all depends on the health of the mother and the position of the fetus.
- Sex is forbidden with the threat of miscarriage in the early stages
- With placenta previa, cervical insufficiency, it is also not permissible to lead an intimate life
- If during sex a woman feels pain, bleeding occurs, sex should be stopped and a gynecologist should be consulted.
- During pregnancy, it is better to choose positions for sex in which there is no pressure on the stomach. Also not desirable are postures on the back.
Why can't you have sex during your period?
- There are no categorical conclusions of doctors that it is impossible to have sex during menstruation
- The most common argument is the possibility of introducing an infection into the female reproductive system. But if you observe personal hygiene and use a condom, then the risk is minimal.
- Another aspect is aesthetic. A woman cannot be liberated during menstruation, and bleeding can be unpleasant for her partner
- Also, during menstruation, many women have a stomach ache, weakness and dizziness. Naturally, in this state, there is no time for sex at all.
- But if there are no unpleasant sensations, then there are no objective reasons to refuse intimate life during menstruation.
Why can't you have sex after an abortion?
- Abortion can be medical or surgical. In any case, this is a serious burden on the reproductive system of a woman.
- Medical abortion is the effect of special drugs on the hormonal system of a woman, which causes the rejection of the fetus. In this case, the uterus is injured, as after a surgical abortion. The cervix remains open for some time
- Surgical abortion is surgery on a woman's body. With it, the uterus, the walls of the vagina are also seriously injured.
- With early sex after an abortion, you can cause severe trauma to the uterus. May open bleeding, infection
- Doctors recommend having sex no earlier than 1 month after the abortion, if there are no complications
How long can you not have sex after a spiral?
- The intrauterine device is installed in the uterus, preventing the penetration of sperm into its cavity
- Usually this procedure takes place with the help of a gynecologist and he gives precise recommendations for its operation.
- After the establishment of the spiral, it is not recommended to have sex for at least a week. This is due to the fact that the spiral is a foreign object. It takes time for it to take its place in a woman's body.
- If a woman or partner feels uncomfortable during sex, you need to see a doctor. He will conduct an examination and correct the spiral, if necessary.
- After removing the spiral, it is also necessary to refrain from sexual intercourse for some time.
- When removed, the uterus is injured and it takes at least a week to heal it
How long can you not have sex after a miscarriage?
- A miscarriage is usually accompanied by moral and physical trauma. Therefore, it is not worth rushing to resume sexual activity during a miscarriage.
- After a miscarriage, the uterus is cleaned, because of which it is severely injured. Some bleeding has been observed
- Doctors do not recommend having sex before the next menstruation. It comes in about a month
- After a miscarriage, you do not need to choose positions in which the penis penetrates deep into the body of a woman. Should not feel uncomfortable
- For 3 months after a miscarriage, you should not have sex more than a couple of times a week
How long can you not have sex after cauterization of erosion?
- Cauterization of erosion is the healing of a wound (erosion) on the cervix. It is carried out with liquid nitrogen, laser, current, or chemicals.
- In any case, the wound heals, but it takes some time for complete healing.
- At the same time, the doctor prescribes additional treatment with the help of special tampons, ointments and herbs.
- Having sex after cauterization is not worth it until the end of treatment.
- After completing all the procedures, you need to see a doctor to assess the condition of the cervix. After that, he will be able to tell if sex is possible or not.
How long can you not have sex after giving birth?
- It is impossible to have sex immediately after childbirth for a number of reasons: the uterus has not yet healed after placental abruption, the vagina has not narrowed, the woman feels weak
- Doctors recommend having sex no earlier than a month after giving birth
- Even if a caesarean section was performed, you should not rush into sex. The uterus and sutures are still healing. As after any surgical intervention, physical activity is contraindicated
- If stitching was necessary after childbirth, you need to wait even longer with intimate life. The exact timing will be able to tell the doctor, depending on the state of health
- Many women after childbirth face the problem of relaxation of the vaginal muscles. They usually return to normal within a month. But in order to return them to their previous state, you need to do special exercises.
Why can't you have sex after surgery?
- Restrictions in intimate life after surgery depend directly on the severity of the surgical intervention
- Usually sex is a physical activity. When suturing, any physical activity is contraindicated. Therefore, sex will have to wait until the stitches are removed.
- Another nuance is anesthesia and its tolerance by the body. There is local and general anesthesia. Usually local is easier to carry human body. But the general has a serious impact on nervous system. The body may need some time to recover.
- So, if the operation is serious, then you will have to abstain from sex for about a month. If the surgical intervention is superficial and healing occurs quickly, then the restriction will be removed much earlier.
Why can't you have sex during treatment?
- It all depends on what the person is being treated for. But with any disease, the body feels weak and libido weakens.
- If the treatment comes from infectious diseases, then not only from sex, but also from other physical contacts with a partner (kisses, hugs) should be abstained. The attending physician will tell you when the danger of infecting another person has passed
- Particular attention should be paid to the restriction of sex during sexually transmitted diseases. Many mistakenly believe that only by starting treatment, the danger of infecting a partner disappears. But it's not. To completely avoid infection, you need to complete the treatment
- After a number of diseases of the cardiovascular system, physical activity is contraindicated for a long time. That is why you need to consult a doctor about the possibility of having sex.
- In any case, when prescribing treatment, the doctor himself will tell you what restrictions on life should be introduced.
How long can you not have sex after a biopsy?
- To understand the restrictions on sex, you need to understand what the biopsy procedure is. A biopsy is the removal of pieces of tissue in order to find out the presence of cancer cells in it.
- There are several types of biopsy. Usually, a wound remains on the uterus after this procedure, which bleeds for a while.
- Sometimes a biopsy is done with a laser. There is no blood, but the wound is still there. It takes time to heal
- Doctors advise not to have sex after the biopsy for two weeks. And if the healing goes badly, then within a month
- At early lesson having sex (even with a condom) has a high risk of infection. In addition, the uterus is injured and healing takes an extremely long time.
Video: Sex after childbirth
Cervical biopsy is one of the gynecological research methods, in which a small area of tissue is excised from the cervix and subsequently examined under a microscope for diagnostic purposes. How quickly sex is likely after a cervical biopsy is a question that worries all women.
This method is considered the most reliable for suspected cervical dysplasia or cancer. Additional studies are practically not required, the biopsy results are final, thanks to them the gynecologist is able to establish the nature of the pathology and prescribe adequate treatment.
But you should not worry in advance and make yourself non-existent diagnoses if the gynecologist has prescribed a biopsy. Often, experts recommend a biopsy in the presence of any abnormal changes in the cervix (erosion, polyps, condylomas, leukoplakia, as well as positive smear results for cytology).
Experts consider the second week to be the most suitable period for cervical biopsy. menstrual cycle(7-14 days). It must be remembered - in order to avoid complications, a couple of days before the date when the cervical biopsy is scheduled, sex should be excluded, do not use tampons, do not douche and do not inject any drugs into the vagina.
Experts call contraindications for cervical biopsy: acute inflammatory diseases (in this case, it is transferred until the end of the treatment of inflammatory processes) and poor blood clotting.
Cervical Biopsy Methods
A biopsy of the cervix is performed by a qualified specialist in a gynecological chair. Gynecological mirrors push the walls of the vagina and produce tissue sampling from abnormal places. Depending on the tool used
biopsy is divided into the following types
- radio wave method. A biopsy is performed using a special "radio knife". When using this method, there is practically no pronounced tissue damage. Narcosis is not applied. Complications after a biopsy by this method are uncharacteristic. Bloody discharge is virtually absent after a radio wave biopsy of the cervix is applied. Sex is recommended no earlier than ten days after the procedure.
