#Endo biopsy inconclusive full#

#Endo biopsy inconclusive full#

With the sheath positioned within the uterine cavity and stabilized with the thumb and index finger of one hand, the internal piston on the catheter is rapidly and fully withdrawn the full permissible distance to create suction at the catheter tip. Traction on the tenaculum, if used, should then be released. A pressure release may be detected after passing through the internal cervical os, and the next resistance felt will be the fundus. The physician should avoid contamination from vaginal tissue. Next, the physician should insert the endometrial biopsy catheter through the cervical canal and advance it to the uterine fundus according to the depth obtained from sounding. Systematic review and meta-analysis of randomized controlled trials with consistent findings showing reduced biopsy-associated pain Two randomized controlled trials demonstrating more adverse effects without increased ease of biopsyĬonsider using topical lidocaine to reduce procedure-associated pain during endometrial biopsy. 3ĭo not routinely use oral misoprostol (Cytotec) before endometrial biopsy. Women with postmenopausal bleeding but no risk factors for endometrial hyperplasia or cancer may have transvaginal ultrasonography or endometrial biopsy as a first-line approach to evaluation. 4, 8Įxpert opinion and consensus guidelines in the absence of clinical trials Postmenopausal women and women with persistent or recurrent symptoms should receive further evaluation even when biopsy results are normal because blind sampling may miss focal lesions.Įndometrial biopsy should be performed for patients with abnormal uterine bleeding who are 45 years or older, and in younger patients with a significant history of unopposed estrogen exposure, persistent bleeding, or in whom medical management is ineffective. Patients should be referred for further evaluation if the procedure fails or an insufficient sample is obtained. Cramping is a common adverse effect, but serious complications are rare. A tenaculum should be applied only if required by cervical mobility or uterocervical angulation because it increases pain and lengthens procedure times. Nonsteroidal anti-inflammatory drugs can be administered orally before the procedure, and topical lidocaine can be applied to the cervix before starting the procedure to reduce procedure-associated pain. Tissue sampling occurs by rolling the catheter while moving it in and out of the uterine cavity. The catheter's piston is then drawn out to create suction. The biopsy is performed with an endometrial biopsy catheter that is inserted through the cervix into the uterine cavity. Pregnancy is the only absolute contraindication to the procedure.

Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in postmenopausal women.

Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding.