What is an endometrial biopsy?
An endometrial biopsy involves taking a small sample of tissue from the endometrium (lining of the uterus) usually to ensure that there is no serious disease.
At one time, a D&C operation was one of the most commonly performed of all operations. It was undertaken as a check to exclude pre-malignant or malignant conditions of the lining of the uterus when there was abnormal bleeding, most commonly heavy periods - menorrhagia. It could also be done during investigations of other problems such as infertility.
To enhance the information provided by the D&C, hysteroscopy was added when it became available in the mid 1980s.
We now know that an endometrial biopsy can provide virtually as much information as the D&C and in combination with pelvic ultrasound, it is about as accurate as hysteroscopy and D&C.
Endometrial biopsy has been shown to accurately identify endometrial cancer.0301Outpatient endometrial biopsy has a high overall accuracy in diagnosing endometrial cancer when an adequate specimen is obtained. A positive test result is more accurate for ruling in disease than a negative test result is for ruling it out. When abnormal uterine bleeding symptoms persist despite negative biopsy, further evaluation is warranted.0201
What is meant by a hysteroscopy and D and C?
D and C involves the dilatation of the cervix (neck of the womb) and curettage (a curette is a surgical spoon) to "scrape" representative samples of the lining of the womb. These "curettings" are sent to the laboratory and examined under the microscope. These days most gynaecologists combine the D and C with hysteroscopy (8). Polyps or fibroids distorting the cavity of the womb may be diagnosed or excluded. The D and C is generally recommended to ensure that the lining of the womb is not seriously abnormal (for women aged 40 or more) before commencing medical treatment.
For many years it was believed that the D and C had a therapeutic effect. It is now recognised that the first period after a D and C may be lighter but there is no long-term improvement. It should be emphasised that the D and C, like a blood test or an x-ray, is a diagnostic procedure and not a treatment.
Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