- electrosurgical method. A biopsy is performed using a special tool that looks like a loop. With this tool, using an electric current, abnormal areas of the cervix are exfoliated. The procedure is performed under local anesthesia. Bleeding may continue for several weeks. Sex after a biopsy of the cervix, gynecologists recommend to exclude at least a month.
- Surgical method (knife biopsy). This biopsy is performed using a conventional surgical scalpel. Compulsory anesthesia is used (sometimes general anesthesia, more often epidural or spinal). Since not only abnormal zones are removed, but also healthy ones, this method is also called an extensive biopsy of the cervix. Sex is excluded until the complete cessation of bleeding, in some cases up to several weeks.
- Colposcopic method (aimed biopsy). The use of this method is considered the safest in the diagnosis of a variety of dysplasia and cancer. To excise a small area of tissue, a needle is used, which the gynecologist inserts to a certain depth, thereby taking all the necessary tissue layers. Does not require anesthesia. Bloody discharge from the vagina may appear within two to three days after the biopsy of the cervix has been performed. Sex is recommended to be excluded for at least ten days.
After a biopsy, in order to avoid complications, some recommendations should be followed:
- do not use tampons;
- do not take baths, do not visit the pool and sauna, bath;
- exclude sex after a biopsy of the cervix for a period determined by the doctor;
- exclude physical activity (gym, fitness, etc.);
- do not take medicines, douche, do not use aspirin without the advice of a doctor.
If these recommendations are not followed, there is a risk of some complications: infection, bleeding, or the appearance of unusual discharge (sometimes with a smell). They are easily eliminated with timely access to a gynecologist. The healing and recovery period can last from two days to several weeks, its duration directly depends on the patient.
So, sex plays an important role in a person’s life, but the most important thing is whether it will harm this case? A biopsy of the cervix is a surgical intervention, therefore, complications are possible. Most gynecologists recommend excluding intimate relationships for at least ten days, even if there is no bleeding from the vagina. During sex, infection of the wound can occur with all the ensuing consequences, so it is best to follow the recommendations of doctors, waiting for a full recovery.
The cervical biopsy procedure is prescribed by the attending gynecologist, based on the patient's complaints and the problems found with the female reproductive system. A biopsy is a small and painless surgical intervention, which is performed without anesthesia, anesthesia and takes no more than 15 minutes. The main indicators for this procedure are conization, the presence of erosion, suspicion of cervical cancer.
A biopsy requires the woman to comply with certain conditions a few days before the scheduled procedure, and also for some time after it. One of the mandatory prescriptions is complete rest.
Can I have sex before the biopsy?
Since during the biopsy tissue is taken from the cervical area, the procedure is prescribed 2-3 days after the end of menstruation. Sex a few days before the biopsy is strictly contraindicated.
Such preventive measures help to avoid complications that are possible during the procedure itself. Sexual intercourse should be completely excluded, regardless of whether you are protected by a barrier method or not.
Sex after cervical biopsy
During a biopsy, the integrity of the tissue covers is violated. This is typical for any type of procedure, including radio wave and laser tissue sampling. In the latter case, the tissues are injured a little less, since the capillaries and vessels are “washed down” with the laser immediately, due to which the amount of bleeding is minimized.
When tissue is taken with forceps or a scalpel, the resulting small wound can still bleed for 1-2 days.
On the video - talks about radio wave biopsy:
Despite the fact that spotting during this period is scarce, the very presence of a wound is the main reason why you should not have sex after a cervical biopsy.
Despite the fact that the tissues of the cervix are treated with drugs and antiseptics before and after the sampling, sexual intercourse is fraught with the introduction of various infections into the woman's vagina.
In addition to the latter, fungal cells can enter the habitual microflora through the penis, to which a healthy woman's body normally might not have reacted. But, since there is a microtrauma, they become dangerous.
Sex is unacceptable after a biopsy and subject to the use of condoms. Despite, it would seem, the option of the absence of infections, there are a number of other risks that can also result in a subsequent protracted treatment for a woman. The head of the penis can cause even more trauma to already wounded tissues due to mechanical effects during intercourse. The area of the wound will increase, and with it the risk of infections getting into it will increase.
The time period for which it is worth completely eliminating sexual activity is 2 weeks. During this time, the wound will completely heal, and the discharge of the genitourinary system will normalize. This period of abstinence is relevant for those women in whom the biopsy procedure was completed without complications.
Consequences of violation of sexual abstinence
If during the biopsy of the cervix, other vessels were affected, bleeding began, or there were increased, uncharacteristic discharges for a healthy body, you should definitely consult a doctor. Only after examination and taking smears, the doctor will be able to make a verdict. He also needs to be asked: is additional treatment needed and for how long will sex be excluded?
Usually, if complications arise, the period of abstinence from intimate relationships increases by another 2 weeks.
The consequences of having an intimate life after tissue sampling from the cervix during the period of the prohibition indicated by the doctor are:
- Increased wound healing time;
- Bleeding;
- Inflammatory process;
- Drawing pains.
Before returning to a full sexual life after a biopsy, it is necessary to go for an examination to your doctor. During it, the doctor will be able to reliably say whether the wound surface has healed and whether this procedure has passed for the body without consequences.
Identification of certain gynecological diseases requires not only examination and smear analysis, in some cases more complex studies are needed to establish a definitive diagnosis.
Often diseases of the cervix are latent due to the absence of receptors in these tissues. A woman is not bothered by pain and discomfort until the last stages of the development of the disease. IN overall structure gynecological sphere, such pathologies occupy one of the leading positions. Diseases of this part of the uterus are prone to long-term course and in some cases are the cause of cancer. If oncological and precancerous conditions are suspected, a biopsy is prescribed.
What is a cervical biopsy?
The cervix is the junction of the uterus with the vagina itself, it is the narrowest lower part of it. Its mucous membrane blocks the entry of microorganisms into the uterus, so it is vulnerable and prone to diseases such as erosion, inflammation and tumors, and others.
If an oncological disease is suspected or to confirm the results of cytology, a biopsy procedure is performed - this is the taking of a small area of tissue for analysis for further laboratory analysis. With the help of a biopsy, it became possible to diagnose oncological diseases in time and prevent their further development.
Why is a cervical biopsy done?
When viewed on the cervix, an epithelium with a modified structure can be detected, which indicates a disease. A visual examination and smear results alone are often not enough to establish a diagnosis; more in-depth studies are needed to identify atypical areas.
Who needs to have a cervical biopsy?
Direct indications for histological examination are the following signs:
- iodine-negative zones;
- altered color of some sections of the mucosa under the influence of acetic acid;
- erosion, ulceration and papillomas.
A biopsy is prescribed to confirm or refute such diseases:
- dysplasia;
- endocervicitis;
- papillomavirus;
- polyps;
- leukoplakia;
- mucosal condylomas caused by oncogenic viruses;
- malignant neoplasms.
Many gynecologists are of the opinion that
erosion on the cervix
not considered an indication for biopsy. In young girls, this problem is quite common and erosion itself is not dangerous in terms of transition to cancer.
How to prepare for a cervical biopsy?
A tissue sample is taken only if there are no infections in the genital tract. To do this, before carrying out manipulations, the microflora of the vagina is examined.
To reduce the likelihood of complications and get the most reliable biopsy result, you need to listen to the recommendations of the gynecologist:
- 3 days before the procedure, refuse sex;
- do not douche or use tampons for two days before the procedure;
- do not use vaginal medicines other than those prescribed by a doctor;
An hour before the operation, a woman can take sedative tablets of motherwort, valerian, an ibuprofen tablet, or indomethacin. If anesthesia is to be used, the patient should not take medications, food and water within 12 hours prior to tissue sampling.
