After the biopsy, the menses are clear. Pipelle biopsy

Ask your gynecologist for a special device that allows you to collect material without additional manipulation. The procedure is considered to be as safe and gentle as other types of biopsies due to the fact that there is no dilation of the cervix.

Pipelle biopsy of the endometrium is used to examine the inner uterus, in which there is no opening of the cervical canal. The gynecologist takes the material for analysis for further laboratory diagnostics such as follow-up. To perform a biopsy, the gynecologist quickly uses a pipette tube. At the end of its opening, through some necessary diagnostics, the material is lost throughout. No additional manipulations for collecting the endometrium do not require permanent cleaning of the tube.

Pipelle biopsy allows you to make clinical visits within an hour of the procedure, as required.

What does it show

Pipele endometrial biopsy shows:

• presence of atypical (cancerous) cells;
• detection of bacteria and viruses, and the risk of other infectious diseases;
• hyperplasia (growth of the endometrium).

The diagnosis is confirmed or simply transferred after testing the material in the laboratory.

Advantages and disadvantages

The advantages of performing a Pipel biopsy are that:

• the procedure is carried out in the gynecologist’s office, there is no need to register at the hospital;
• it's hard to worry about;
• it is allowed to investigate for the presence of various illnesses if other types of biopsies are present;
• disposable instruments are purchased;
• traumatization is minimal;
• there is no need for prolonged anesthesia;
• high information content of the method;
• The price varies between 3000 rubles.

All patients who have undergone pipell biopsy of the endometrium are subject to negative effects. Most often, the smell is associated with incorrect procedures performed by the doctor, if there is trauma to the fundus of the uterus. The material is also uninformative, due to the fact that the patient did not remember the date of the procedure or other benefits. There’s a lot to be said for how painful the procedure is.

Showing

A Peipel biopsy is ordered by the doctor to confirm and clarify the diagnosis.

Indications for the procedure are as follows:

• infertility;
• preparation before EKZ;
• bleeding not associated with menstruation or after taking hormonal medications;
• bloody visions that would not end after the curtains;
• fibroids;
• presence of polyps;
• endometriosis;
• hyperplasia;
• disruption of the menstrual cycle;
• suspicion of the presence of malignant cells.

Contraindications and restrictions

Pipelle biopsy of the endometrium has a low contraindication before the procedure:

• vagusness;
• impaired throat blood.

In the middle of the hour, the traces show the active stage of inflammation of the sechostatic system.

On which day of the cycle can you often undergo a biopsy?

Pipelle biopsy of the endometrium is performed on the 25th or 26th day of the cycle before menopause. In case of clear bleeding during the hour of menstruation, the doctor may prescribe an operation on days 5 to 10 or days 17 to 20 of the cycle. After menopause or if cancer is suspected, a biopsy can be performed any day.

A pipell biopsy of the endometrium is performed on the same day of the menstrual cycle as prescribed by the doctor. You can’t choose a day on your own. For different diagnoses, the days vary.

This type of quilting can be done often, as it was prescribed by the doctor. Sometimes, to clarify the diagnosis, the procedure is carried out twice during one menstrual cycle.

Preparation before investigation

Preparation before pipel biopsy of the endometrium must be completed to avoid complications.

Primary includes low quilting:

• smear from a gynecologist;
• coagulogram.

A smear is necessary to exclude infections or other illnesses. Ultrasound indicates the presence of pathology and confirms the presence of viscosity. It is necessary to perform a coagulogram to exclude problems with blood throat. This biopsy transfers a vicoristic coagulant to seal the vessels in case of bleeding.

How to prepare before pipel biopsy of the endometrium, if the procedure is allowed:

• 3 days before the procedure, turn off contacts, douche and do not use vaginal suppositories;
• If you need to see a doctor, consider taking hormonal drugs and medications that will thin the blood.

Vikonanny technique

The technique of this procedure suggests an examination by a gynecologist and looks like this:

1. The woman unwinds and sits down on the chair.
2. The medicine should be injected directly into the mouth using a speculum.
3. Then the size of the uterus is measured by introducing a special vibrating device through the cervical canal. This is necessary for the correct choice of straw.
4. A pipette is introduced into the uterus and material is collected from 3 different places.
5. Possession remains, the woman can get up from the gynecological chair.

The video below shows the procedure for 3D animation. Taken from the Promatka channel. ru.

