Cervical Biopsy

A cervical biopsy is a surgical procedure by which a small amount of tissue sample are taken from the cervix and examined for any disease or problems. Cervix refers to the narrow end of the uterus at the end of the vagina. Cervical biopsy is done to detect risk for developing cervical cancer. It is a diagnostic tool for benign polyps on the cervix or genital warts. Normally it is performed by her gynecologist.

As such, cervical biopsies can be done by three different methods, the punch biopsy where small pieces of tissue are taken from her cervix by an instrument called biopsy forceps, the cone biopsy, where a large cone shaped tissue is taken by scalpel or laser and endocervical biopsy, where cells are removed by a hand held instrument, shaped like a small scoop.

Cervical biopsies are done a week following menstruation. This will enable the doctor get a clean specimen. As some medications can increase the risk of bleeding, it is recommended to stop taking these drugs for some time before the biopsy. Similarly, the patient is advised to avoid using tampons and medicated vaginal creams for at least 24 hours before the procedure. Sexual intercourse should also be refrained from.

The cervical biopsy procedure is not elaborate. A routine pelvic exam is done and the gynecologist administers local anesthetic. A speculum is inserted into the vagina and the canal open during the procedure after the cervix is washed with vinegar and water. This is Schiller test, by which the doctor is able to identify the abnormal tissues. The procedure is not painful; only a pinching sensation is felt. After the biopsy is done, the doctor packs the cervix with absorbent material to reduce the amount of bleeding, but not every biopsy needs such packing.

The recovery process will vary and this depends upon the type of biopsy performed. Except for some mild cramping and spotting, recovery is not difficult. At times, the cramping and bleeding may run for a week. Post cervical biopsy activities are restricted and it is better to avoid heavy lifting, intercourse, using tampons for several weeks especially after a cone biopsy.

Colposcopy

Colposcopy is a diagnostic tool that is often followed after an abnormal Pap smear test. A Colposcope is much like a large electric microscope that allows the physician to visualize the cervix, vaginal and genital area.

Basically a Colposcope is a complex optical instrument using light and magnification to distinguish dysplasia and cervical cancer from benign cervical findings. The word Colposcope is derived from 'colpo' indicating a vagina and 'scope' which refers to 'look'.

The physician applies vinegar solution to look for Leukoplakia and abnormal vessels. Colposcopy aids in viewing the cervix for any abnormal vascular changes. A colposcopy is suggested when there is any abnormality observed in the cervix or there is evidence of HPV. With a camera attached, images can be saved for records. During this procedure, any tissue sample or cervical biopsy can be taken for further investigation. This may cause slight discomfort and cramping. This diagnostic tool can be helpful in detecting any inflammation, cancerous growth or infection.

Preparation before colposcopy: Some conditions may require some medications before a session of colposcopy. Atrophic vaginal or cervical epithelium can be treated with intravaginal estrogen for 2-4 weeks before colposcopy in order to 'normalize' the epithelium.

Primary indications for colposcopy include abnormal Pap results or an abnormal appearing cervix. Early detection of cervical cancer is possible with colposcopy. Colposcopy is done in cases where a woman has unexplained bleeding during intercourse or there is any abnormal tissue on the cervix, vagina or vulva.

The Papanicolaou smear (Pap smear or Pap test) is a common test for dysplasia and cancer of the uterine cervix. In the US alone more than 50 million Pap Smear tests are taken every year. The Pap test is a cytologic examination of cells from the cervical transformation zone. A Pap test is often used to differentiate malignant cysts from common and mostly benign cysts. For example, Nabothian cysts are common and considered as a normal feature of the adult cervix.

A pelvic examination can sometimes help detect cysts and polyps. Endocervical polyps are the most common benign neoplasms of the uterine cervix. They are usually asymptomatic (but sometimes may cause vaginal discharge or post coital spotting) and occur in the 40 - 60 years. Most polyps are benign and the incidence of malignancy is approximately 1 in 1000.