What tests should be done before a cervical biopsy?
The procedure is invasive, therefore it is always accompanied by the risk associated with infection by pathogens. To prevent negative consequences, an examination is prescribed before such manipulations.
Common gynecological practice involves a comprehensive clinical and laboratory examination, including:
- coagulogram;
- clinical blood test;
- colposcopy;
- vaginal smear for microflora;
- cytological analysis;
- examination for latent infections;
- testing for hepatitis, syphilis and HIV.
If at least one of the listed diseases is detected as a result of laboratory tests, the biopsy is postponed until the moment of recovery after a course of antibiotics.
On what day of the cycle can a cervical biopsy be done?
All manipulations of a gynecological nature are usually performed after the cessation of menstruation on the 5th-13th day of the cycle, so that the damaged surface can drag on until the start of the next cycle. As a rule, tissue regeneration takes from 10 days to two weeks.
Contraindications for cervical biopsy
The following reasons may prevent a biopsy:
- systemic diseases of a woman;
- pathology of the reproductive system;
- inflammatory diseases;
- blood coagulation disorders;
- pregnancy (relative contraindication).
The cervix is permeated with many small blood vessels, their slight damage in this case can cause significant blood loss. Although a biopsy is a minor surgical intervention, this procedure is contraindicated in patients with reduced blood clotting.
Blood diseases are quite rare, much more often doctors have to deal with infections, and they are the most common contraindication to a biopsy. During the procedure, pathogenic microorganisms (bacteria, fungi) penetrate the damaged mucous membrane and can provoke a strong inflammatory process in the tissues of the genital organs.
Can a cervical biopsy be done during pregnancy?
Usually, such procedures are not carried out during pregnancy, they are tried to be postponed until the postpartum period. By this time, the woman's cervix is completely restored, which makes it possible to obtain a reliable result of the study.
A biopsy of the cervix in expectant mothers does not differ from the standard procedure and is performed in the same manner. The likelihood of complications or side effects is negligible and the manipulation does not affect the unborn child and the course of pregnancy.
In the first trimester, a biopsy may slightly increase the risk of miscarriage, and in the last weeks it may cause a premature delivery. From the 13th week of pregnancy, such risks are minimal, therefore, if necessary, doctors recommend that a cervical biopsy be performed in the second trimester.
After the intervention, short spasmodic pain and discomfort may occur - this is not at all a sign of a possible miscarriage, but a normal phenomenon. The following symptoms should alert a woman:
- increase in body temperature;
- severe vaginal bleeding;
- discharge of yellow or greenish color with an unpleasant odor;
- abdominal cramps for two or more days.
The above signs are a good reason to apply for medical care in the shortest possible time.
What types of cervical biopsy are there?
Depending on the technique of the operation, the following types of biopsy are distinguished:
- electrosurgical loop;
- wedge-shaped;
- sighting (simple, colposcopic);
- endocervical.
The choice of tissue material sampling method is made by a doctor, taking into account the preliminary diagnosis and other indicators known to the attending gynecologist. Certain types of biopsy serve not only as a diagnostic method, but also act as a therapeutic measure.
Colposcopic (aiming, puncture) biopsy of the cervix
Targeted biopsy has rightfully become the standard in modern diagnostics of gynecological diseases. The puncture is made with a thick needle under colposcopy control. The doctor takes the material only in suspicious areas. The "column" of tissue obtained with a hollow needle contains all the necessary information about the different layers of cells and can serve as material for an accurate diagnosis. Immediately before the sampling of the material, the cervix is treated with Lugol's iodine solution and pre-acetic acid to identify the affected tissues.
Needle biopsy is considered the simplest and least traumatic type of this procedure. It does not require anesthesia and hospitalization, manipulations can be carried out in the gynecologist's office. Tingling sensations and some discomfort last no more than 10 seconds, after which bloody discharge may appear. In some cases, the patient is prescribed sedatives.
Conchotomy biopsy of the cervix
The technique of conchotomy biopsy is generally similar to the colposcopic biopsy described above. The difference is that a tool is used to take the material - a conchotom, which resembles scissors with sharp edges.
Before the procedure, lidocaine may be injected into the cervix for local anesthesia. A woman does not need hospitalization and after a biopsy she can continue a normal life with some restrictions on the recovery period.
Radio wave biopsy of the cervix (biopsy with the Surgitron apparatus)
In the CIS countries, it is customary to use the Surgitron high-frequency electrosurgical apparatus for the radio wave biopsy procedure. The operation involves the use of a "radio knife". This intervention does not lead to tissue damage, it is performed on an outpatient basis, and anesthesia is not required. Minor injuries can cause moderate bleeding for up to a week. Minimal manipulation reduces the risk of complications and scarring, so this gentle method is preferred for women who want to have a baby in the future.
The disadvantage of radio wave biopsy is coagulation damage to the material sample, which may affect the histological examination.
Loop biopsy of the cervix
This diagnostic method can be called differently - electrosurgical biopsy or electroexcision. IN Western countries it is commonly called LETZ and LEEP.
To take a section of the affected tissue, an instrument is used that resembles a thin wire loop, through which a low-power electric current is passed through the installation. With this loop, the necessary tissue sample can be detached for examination for neoplasms. A cone-shaped sample of the cervix can be obtained and capture the surface of the cervical canal.
The use of a radio wave loop is not always justified; the tissue sample may be damaged due to coagulation. In addition, there is an opinion about the effect of loop biopsy on the formation of scar tissue at the site of sampling. In the future, this may affect the possibility of conception and gestation, therefore, electrosurgical biopsy is not recommended for nulliparous women and girls.
Laser biopsy of the cervix
The procedure is usually performed under short-term (5-20 minutes) anesthesia in a hospital setting. Laser conization consists in excising a wedge-shaped sample using laser beams that are directed by a mirror light guide. The beams move in a three-dimensional plane and capture the cone-shaped area along with 2–3 mm of the tissues surrounding it. Laser vaporization allows you to adjust the depth of exposure to the changed area, while the rapid heating of the tissues makes it possible to avoid bleeding.
The use of a laser is the most modern, but also the most expensive of the proposed methods. General anesthesia may be required to remove the tissue sample, but local anesthesia is more common.
The use of a laser knife is considered a low-traumatic method of intervention, complications occur quite rarely, and the postoperative period is much easier. As a result of the manipulation, the patient develops bloody discharge, which disappears on its own.
Circular biopsy of the cervix
This type of biopsy is also called circular, it is performed using an ultrasonic scalpel, radio wave knife or Rogovenko tip. It provides for the fence of a large area, along with the affected tissues, the surface of the cervical canal is captured (at least 1/3).
This method is used not only for the purpose of diagnosis, but also for the treatment of certain problems of the cervix. Since adjacent healthy tissues are also checked during material sampling, this method belongs to an extended biopsy. An indication for the use of a circular biopsy is the inaccessibility of a visual examination of the affected area and its prevalence in the cervical canal, as well as the precancerous condition of the endocervix and the suspicion of latent invasion during colposcopy.
Regeneration of the wound surface is completed after 4-6 weeks, depending on the intervention technique.
Wedge biopsy of the cervix (conization of the cervix, cold knife biopsy, knife biopsy)
To obtain the most informative test results, a small wedge-shaped part of the neck is excised from the neck. Unlike a puncture biopsy, when only suspicious tissues can be taken for analysis, a wedge-shaped biopsy also requires surrounding areas that are healthy at first glance, so this type of biomaterial sampling is considered the most extensive.