How to collect material

The procedure goes like this: the doctor creates a negative pressure behind the piston at the bottom of the tube. The endometrial tissue flows through the middle of the device through the hole at the end of the pipe. Possession of the material is carried out and sent to the laboratory.

How painful the procedure is and how much it involves

If you perform a pipell biopsy of the endometrium, you will need to meet a specific pain threshold. Doctors claim that the procedure is painless. Some gynecologists tend to recommend taking pain medications before undergoing a biopsy. As a rule, pain sufferers do not worry about pain often and there are short-term unpleasant symptoms.

The duration of a biopsy is approximately 2 minutes.

What you cannot do after the procedure

After a tube biopsy of the endometrium it is not possible to:

• for the presence of bloody vision, use tampons;
• take a bath, overheat;
• get cold;
• lead the story of life;
• stop antibiotics;
• Vikoristovat hormonal contraceptives.

It is important to avoid physical stress and adhere to bed rest for 2 days. The restrictions are imposed in 2-3 days, if the doctor does not recognize otherwise. If during the procedure there was trauma to the uterus, it should be continued for up to 30 days.

Terms for extracting results and decoding them

The results are reported 7-10 days after endometrial tissue collection. As a rule, the decoding consists of one phrase that has reasonable meaning for a gynecologist.

This may be, for example: normal epithelium in the proliferative phase. If the material is taken for a few days at the beginning of menstruation, such a diagnosis means hormonal disorders in the body.

Therefore, in order for the doctor to make an accurate diagnosis, it is important to follow the recommendation and undergo a biopsy on the required day of the cycle. Otherwise, the diagnostic result will be incorrect.

Inherits and possible complications

After a biopsy, the following are possible:

• locking in a 10-day term, or a scanty/half-month period;
• perforation of the uterine fundus (as the procedure is carried out due to the presence of inflammation).

Complications rarely appear and look like this:

• bleeding associated with the patient’s throat or uterine injuries;
• the presence of a bacterial infection after the procedure, which is lost from the soil;
• vision of brown color;
• Endometritis.

Pipe biopsy is not characterized by strong vision, so the trauma is minimal. If the woman is not crooked, but there is obvious bleeding - after 3 pads for 2 years - hospitalization is required. If there are any difficulties after the operation, it is easy to get lost while waiting for the next steps.

Of course, the first reaction of a woman when a gynecologist prescribes a needle biopsy of the endometrium is fear of the name itself, and not just before the procedure of taking an analysis. It is advisable to understand all the nuances of this diagnostic method and understand if you are afraid of it. In our article, you will learn about the meta-indication before undertaking the procedure, the specifics of the procedure and contraindications.

Why is it carried out?

First of all, we want to reassure those who panicked when it was recommended to undergo this procedure. This is a standard diagnosis, which is prescribed for rich women in order to determine the development of the internal mucous membranes of the uterus - the endometrium. The idea is that, using a special tube (pipel), the doctor penetrates the empty uterus and then removes a small amount of tissue for further histological analysis in the laboratory.

Previously, the analysis was performed as a biopsy, but for this procedure it is necessary to expand the cervical canal, which is even painful, which requires anesthesia. The main benefit of pipel biopsy is painlessness. A thin catheter with a diameter of 3 mm can be passed through the neck without any expansion, tissue or the middle, using a piston similar to the one used on a syringe. In this case, the patient may experience minor, completely tolerable discomfort.

• there is a great need for stationary minds;
• daily consumption in the enlarged cervical canal;
• minimal risk of infection, scraps of parcant are handled with a disposable instrument;
• the possibility of taking analysis from any area of ​​the endometrium;
• outside saving of a woman's usefulness;
• increasing the chances of successful embryo transfer in the hour before IVF.

Pipelle biopsy of the endometrium is the most accurate diagnostic method, which allows you to correctly diagnose and monitor the effectiveness of treatment.

Do you know? For more than a decade, cervical cancer has been the leading cause of cancer in women after breast cancer. For the immediate detection of hundreds of cases, the mortality rate due to illness becomes 9%. With advanced oncology of other organs - 83%.