Conization is not only a diagnostic method, it can be used to treat certain diseases of the cervix. The operation requires the use of general anesthesia, spinal or epidural anesthesia. To excise the wedge-shaped area, a conventional surgical knife is used, which is not previously heated by current or radio waves.
After the operation, a woman can leave the hospital on the same day or a day later. For some time, she may feel pain, and spotting of various intensity is also possible.
The knife biopsy method is used quite rarely, as it leaves deep scars on the cervix. This complication in young women of childbearing age prevents the normal opening of the cervix during childbirth. For nulliparous and women in reproductive age it is better to use more modern and safe methods of diagnostics and therapy.
Endocervical curettage
Using the procedure of endocervical curettage, it is possible to obtain cells from a narrow cervical canal for further research. The indication for its implementation are abnormal smear results for cytology in the absence of a clear boundary between the altered and healthy tissue.
Lidocaine or novocaine is used locally for pain relief, in some cases short-term intravenous anesthesia may be required. A special tool is inserted to the internal pharynx and firmly pressed with a sharp side against the canal wall. With the help of successive movements from top to bottom along all its walls, it is possible to collect a sample for analysis.
The material obtained as a result of endocervical curettage may be scarce and not suitable for the correct interpretation of the results of the study. Assessing the degree of tissue change can be difficult, so experts prefer to use the loop biopsy method.
How is a cervical biopsy done?
The choice of biopsy technique depends on the proposed diagnosis. Basically, the procedure takes place without anesthesia, but in some cases, local anesthesia or general anesthesia is necessary. All manipulations are carried out on a gynecological chair. First, asepsis of the cervix is performed with Lugol's solution and pre-treatment with acetic acid to identify pathological unstained areas, and then examination with a dilator.
The cervix is fixed with bullet forceps and slightly lowered. Using special instruments (radio knife, laser, electric loop) or a scalpel, the doctor cuts out a wedge-shaped area on the border of the altered and healthy tissue. Such pathological zones are detected using a colposcope. If there are several, then samples are taken from each zone, while the width of the material should not be more than 5 mm.
The obtained biomaterial samples are immediately fixed in a formalin solution. Sample tubes are clearly labeled, each of them is recorded in the patient's card with an indication of the place of its taking. If the pathological area of the cervix is localized and small in size, then it is removed when taking a sample as a sample, this makes it possible to avoid additional intervention in the future.
In order to prevent bleeding and possible complications, coagulation is done at the site of the cut with a scalpel or catgut sutures are applied. When using hardware techniques, stitching is not required. The procedure takes no more than half an hour, and when using general anesthesia from 40 minutes to an hour and a half. If the biopsy was performed on an outpatient basis, then there is no need for hospitalization, in the case when the biomaterial was taken in a hospital, hospitalization for 1–2 days is possible.
The taken material is sent to the laboratory for further research, it takes 2 weeks to get the result.
Cervical biopsy: does it hurt?
The cervix is almost completely devoid of sensitivity due to the absence of pain receptors. During the procedure, some patients feel unpleasant pulling pain due to the contraction of the walls of the uterus. So the muscles of the body react to irritation of the nerve endings.
There are other factors that affect the pain of the procedure:
- irritated and inflamed areas on the cervix;
- biopsy sampling volume;
- biopsy technique (using an electric loop is less painful than using a scalpel);
- individual sensitivity threshold of a woman;
- emotionality of the patient and her mood before the procedure.
To reduce the severity of pain and discomfort, local anesthesia can be used, for this the doctor injects an anesthetic into the cervix. Certain biopsies are quite painful and require general anesthesia or an epidural.
After the procedure, many women report pain. To reduce their severity, the doctor prescribes an analgesic.
What happens after a cervical biopsy?
Pain and scanty discharge are considered normal after a biopsy. Their cause is a violation of the integrity of the cervix. The amount of discharge should not exceed normal menstrual bleeding, and their duration cannot be more than 10 days.
The duration and amount of bleeding may depend on the biopsy technique:
- after a loop biopsy or conization - spotting for a week, and then a few more weeks of spotting;
- after conchotomy, targeted, radio wave and laser biopsy - isolation lasting 2–3 days.
A slight short-term rise in temperature may indicate stress. A symptom of infectious complications is usually an increase in temperature to 37.5 ° C and above.
For normal tissue repair, within 4-8 weeks, a woman should eliminate the following factors:
- lifting and carrying heavy objects (you can lift a weight not exceeding 3 kg);
- sexual life;
- hard labour;
- swimming in open water, visiting public pools, saunas, baths;
- using tampons and douching;
- taking aspirin.
Compliance with these rules will reduce the likelihood of complications and greatly facilitate the postoperative period.
Can I have sex after a cervical biopsy?
The postoperative period is characterized by vaginal discharge, this time it is recommended to refrain from intimate relationships. The minimum term is about 7 days, but in individual cases, strict sexual rest is necessary for 2-3 weeks. Such measures are required for normal tissue regeneration and prevention of complications.
Complications of cervical biopsy
The main complications of the biopsy procedure are infection and bleeding. Such phenomena are rare, but women should be informed about the possible negative consequences of a biopsy.
The following symptoms may indicate deviations in the normal recovery period:
- profuse bleeding of a bright color or dark with blood clots;
- bleeding that lasts longer than a week
- light discharge that lasts longer than 2-3 weeks;
- temperature rise to 37.5 °C and above;
- vaginal discharge with an unpleasant odor.
The cause of the infection may be not fully cured disease. In this case, to prevent aggravation of the situation, a course of antibiotics is prescribed.
Modern methods of hardware biopsy, due to the coagulating effect on damaged tissues, make it possible to avoid bleeding and prevent the formation of scars on the mucosa.
Consequences of cervical biopsy
As a rule, such types of biopsy as conchotomy, radio wave, laser do not have serious consequences and are characterized by a short recovery period. After a loop and conical (circular and wedge) biopsy, scar tissue may form on the tissues of the cervix. In the future, these women may have problems with conception, and then with pregnancy.
Such a phenomenon as cervical adhesion is quite rare, but leads to infertility due to the fact that spermatozoa are not able to enter the uterus for further fertilization. A negative consequence of the biopsy may be premature birth. The cervix itself is a kind of muscle that supports the uterus during pregnancy. The operation may cause the cervix to weaken and begin to open. ahead of time. To avoid this, doctors put stitches in the cervix of pregnant women with similar problems and then remove them before giving birth.
When choosing a biopsy method, the doctor should rely not only on the proposed diagnosis, but also take into account the woman's age and her plans for future motherhood.
How to interpret the results of a cervical biopsy?
Typically, the results of tissue analysis are available no earlier than 2 weeks after the procedure. Only a specialist of a narrow profile can interpret them correctly.
The study of biomaterial tissues can provide the following results:
- invasive cancer;
- dysplasia (severe, mild, moderate);
- koilocytosis, or papillomavirus changes;
- infections, inflammation;
- insignificant cellular changes;
- norm.
The result of the analysis is influenced by factors such as:
- compliance with the rules for the preparation of the drug;
- selection of mucosal sites for tissue sampling;
- qualification of a morphologist.
The biopsy result is usually the final step in making a diagnosis.
What are koilocytes?
Papilomovirus damage to the tissues of the cervix has a characteristic morphological feature - the presence of koilocytes as a result of biopsy analysis. Koilocytes are called cells with various lesions of the nuclei and vacuolar dystrophy (intracellular edema).
The presence of koilocytes indicates the active presence of the papillomavirus, while normally they are absent. Such an analysis result does not indicate a cancerous and precancerous condition, but should serve as a signal to a woman to be more attentive to her health and be observed by a gynecologist.