Showing before stagnation

Pipelle biopsy is indicated for the following conditions:

• uterine bleeding during menstruation or at the beginning of menopause, after abortion, subject to the hour of hormonal treatment;
• there was concern for the evidence of normal tests;
• plentiful innocence of vaginosis;
• daily occurrence of menstruation, menstrual cycle disorders, cramping, in the luteal phase;
• the presence of fibroids, other swelling for significant malignancy, suspicion of cancer;
• obvious heat and suspicion about them;
• endometrial hyperplasia;
• after hormonal treatment to evaluate its effectiveness.

Depending on the specific type, the analysis is performed on the first day of the menstrual cycle. There may be indications in case of blurred symptoms and an unclear picture of the causes of the problem with women's health, in order to confirm or simply transfer the diagnosis. If carcinoma is suspected, material may be collected on any day of the cycle.

Do you know? The uterus is the only organ of the human body that may not lose its function in an hour of life. This is due to the fact that the woman never fell in love. This is the same organ that can increase in size tenfold, and then rotate to its full parameters.

Preparation before the procedure

There is no need for special preparation before the procedure. In this case, the doctor knows that the accuracy of the analysis can only be achieved by following these simple rules:

• do not contact other people for money before the biopsy;
• do not insert tampons or candles into empty soil, do not smear the soil with ointments, do not apply lubricants, do not syringe - it is necessary to preserve the natural core of the soil.

The gynecologist will also perform additional tests that will need to be performed first in order to accurately determine the location from which tissue will be collected. Typically a woman goes through:

• blood test for HIV, hepatitis, Rh factor;
• external blood test;
• skin smear for microflora and cytology;
• Ultrasound of the uterus.

Important! It is not advisable to carry out the procedure on your own. You only need to work according to the doctor’s directions. Self-indulgence can lead to unfavorable consequences and devastation.

Most often, for women of the reproductive age, the procedure is prescribed on days 21-23 of the menstrual cycle. However, if a specific illness is suspected, the day of collection will be determined individually for each patient.

From the eighth to the 11th day, the procedure is carried out before the EKZ, in order to accurately determine the endometrium.

Women who have reached the menopausal period are directly given one day at a time.

When undergoing a procedure, the patient must inform the gynecologist about the medications she is taking. Particularly worth mentioning are those used to thin the blood.

Contraindicated

Pipel biopsy is not recommended for women who have:

• inflammation of the skin, cervix, pelvic organs;
• impairment of hemostasis;
• anemia;
• purulent cervicitis.

If a woman has a low pain threshold, anesthesia will be instituted before diagnosis. In this case, the patient feels absolutely nothing during tissue collection.

How to be carried out

However, the pipel biopsy procedure is quite simple and is carried out in a polyclinic on a gynecological chair.

Before the procedure, the doctor coats the neck with an anesthetic or uses another syringe. Then the gynecologist inserts a tube with a piston into the cervix. When it is lowered to the bottom, it is necessary to soak a large amount of fabric into the cylinder, which is located at the end of the pipe. After removing the tube, the material is sent for histology.

In an hour, the parcanu procedure takes about half of the time. The entire process, from manual inspection of the uterus to the insertion of the pipe, takes about 10 minutes.

After the procedure, you may rarely experience painful spasms or minor bleeding. This is a reaction to handing over an empty uterus. It is unacceptable to go through the trouble. If pain is avoided, it can be relieved with antispasmodics.

Important! Unusual situations after the procedure include early menses, brown spots that smear, an unpleasant odor that lasts for a long time (even more), severe pain in the lower abdomen. So begin to force the ungainly beast to the doctor.

Regardless of the fact that the pipell biopsy does not affect the woman’s productivity, on the day of aspiration you still try to engage in sports, important physical activities, and the severity. It is also necessary to wait until you take a bath if you notice any oily vision, until it goes away again. It is best to perform the mittya procedure in the shower. Before finishing, you will see a trace of the article contacts.

Result

The results of the analysis will be ready in 7-10 days. They are deciphered by a gynecologist who wrote directly.

Thus, pipel biopsy is a thorough method of aspiration biopsy, the advantages of which lie in painlessness, to give rare caution to the success and complexity and reliability of the results . Therefore, such aspiration can be performed without pain relief or with prolonged local anesthesia. To obtain a reliable result, you will need to carry out two or three fences.

Video: indications before aspiration biopsy of the endometrium

Biopsy of the endometrium of the uterus- A procedure during which samples from the mucous membrane of the uterus are collected - endometrium. The tissue samples are delivered to the laboratory, where a histological analysis is carried out - the tissue of the mucous membrane is examined and atypical signs are identified in the tissues.