What is acanthosis, parakeratosis, hyperkeratosis, leukoplakia?
All these local processes indicate keratinization of the squamous stratified epithelium of varying severity. Such pathological conditions are not accompanied by any symptoms, but may have clinically pronounced forms that are diagnosed during a gynecological examination or colposcopy.
Acanthosis, hyperkeratosis, parakeratosis, leukoplakia are not cancerous or precancerous but should be considered along with other biopsy findings. For example, leukoplakia, together with atypia of cells on the cervix, refers to precancer and is preferred to be removed with part of the cervix. Nevertheless, it is recommended to get rid of such pathological processes, even if they do not carry a potential danger.
What is cervical dysplasia?
Cervical dysplasia is commonly understood as an atypical change in epithelial cells from the side of its vaginal part, which is referred to as cancerous and precancerous processes. The first stages of this disease are characterized by reversibility, so the early detection and removal of altered tissues is of great importance in the prevention of oncological female diseases.
Dysplasia leads to disturbances in the cellular structures of the affected tissues lining the surface of the cervix. As a rule, the disease is detected in patients aged 25–35 years, while they have no complaints and clear clinical manifestations of the disease, therefore, laboratory, clinical, and instrumental methods are important to detect the disease.
What should I do if I get bad results from a cervical biopsy?
The vast majority of diseases on the cervical mucosa are cured. Even oncological tumors with timely detection can be successfully cured. On the issues of therapy, you need to consult only with specialists in the medical field, it is possible that, in addition to a gynecologist, you will need to consult an oncologist or another doctor. The specialist must tell possible risks pathology and methods of its treatment.
A bad biopsy result should not be a cause for panic, but rather an opportunity to get rid of a hidden problem, change your lifestyle and continue to be attentive to your health.
Biopsy of the cervix- a method for diagnosing diseases of the internal female genital organs, its main goal is to identify oncological diseases cervix. During the procedure, a piece of tissue is taken from a suspicious area of the mucosa. The sample is delivered to the laboratory, where they study the structural features of the epithelial cells and the underlying layers. The procedure allows you to clarify the diagnosis and give an answer whether these changes are signs of a malignant tumor. Thanks to this study, cervical cancer can be detected at an early stage, when it can be successfully treated.
A cervical biopsy is performed from the 7th to the 13th day of the menstrual cycle (the first day of menstrual bleeding is considered the first day of the cycle). Experts recommend to carry out the procedure immediately after menstruation. In this case, the cervix has time to fully recover before the next critical days, which reduces the likelihood of inflammation.
Cervix
Cervix represents the lower part of the uterus, connecting the body of the uterus with the vagina. Its dimensions: length 3.5-4 cm, width about 3 cm.Penetrates the cervix cervical canal or cervical canal. In its walls are branching tubular glands that produce cervical mucus. This secret is able to change its properties depending on the phase of the cycle. So, during the period of ovulation, the mucus becomes more liquid, which contributes to the penetration of spermatozoa into the uterus. Outwardly, this manifests itself as a "symptom of the pupil", which is revealed during a gynecological examination. The rest of the time, the mucus thickens and clogs the channel, preventing the penetration of microorganisms. During pregnancy, the mucus forms a tight plug that protects the fetus from infections.
The cervix has a lot of connective tissue with collagen fibers, which allows it to stretch as much as possible during childbirth. It also contains a layer smooth muscle cells that allow her to contract and relax. With contraction, the cervix squeezes the secret of the glands of the cervical canal into the vagina, with relaxation of the muscle layer, spermatozoa are drawn in after intercourse.
There are several segments in the cervix:
- vaginal part- the part of the cervix, which protrudes into the vaginal cavity and is accessible during a gynecological examination;
- supravaginal part- the part of the cervix, which is located above the vagina and opens into the uterine cavity;
- cervical canal- a through hole, a channel that connects the vagina and the cavity inside the body of the uterus. The mucous membrane in it is collected in folds - crypts and contains a large number of glands;
- External pharynx- an opening from the vagina into the cervical canal;
- Internal os- the opening of the cervical canal into the uterine cavity.
The structure of the mucous membranes of the cervix:
- Basal- large prismatic cells attached to the basement membrane.
- spinous (prickly) are large cells with spiny outgrowths. Together with the basal, it forms germ layer providing constant renewal of the epithelium.
- Surface- formed by flat cells that have a short lifespan and are quickly replaced by new ones.
The cellular composition of the stratified epithelium depends on the phase of the menstrual cycle.
Indications for cervical biopsy
- cervical dysplasia- a precancerous condition in which atypical cells are found among epithelial cells. They are not yet cancerous, but have a tendency to malignant transformation;
- Ectopia of the cervix- pathological changes in the mucous membrane of the vaginal part of the cervix. Bleeding or crumbling when touched with a heterogeneous surface, erosion always needs a biopsy;
- Leukoplakia- thickening, coarsening and increased keratinization of the squamous epithelium of the cervix. It looks like a white spot with clear boundaries;
- Polyps of the cervix- local benign growths of the mucous membrane of the cervix and cervical canal;
- Genital warts(genital warts) - an infectious viral disease, sexually transmitted. Manifested by cone-shaped outgrowths on the mucous membrane;
- Changes detected during colposcopy - visual examination of the cervix:
- Iodine-negative areas- do not stain with iodine solution. Light areas may indicate dysplasia, atrophy, or leukoplakia;
- Acetowhite epithelium- areas that turned white after treatment with acetic acid. Indicates leukoplakia, dysplasia and infection papillomavirus;
- Atypical vessels that do not respond to acetic acid, vascular proliferation, abnormally tortuous capillaries, small arteries and veins;
- The presence of a rough mosaic, deep damage to the epithelium. May indicate dysplasia or oncological changes.
- Suspicious cells identified by a cytology smear(Pap smear):
- Koilocytes- cells that appear when infected with the human papillomavirus (HPV);
- ASC US(atypical squamous cells of undetermined significance) atypical squamous cells, the cause of which has not been established;
- ASC-H(atypical squamous cells, cannot exclude HSIL) atypical squamous cells, which may indicate a precancerous condition or oncological changes;
- AGC(atypical glandular cells) - atypical cells of the cylindrical epithelium;
- HSIL(high-grade squamous intraepithelial lesion) precancerous changes in the squamous epithelium;
- AIS(adenocarcinoma in situ) - precancerous changes in the cervical canal.
- Inflammatory process of the uterus or cervix;
- First and last trimesters of pregnancy;
- Acute infectious diseases;
- Blood clotting disorders;
- Significant weakness of the body.
Biopsy technique
The first step is to prepare for the biopsy of the cervix. It includes treatment of the inflammatory process(if available) and testing:- Blood clotting test;
- smear on flora;
- Pap smear (smear for cytology);
- Colposcopy - examination of the cervix with a colposcope;
- Analysis for latent infections (chlamydia, mycoplasmosis, ureaplasmosis);
- HIV test;
- Analysis for viral hepatitis;
- Wasserman's reaction (analysis for syphilis).
What awaits the patient during the targeted biopsy procedure?
targeted biopsy– tissue sampling from suspicious areas of the cervix using a biopsy needle under control colposcope. This procedure is the most common and less traumatic. - Preparation. The patient is located in the gynecological chair;
- Providing access to the cervix. To do this, the doctor will use a gynecological mirror.
- Surface preparation. The doctor cleans the cervix of mucus with a swab dipped in saline. A 3% solution of acetic acid is applied to the mucous membrane, after which the abnormal areas turn white and their boundaries can be clearly established. Then the cervix is lubricated with a solution of iodine. Healthy areas are uniformly stained brown. Areas with altered epithelium stain abnormally. They are subject to in-depth study - biopsy. This part of the procedure is painless, but some women may experience a slight burning sensation.
- Colposcopy - examination of the cervix using special equipment. A colposcope is an optical device equipped with a light source that magnifies the image of the cervix from 2 to 40 times. The device allows you to examine in detail the state of the mucous membrane. During the study, the doctor determines the areas from which it is necessary to take samples.
- Tissue sampling from suspicious areas. The doctor uses a biopsy needle or other device with which he separates a piece of tissue for examination. If there are several foci where the structure of the mucosa is changed, then samples are taken from all. The resulting tissue samples are placed in a labeled container with formalin and sent to the laboratory for histological examination.
- Antiseptic treatment. The sampling site is treated with an antiseptic. The vagina and external genitalia are also treated. Seams are not applied. The patient is offered to rest for 20 minutes, then she can return home.
- The final stage. Your doctor will schedule your next appointment to assess uterine healing and discuss biopsy results. The waiting time for the result takes up to 2 weeks. The doctor will inform you what to do to speed up healing and prevent inflammation after the biopsy.
Types of cervical biopsy
| Type of biopsy | What tool is used | Type of anesthesia | Possible sensations | Notes | |
| during the procedure | after the procedure | ||||
| Aiming or puncture | A biopsy needle is similar to an injection needle, but has a slightly larger diameter. | Without anesthesia or irrigation with an anesthetic. | Feeling of pressure or short-term stabbing pain. | A slight pulling pain in the lower abdomen. Bloody, watery pink discharge can last up to 5 days. After treating the cervix with antiseptics, the first days of discharge may be dirty green. | The most common procedure. Often performed during a colposcopy. Rarely causes complications. Does not require hospitalization. |
| Conchotomy biopsy | A conchotome is a medical instrument resembling wire cutters or curved scissors. With its help, polyps and fragments of the mucosa are excised. | Local anesthesia - an injection of anesthetic into the cervical region. | Feeling of pressure. | Pain in the lower abdomen and upper vagina. Scanty spotting 4-7 days. Further yellowish or pinkish sanious discharge. | It is used to take larger fragments and remove polyps and condylomas. There is a risk of scarring. Does not require hospitalization |
| Loop biopsy - electroexcision | Electrosurgical apparatus - "Electric knife". A wire that is heated by an electric current. | Local administration of an anesthetic. | slight soreness | Slight or moderate pain in the cervix. Bleeding may last for about a month. | The method allows you to remove suspicious areas. There is a risk of scarring. Not recommended for women planning pregnancy. Performed on an outpatient basis. |
| Wedge or knife biopsy - conization of the cervix | Using a scalpel, the doctor removes a wedge-shaped piece of the cervix containing suspicious and healthy tissue. | General anesthesia, spinal or epidural anesthesia. | A few weeks after the biopsy, pain in the cervix and discharge of varying degrees of intensity are felt. The healing process can take up to one and a half months. | It is prescribed when the results of a smear for cytology and a puncture biopsy differ significantly. Cervical conization can be a method of diagnosis and treatment. The procedure is performed in a hospital. |
|
| radio wave biopsy | Cold "radio knife" - apparatus "Surgitron". It is a loop of wire through which an electric current passes, which is converted into radio waves of high frequency. With this tool, the doctor removes the surface layer of tissue. | Irrigation with an anesthetic or local anesthesia - injections of lidocaine into several areas of the cervix. | Slight discomfort, as during a routine gynecological examination. | Discomfort after the procedure is minimal. There are practically no divisions. In the healing process, light pink discharge is possible for 7-10 days. | Radio waves evaporate fluid in cells and coagulate small vessels. The cut surface remains clean and dry. Recommended for girls and women planning pregnancy due to the low risk of scarring. Does not require hospitalization. |
| laser biopsy | Laser knife. The laser beam cuts off the top layer of the mucous membrane. | Short-term general anesthesia (narcosis). | There is no sensation during anesthesia. | Spotting spotting for 2-3 days. In the healing process, small bleeding is possible throughout the month. | It can be used to remove polyps and condylomas with further cytological examination. Low risk of inflammation and scarring. Requires hospitalization. |
| Circular (circular) biopsy | A scalpel, radio wave knife or electrosurgical apparatus is used. For study, an extensive area of the vaginal part of the cervix and the mouth of the cervical canal is taken. | General anesthesia or epidural anesthesia. | There are no sensations during the procedure. | Drawing pain for 7-10 days, spotting up to 6 weeks. | Performed in a hospital. |
| Endocervical curettage | A small curette is an instrument that resembles a small spoon. With its help, scraping of the mucous membrane of the cervical canal is carried out. Also, brushes of different stiffness are used, which are inserted into the canal and rotated there 5-7 times, collecting the material. | Local anesthesia - an injection of an anesthetic (lidocaine) into the cervix. Sometimes short-term intravenous anesthesia. | Pain sensations are absent. The patient may feel pressure. | Drawing or spasmodic pain in the pubic region and vagina. Allocations with an admixture of blood 5-10 days. | There is a risk of adhesion formation in the cervical canal. During the procedure, it is possible to obtain a small amount of material, which makes it difficult to diagnose. The method is considered insufficiently informative. |
How to prepare for a cervical biopsy?
2 days before the study, it is necessary to avoid any impact on the cervix.- Refrain from sexual contact;
- Do not use tampons;
- Do not douche;
- Do not inject into the vagina drugs that have not been prescribed by a gynecologist;
- In agreement with the doctor, Terzhinan is introduced into the vagina at night;
- If anesthesia (general anesthesia) is to be performed, then you should not eat or drink 8 hours before the biopsy;
- Before the procedure, you must take a shower and thoroughly wash the external genitalia. The inside of the vagina cannot be washed.
What can be the results of the histology of the biopath?
The laboratory conducts a cytological and pathomorphological examination of the biopath - tissue samples obtained during a biopsy. Living or fixed dead cells are examined under a microscope. Particular attention is paid to the shape of the cells, the stage of their maturation, the size and number of nuclei, intracellular inclusions.Terms that you may come across in the conclusion:
The results of the histological examination of the biopath
1. Negative biopath test result - means that the woman is healthy. "Good" biopsy results are:- Without pathology– when examining a biopath, unchanged cells of cylindrical and stratified epithelium were detected. There are no precancerous changes, signs of cervical cancer and other diseases.
- Minor cellular changes- minor changes in the shape of cells, which may be a consequence of the inflammatory process. They do not pose a threat to the health of women.
3. Precancerous conditions- Pathologies requiring treatment. If you do not take appropriate measures, cancer may develop against their background. 
- Signs of proliferation - small cells with a thin membrane;
- Atypical cells with enlarged or reduced nuclei;
- Perinuclear vacuolization - vacuoles are located not in the cytoplasm, but between the outer and inner shells of the nucleus.
- Dysplasia I (weak CIN-I) - atypical cells are found only in the surface layer;
- Dysplasia II (moderate CIN-II) - atypical cells in the surface and intermediate layers;
- Dysplasia III (expressed CIN-III) - atypical cells in all layers of the epithelium in large numbers.
- Violation of the layers of stratified squamous epithelium;
- Small immature cells with thin membranes;
- Cells with different types of nuclei;
- Cells with multiple nuclei;
- Large nuclei occupying most of the cell volume;
- An increase in the number of spiny cells - acanthosis;
- Irregular keratinization of the epithelium - parakeratosis;
- Violation of mitotic activity is an atypical division of epithelial cells.