Goals. Current doctors widely recommend biopsy of the endometrium of the uterus. There are obligatory investigations when preparing a woman before extracorporeal impregnation (IVF). This procedure not only provides information about the endometrial structure, but also significantly increases the chances of implantation of the embryo.
Endometrial biopsy is necessary to detect:

• reasons for infertility and temporary interruption of gestation;
• hormonal disorders;
• causes of uterine bleeding not related to menstruation;
• endometrial hyperplasia - growth of the mucous membrane of the uterus;
• evil changes - uterine cancer.

• Paypel biopsy- The material is collected using a thin plastic tube with a barrel opening at the end. Behind the help of the piston, a negative pressure is created in the tube, so that tissue from the uterus and endometrium is inserted into the cylinder. It is important to take the material in the least traumatic way.
• Aspiration biopsy– the principle of the procedure is the same as during Pipe biopsy, but instead of creating a negative pressure, a syringe or an electric vacuum device is used.
• Diagnostic testing of the uterus- Collect the material using a surgical spoon - a curette. The gynecologist scrapes the upper ball of the mucous membrane from the surrounding sections or from the surface of the uterus. The mucus is scraped from the surface or has the appearance of line scrapers - trains.
• Biopsy under hysteroscopy– samples of the uterine mucosa are collected under an hour of endoscopic closure using an additional hysteroscope – a probe equipped with a miniature video camera and a miniature surgical instrument.

Biopsy follow-up. In the laboratory, the biopsy is watered, removed with fat, and then soaked in paraffin, turning it into a solid cube in special molds. Using a microtome, it is cut into plates 3-10 microns thick. These thin balls of fabric are placed on a slide, stuffed and covered with another slide, which allows you to fix the material and save it for a long time.
Physicians, histologists and pathomorphologists examine tissue samples, vicoristics and light microscopes. The whole process takes 7-10 days, after which the results are seen, which describe the peculiarities of the endometrium. A residual diagnosis is rarely made in obvious cases. Most patients are clinically diagnosed by a gynecologist based on the results of a biopsy and other procedures (subjective symptoms, examination results, hysteroscopy, colposcopy).

Budova uterus

• External ball or parameters- Happy is the tissue that covers the organ of the soul. It also creates ligaments that will ensure the attachment of the uterus.
• Inner ball or myometrium- Smooth meat. A thick ball of meat tissue will ensure the destruction of the fetus and the shortening of the uterus during pregnancy.
• Inner ball or endometrium- Mucous membrane, which avenges a large number of blood vessels. She has uterine deposits, which show mucus that crosses the collapsed walls of the uterus.

• Proliferation phase- Increase in the functional sphere of the endometrium, its renewal after menstruation. Trival from the 5th to the 14th day of the cycle. The proliferation of cells in the endometrium, their proliferation, is stimulated by the hormone estrogen.
• Secretion phase- Actively seeing the secretion by the uterine glands, which creates optimal conditions for the attachment and development of the embryo. It occurs approximately from the 15th to the 27th day of the cycle. Changes are stimulated by the body fat hormone progesterone.
• Bleeding phase- The period during which the functional ball of the endometrium is released and removed from the uterus during menstruation. Trival from the 28th to the 4th day of the cycle. The impairment of the functional ball is associated with progesterone deficiency. Because of their absence, the arteries that give life to the upper ball of the endometrium are squeezed, through which the cells do not maintain enough life and die.

In the mucous membrane of the uterus, a number of storage cells are visible. Your vaginal tissue may change depending on the phase of the menstrual cycle.

• Basal ball- the lower ball that adheres to the meatal membrane of the uterus. Its main function is to ensure the renewal of the functional sphere after menstruation or other periods. Thickness 10-15 mm. Poorly responds to hormonal changes. The cell kernels are oval and are intensively prepared. During each phase of the cycle, the shape of the cells changes and the formation of certain nuclei occurs. There are large clusters of bulbs here, which are immature clusters of migratory epithelium.
• Functional ball- The superficial ball that surrounds the empty uterus. Its function is to ensure the adhesion of the fertilized egg and subsequent implantation. He is the most sensitive to female state hormones. At the hour of menstruation, the veins are completely discharged. In the first days after menstruation, your weight loss is minimal. Until the end of the cycle, the von grows to 8 mm.
• Uterine ovaries- Simply undisturbed tubular parts of the ovary that reveal mucus secretion, which ensures the normal functioning of the uterus. Take your cob from the basal ball. During the cycle, as the functional ball grows, the thickened tube becomes soft and takes on a sinuous shape, but does not soften.

• At the basal ball The uterine glands are narrow, densely spread and separated by narrow stroma. Its surface is lined in one row with a cylindrical epithelium, similar to that covering the surface of the mucous membrane.
• In a functional ball The main parts of the tubes and their visible ducts are located. In the first week after menstruation, the vaginal tube has a straight shape and a narrow lumen. Then it will become soft and develop a sinuous shape. At this stage of the uterus, mucus begins to secrete, which accumulates in the protozoa, and then is released into the empty uterus, dissolving the mucous membrane.

• Endometrial stroma – This is a good tissue because it ensures the integrity of the mucous membrane and binds the cells to the endometrium.

• At the basal ball the stroma is thick, composed of rich cells and a large number of thin collagen fibers. The cells of the stroma are small and round, the cells of the endometrium are smaller. The stench grows in small groups between the uterine veins. The nucleus is round, edged with a thin lining of cytoplasm.
• In a functional ball After menstruation, the stroma is represented by lower argyrophilic fibers, which become coarser until the end of the cycle. The shape of the cells is spindle-like, they have large nuclei. The cells are found at a distance of one type, that is, the stroma of the fluff. During the secretion phase, the endometrium becomes congested and water and life substances accumulate between the stromal cells, increasing the space between them.

Indications before uterine endometrial biopsy

• Intermenstrual acyclic bleeding;
• Bleeding after menopause;
• I experienced bleeding around the time of menstruation;
• Bleeding after a fleeting abortion;
• Bleeding due to the use of hormonal contraceptives;
• Assessment of the effectiveness of hormonal therapy;
• duration of menstruation without pregnancy;
• Understanding the causes of infertility;
• Endometrial polyps;
• During treatment for uterine fibroids, endometriosis, endometrial hyperplasia, ovarian cyst;
• Signs of atypia of the mucous epithelium, revealed by a cytology smear (Pap test);
• Please note that ultrasound examination of the uterus is performed over 3 cycles;
• Swell the endometrium to identify malignancy;
• Preparation before piece filling.

• Any day of the cycle - if there is a suspicion of endometrial cancer;
• Immediately after menstrual bleeding due to endometrial polyps;
• On the first day there is bleeding or bleeding to identify the causes of uterine bleeding not related to menstruation;
• On the 7-10th day, bleeding occurs during dry menstruation;
• On days 17-24 of the cycle to determine the sensitivity of the endometrium to hormones;
• 2-3 days before the start of menstruation in case of infertility, lack of body fluid, for a large number of anovular cycles.

Contraindications before any type of endometrial biopsy are:

• Vaginism;
• Acute infections of the sechostatic organs;
• Inflammatory disease of the pelvic organs – genital and genital;
• Significant damage to the throat of blood.

How to prepare for uterine endometrial biopsy?

• State contacts;
• Douching;
• Use of any vaginal medications without a doctor's prescription.

• Significant blood loss - coagulogram;
• Blood test for HIV, syphilis - RW, hepatitis B and C;
• Smear on flora - bacteriological investigation instead of state paths;
• Test for human chorionic gonadotropin in the blood of a section - a test of significant vasodilation.

Biopsy technique

At the preparatory stage, carry out:

• cleaning external organs with an antiseptic;
• Expansion of the area with a gynecological speculum to provide access to the cervix;
• Cleaning the cervix with alcohol;
• Fixation of the cervix with culo forceps.

1. Diagnostic examination of the uterus

• With the help of Hegar's dilatators (which are metal cylinders with a diameter of 4-13 mm), dilation of the cervical canal is carried out. Its width is similar to the size of a curette - a surgical spoon.
• Into an empty uterus, insert a curette of the required size.
• Having pressed the curette to the anterior wall of the uterus, move it from the fundus to the internal os, dissolving the functional ball of the mucous membrane.
• The spoon with the material is removed from the uterus and the material is collected from the container with formalin.
• This is repeated, successively scraping out the entire mucous membrane from the anterior, and then from the posterior wall of the uterus and the mouth of the fallopian tubes.
• When the reaction of the endometrium to hormones is investigated and the cause of infertility is determined, the doctor does not scrape the entire surface of the uterus, but is surrounded by three adjacent scrapers - trains.