Remember, precancerous is not cancer. This phrase indicates that without treatment, this disease in 40-65% can turn into cancer, through certain time(months, years).
4. Cervical cancer - malignant neoplasm on the cervix.
- Proliferating leukoplakia- thickening and keratinization of the epithelium covering the vaginal part of the cervix. The sample contains malignant cells.
- Fields of atypical epithelium- foci of proliferation with clear boundaries and a concave surface. Cancer cells are found among atypical cells.
- Papillary zone of atypical epithelium- white-yellow foci of epithelial growth near the external pharynx, containing cancer cells.
- Zone of atypical transformation in the zone of transformation of the cylindrical epithelium into a multilayer one, malignant cells with abnormal nuclei, impaired maturation, atypical vessels, and keratinized glands are found. More than 1/3 of the cells of the stratified squamous epithelium have signs of proliferation - active pathological cell division.
- Area of atypical vascularization- atypical vascular growths that do not contract under the action of acetic acid and vasoconstrictor drugs. Capillaries are short, tortuous, unevenly dilated. The vessels have an unusual shape (corkscrew, comma), they do not have anastomoses - the places where the vessels join. Such changes in the capillaries are caused by a malignant process.
- Preinvasive cervical cancer(intraepithelial carcinoma). initial stage uterine cancer, when the tumor does not extend beyond the basement membrane. Malignant cells are not yet capable of infiltrative growth - they do not penetrate deep into the tissue, do not violate its structure and functions. Appears in the area of the external pharynx, in the transformation zone on the border between the cylindrical and stratified epithelium. In women older than 50 years, it can be localized in the cervical canal. Does not form metastases. It responds well to treatment, it is necessary to remove a section of the mucosa. Depending on the structure of atypical cells, 2 forms of intraepithelial carcinoma are distinguished:
- Differentiated form - malignant cells retain the ability to differentiate, resemble the epithelium of the cervix.
- Undifferentiated form - cells lose the ability to mature and differentiate. Because of this, there is no layering in the squamous epithelium.
- Microinvasive cervical cancer(microcarcinoma). A slightly aggressive form of cervical cancer. The primary focus of the tumor grows in the depth of the mucosa up to 5 mm and in length up to 7 mm. Treatment - removal of the uterus, the upper third of the vagina, pelvic and other regional lymph nodes.
- Invasive cervical cancer. Malignant tumor of the cervix of different sizes. At this stage, there are metastases to the surrounding tissue and lymph nodes. Treatment: removal of the uterus with appendages and chemoradiotherapy (chemotherapy and irradiation of the pelvic organs). In the later stages, only chemotherapy is used.
The interpretation of the biopsy results should be done by your doctor. At the same time, he takes into account age, hormonal levels, the number of births, the results of colposcopy and a smear for cytology, and the woman's complaints. Based on these data, the gynecologist makes a diagnosis and prescribes treatment or refers to a consultation with an oncologist.
What diseases can be detected by biopsy of the cervix
| Diseases | Definition | Signs found on biopsy | Treatment tactics |
| Chronic cervicitis | Inflammation of the vaginal segment of the cervix. | Proliferation - accelerated cell division. Leukocyte infiltration - a high content of leukocytes in the tissue. There may be signs of dystrophy and degeneration of cells. | Anti-inflammatory treatment is needed: vaginal tablets and capsules Terzhinan, Polygynax, Klion-D. |
| Squamous metaplasia | The normal healing process of cervical erosion during which the columnar epithelium is replaced by a stratified squamous epithelium. | Metaplastic epithelium in large quantities. Cells of cylindrical and squamous epithelium without changes. | Treatment is not required. |
| Ectopia or pseudo-erosion | Pathological process, accompanied by the release of the cylindric epithelium beyond the boundaries of the external os to the vaginal part of the cervix. | Cells of metaplastic (transitional) epithelium with a large nucleus. Cells of normal columnar and squamous epithelium. Deformed cells of irregular shape. | Hormonal and anti-inflammatory therapy. Restoration of the microflora of the vagina. If necessary, laser or cryodestruction or cauterization with drugs (solklvagin). |
| Polyps of the cervix | Outgrowths in the cervical canal. Usually these neoplasms are benign, but in some cases their cells transform into cancerous ones. | Cylindrical or stratified squamous epithelium. Deformed irregularly shaped cells indicate inflammation. Atypical cells with abnormal cytoplasm, altered nuclei, etc. are possible. | Removal of polyps by scraping the mucous membrane of the cervical canal. |
| Flat condyloma | Viral disease of the cells of the cervix, sexually transmitted. Often accompanied by dysplasia. | Koilocytes in different layers of the epithelium. Atypical cells with enlarged nuclei of irregular shape. Epithelial cells of varying degrees of keratinization with impaired maturation. Enlarged cells of the basal layer of the squamous epithelium. Signs of proliferation are small cells with a thin membrane. Perinuclear vacuolization - vacuoles between the outer and inner shells of the nucleus. | Antiviral treatment. If it turned out to be ineffective, surgical removal of the condyloma is necessary. |
| Leukoplakia with atypia | Increased keratinization of stratified squamous epithelium on the vaginal part of the cervix. | Cells of stratified squamous epithelium with impaired maturation. Numerous scales of squamous epithelium in the cytoplasm, which lack a nucleus. Characteristic grains within epithelial cells, similar to inclusions found in malignant cells. Cells lack glycogen. Random arrangement of basal cells in the thickness of the epithelium. Atypical cells may appear. | Surgery. Removal of the altered area with a surgical instrument, laser or radioknife. |
| cervical dysplasia | A disease accompanied by a violation of the structure of the epithelium of the cervix. Often caused by human papillomavirus. | Violation of the layers of stratified squamous epithelium. Spiny cells in large numbers. Anomaly in the structure of cells - atypical size, shape, structure of the nucleus and features of the cytoplasm. Cells with impaired keratinization. The result of a biopsy depends on the degree of dysplasia:
| Antiviral and anti-inflammatory treatment. Stages 2 and 3 require surgical treatment, cauterization or cryodestruction. |
| Cervical cancer | The appearance of malignant cells in the mucous membrane of the cervix. | Atypical cells with thin membranes and a large number of nuclei are revealed. The nuclei are large, have a spongy structure and a deformed nuclear membrane. The shapes and sizes of malignant cells vary considerably. | Oncologist treatment. Depending on the form and stage of cervical cancer, it is required to remove a portion of the mucosa, uterus, uterus with appendages and lymph nodes. In parallel, chemotherapy and radiation therapy are carried out to destroy malignant cells that could spread from the primary focus of cancer and cause metastases. |
What to do after taking a biopsy
2 weeks after the biopsy, you will have to follow a number of rules. They are aimed at reducing the risk of bleeding and preventing infection of the wound. - For bleeding, you can use pads. Tampons injure the cervical mucosa and prevent healing, so they are prohibited in this period;
- To reduce pain, you can take ibuprofen-based drugs or paracetamol ;
- Exclude sexual contacts for 2-3 weeks;
- Refuse to visit the bath, sauna, do not take a hot bath;
- Do not visit the pool, beach, do not swim in open water;
- Do not take blood thinners that can cause profuse spotting - aspirin, heparin, warfarin;
- Limit physical activity. Temporarily exclude sports, weight lifting more than 3 kg;
- Limit sitting position. In this case, the pressure on the cervix increases;
- Do not use vaginal forms of medicines (candles, tablets, douching solutions) without a doctor's prescription.