• In case of constant exclusion of the rhizik, there are signs of atypia or endometrial cancer;
• It is possible to immediately remove pathological defects within an hour of the procedure.

• Check in with the hospital;
• Requires administration of internal anesthesia;
• The procedure is highly traumatic;
• Trival period of renewal – up to 4 years;
• There is a risk of development of complications if the procedure is carried out incorrectly.

• Insert a catheter (thin empty tube) with a diameter of 2-4 mm through the cervical canal near the empty uterus. You squeeze him tightly at the end of the uterus.
• Apply a syringe to the outer edge of the catheter.
• By pulling the syringe plunger, touch the epithelium of the uterine mucosa.
• Apply the remover material in a thin ball onto a non-greasy object.

• Using a thin catheter and syringe, inject 3 ml of physiological solution with added sodium nitrate into the empty uterus. Remaining necessary for preventing the formation of blood clots.
• Immediately after insertion, the area is removed with a syringe.
• The cleaned mixture is removed, placed in a test tube and sent to a centrifuge for 8 minutes. After which, at the bottom of the test tube, a sediment from the cells settles. This method allows you to retrieve information about the features of the surrounding cells, but not about the mucous membrane as a whole.

• 30 days before surgery, take medications to relax the cervix and reduce weakness (baralgin, analgin, diphenhydramine) or give an injection of an antispasmodic into the cervix of 1-2% dilution of iceocaine with adrenaline. Ice docaine can also be injected into the uterine tissue.
• Place a probe in the empty uterus to determine its depth.
• After the probe is inserted, an aspiration tube is inserted into the empty uterus, which is connected to an electric vacuum aspirator.
• The doctor, moving the catheter of the empty uterus, collects material from different sections.
• The collected material is placed in a container containing formaldehyde.
• The procedure is carried out blindly or under ultrasound control.

Advantages:

• Low morbidity of 1st and 2nd procedure options;
• Short update period after options 1 and 2.

• It is impossible to insert the structure into the endometrium.
• The vacuum period after aspiration takes 3-4 vacuum.

• The gynecologist inserts a probe through the cervical canal into the empty uterus.
• When the piston is pulled, a negative pressure is created in the cylinder, and it is pressed against the wall of the uterus.
• Through the hole at the end of the probe, the empty material is drained.
• The procedure is repeated 3 times on different sections of the mucous membrane.
• The probe is removed from the empty uterus.
• The probe is placed in a container filled with 10% formaldehyde.

• It may be carried out at the gynecological office;
• There is no need for anesthesia;
• Painless and non-traumatic;
• Shvidka suppresses the mucous membrane;
• Sensitivity 60-90%
• There is no difficulty when the procedure is carried out correctly.

• Using different fragments of the mucous membrane, it is easy to assemble the structure of the endometrium;
• Collecting material from the surrounding sections of the uterus. It’s a good idea to miss pathological spots.

• In the empty uterus, a sterile physiological injection is injected to remove the high-quality image.
• A hysteroscope is inserted through the cervical canal near the empty uterus.
• Inspect the mucous membrane with the image displayed on the monitor screen.
• The plots from which it is necessary to take samples of the material are indicated.
• Insert a curette or other surgical instrument through the hysteroscope port. It will help to take pieces of the endometrium by scraping or aspiration.
• The mucous membrane samples are placed in a container.
• The tissue is removed from the empty uterus, then the hysteroscope is removed.

• It is possible to identify visible pathologies – polyps, synechiae;
• Short wet season;
• High diagnostic accuracy.

• The need for internal anesthesia;
• The complexity of the procedure is high;
• Insufficient number of blades equipped with all necessary equipment.

What can be the results of histology biopsy?

1. Informativeness of the expression.

• Uninformative, inadequate vision. This phrase in a histological context shows that the extracted material has enough tissue in the endometrium. There may be blood cells, squamous epithelium of the cervix, cylindrical epithelium of the cervix. This situation is possible if the sample is collected incorrectly.
• Informative, an adequate image – the biopsy has sufficient thickness of endometrial cells.