To accelerate the healing of the cervix after a biopsy, apply:
- Ornidazole 500 2 times a day for 5 days for the prevention of infections after the intervention;
- Genferon 1,000,000 units rectal suppositories at night for 10 days. Immunomodulatory drug that accelerates regeneration and improves immunity;
- Terzhinan - vaginal tablets. Antibacterial and antifungal drug for the prevention of inflammatory complications. Enter into the vagina at night for 6 days.
- Betadine suppositories. Antimicrobial agent effective against bacteria, fungi and viruses. 1 time per day for 7 days.
- Depantol candles. Accelerates regeneration, has an antimicrobial effect. Enter into the vagina 1 suppository at night for 10 days;
- After 10 days, Galavit is an immunomodulator with an anti-inflammatory effect. 1 suppository at night vaginally. The first 5 days daily, then every other day.
Symptoms that may indicate complications after a biopsy include:
- An increase in body temperature above 37.5 degrees;
- severe pain in the lower abdomen;
- Profuse spotting lasting more than 7 days;
- Profuse spotting after scanty;
- Dark discharge with blood clots;
- Yellow discharge with an unpleasant odor;
- Increased pain in the uterus, deterioration of the general condition.
Hello my readers!
I am such an interesting person who manages to try all sorts of not very pleasant procedures on himself without preparation.
I don’t really like hospitals, and thank God I don’t appear there often, but if I come, I do a full examination.
Many people, having learned that they will have this or that procedure, try to read reviews about it and mentally prepare.
I never do it. Because then it's scary to go to the procedure.
All people are different, have different pain thresholds, mental stability, and for someone to take blood from a finger is an event.
I always go to the hospital "unread"; to the point of being afraid. I know enough about the process, but I don't read real people's reviews of it.
WHAT IS A BIOPSY?
A biopsy of the cervix is gynecological examination, which allows you to clarify the diagnosis if you suspect dysplasia or cervical cancer.
In my case, this is cervical erosion, which formed after childbirth.
She's big, so specifically for me the diagnosis did not need to be confirmed.
The biopsy procedure was needed as a regular study, which is constantly prescribed by a gynecologist if there is erosion or other pathologies in the uterus, and I also had an iodine-negative area.
I know all these nuances for sure, because where I did the research, in front of my nose hanging three monitors where you can see all your insides and manipulations of the doctor.
WHO NEED A CERVICAL BIOPSY?
- Poor Pap smear results
- the presence of suspicious changes in the cervix during colposcopy (acetowhite epithelium, iodine-negative areas, atypical vessels, the presence of coarse mosaic and punctuation, etc.)
- cervical erosion
- leukoplakia (hyperkeratosis)
- cervical polyps
- warts.
Need to do a biopsy after graduation critical days, better on the 7-13th day of the cycle. In my case, it turned out on the 9th day of the cycle, but if there is an urgent need, I do not think that doctors will wait for a certain day and perform the procedure immediately.
Biopsy does not require any special preparatory procedures other than those normal people so do before a visit to the gynecologist.
Namely:
Three days before the visit and, accordingly, before the biopsy it is forbidden live sexually;
- Necessarily conduct personal hygiene, do not need to douche and rub the causal place with delicious-smelling wet wipes;
***It would seem that hygiene is so elementary that you don't even need to write about it. But it's not.
I will always remember the lady with whom I was in the ward after childbirth. There were two of us, a double room.
So after the birth and the next three days after the birth, she never went to the shower. Never!
Those who gave birth, you imagine what happens after childbirth and the rest of the days. And how can you not swim?
I just walked away from anesthesia and cancer, sideways, but trudged into the shower, because how else?
Moreover, the girl was so impenetrable that when the doctor made a remark during the examination, because there was nothing to breathe in the ward, the girl, as if nothing had happened, said that she was already buying at home.
So hygiene is a must!
- do not use swabs 2 days before the biopsy;
- do not enter no drugs in the vagina unless recommended by a doctor;
If the biopsy will be done under general anesthesia, then you should try not to eat 8 hours before the procedure.
HOW IS A CERVICAL BIOPSY PERFORMED?
After the examination and during the colposcopy, the doctor (at least a normal doctor) will tell you exactly how the procedure will take place so that you are not afraid.
Tells you what you will hear and feel.
***When the doctor told me for a very long time, she convinced me that it almost did not hurt, that we would not anesthetize (I am allergic to Lidocaine), that there was no need to worry. That I would experience heaviness and pain like menstruation.
In general, from her story, I prepared to endure pain akin to installing a pessary.
The doctor puts under the buttocks a special grounding mat approximately 10 * 15 in size, and using a special needle-loop, takes a "column" of cervical tissue containing all the layers of cells necessary for the study.
This so-called puncture biopsy.
There is also radio wave biopsy, then the procedure is carried out with a special radio knife. It lasts for a second and at the same time you can feel the smell of fried.
In this way, the doctor, as it were, “burns out” the desired area and a trace remains at the place of burning, which heals quickly.
The risk of scarring on the cervix after a radio wave biopsy is extremely small, and therefore this type of biopsy is recommended. girls and women who are planning a pregnancy in the future.
It turned out that the biopsy procedure was not only second and it feels like you were bitten by a mosquito . Only inside!
I can't even compare it to taking blood from a vein, taking blood is much more unpleasant.
I can’t say that it’s unpleasant, it hurts - it doesn’t! As my daughter says, "Oh, that's it."
After the whole process, I had only one thought: are there people who anesthetize? For what? Once again drip / pour / inject yourself with this muck if there is nothing to endure, everything is so fast.
But I want draw attention to what exactly sighting biopsy anesthetize do not see the point! If these are other, more serious types of biopsy, then you need to anesthetize.
WHAT HAPPENS AFTER THE BIOPSY?
Almost all women experience bleeding from the vagina after a biopsy. Depending on which biopsy method was used, the discharge may be more or less abundant and prolonged.
I didn't have any bleeding at all.
Immediately after the procedure, I experienced internal discomfort and slight pulling pains in the lower abdomen.
An hour later, chills began and mild pain in the ovaries is similar to that of a cold.
After half a day, light yellow discharge began, not abundant, which lasted two days. By this time, all the pains were gone and only small discharges remained.
If you have spotting, use a pad. You can not use tampons, douche and have sex until the discharge has completely stopped.
WHAT ELSE CAN YOU FEEL?
- Pain inside the vagina and lower abdomen. This is completely normal and will go away in a day or two.
The body temperature rises. If it rises above 37.5, then there may be an infection and you need to go to the hospital.
WHAT NOT TO DO AFTER A BIOPSY?
In no case after the procedure you can not have sex for at least 7 days.
And this applies not only to vaginal sex, but also to anal and other ways of delivering pleasure.
In some cases (depending on the type of biopsy you have), your doctor may recommend sexual rest for 2-3 weeks after the biopsy.
It is forbidden take a bath, take a bath . Only a shower and when washing, you do not need to try to wash deeper. Only outside.
There are usually no problems or complications after a biopsy, but if you feel unwell (bleeding is bright red, "menstruation" after a biopsy lasts more than 7 days, spotting is not abundant, but lasts more than 2-3 weeks, you have a fever body) then you need definitely go to the doctor!!
I, like many people, can not stand interference in my body. I don't take pills (at least when it can be avoided.
***If I overate, I won’t run to swallow Mezim, if my head hurts, then this should really interfere with my life so that I take a pill).
I try to keep a healthy lifestyle and stick to a not quite traditional diet.
But if there is a need for such procedures as a biopsy, then this cannot be avoided. To be honest, although it doesn’t hurt, it’s all unpleasant. The very fact of holding is unpleasant, the waiting is unpleasant and it is not very pleasant to look at it on the monitor).
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