1. Macroscopic description of the drug.

• Vaga of representations of images;
• Size of fragments (large, small);
• Color (gray to bright red);
• Consistency (fluffy, thick);
• Blood clots, thrombi;
• Slime

1. Microscopic description of the drug.

• Type of epithelium (cylindrical, cubic, flat, indifferent), its size, number of balls;
• Stroma – its visibility, thickness, uniformity.
• The size and shape of stromal cells;
• Fibroplasticity of the stroma - the number of combined fibers;
• The deciduo-likeness of the stream is the acquisition of the countryside and living rivers;
• Uterine ovaries, their shape, describe the epithelium that lines them;
• The shape and size of the opening of the openings, the visibility of the secretion in the middle of the openings, the alignment;
• Lymphoid accumulations are signs of inflammation;
• Chorion chorion pressure, the presence of swelling or dystrophic changes - this option indicates that the woman had vaginosis, froze, or had an unexpected, fleeting abortion.

1. Diagnosis

• Which phase of the cycle is indicated by the endometrium;
• The presence of hyperplasia is the growth of the endometrium;
• The presence of polyps and a description of the tissue from which the smell develops;
• The presence of endometrial atrophy is a thinning of the uterine mucosa;
• Hypoplastic mixture of the endometrium is a borderline region, which is not a disease;
• The chorionic villi, which contain parts of the fetal membrane, indicate interrupted uterine function.
• Degeneration of the epithelium or chorionic villi - talk about those who have been born since the beginning without removing the living ribs that could have caused his death.
• The presence of atypia is cliniform with signs that are not characteristic of this tissue, talking about a precancerous endometrium;
• The presence of malignant (cancerous) cells indicates endometrial cancer.

What types of illnesses may be revealed in these investigations?

What to do after taking a biopsy

• Ryasna krovetecha - over 3 pads in 2 years;
• Severe pain in the lower abdomen and across the abdomen, which cannot be felt after taking painkillers;
• Trival bloody vision: up to 5 days after pipel biopsy, more than 4 days after scraping;
• Visible with an unpleasant odor;
• The temperature rises above 37.5°C.

• Take a shower instead of a bath;
• Carefully maintain the hygiene of your organs – water procedures at least 2 times a day;
• Use article contacts;
• Unique physical properties;
• Avoid overheating and hypothermia;
• Take antibiotics after diagnostic scraping and vacuum aspiration to prevent infections;
• taking hormonal contraceptives as prescribed by a doctor to update hormonal levels;
• Bed rest should be continued for 2-3 days after diagnostic scraping and vacuum aspiration.

Endometrial biopsy is an effective and informative diagnostic procedure that is widely used in the gynecological field. This technique allows for laboratory examination of the tissues of the mucous membrane of the uterus to identify possible atypical cells. Biopsy of the endometrial ball is one of the most accurate ways to diagnose oncological processes in the early stages of development.

What is endometrial biopsy? This procedure involves scraping the empty uterus and taking tissues for further histological examination. The peculiarity of this technique lies in the fact that under the influx of hormones and with the development of pathological processes, the endometrium changes, and the significance of its transformation, assessing the problem, is only possible through laboratory analysis of the tissue.

The procedure for biopsy of the endometrium of the uterus is minimally invasive. Since previously, to carry out diagnostics, procedures (surgery) were traumatic and threatening with numerous unpleasant consequences, then current patients are stuck with the most gentle and safe methods of biopsy.

For which the following methods are used:

• Aspiration- a minimally invasive procedure characterized by painlessness and minimal downtime. The procedure is carried out in outpatient clinics. During the diagnostic process, a special tip connected to an electrical device is inserted into the patient’s uterine sac.

• Pipel- The most secure, perfected aspiration technique. During the procedure, a special catheter is inserted into the patient’s uterus, which allows for the removal of both tissue and tissue for observation. Diagnosis using this method should be done before the start of your period. Respect one of the shortest methods of taking a biopsy sample (exposure to the material).
• Hysteroscopy- the most informative method that allows you to identify oncology, polyposis, cystic neoplasms, uterine fibroids, adenomyosis. Hysteroscopy with diagnostic biopsy also allows physicians to assess the stage of development of the pathological process and the level of its malignancy, to develop the most effective treatment program. The examination is carried out under internal anesthesia using a special device – a hysteroscope.

The optimal method for performing a biopsy of the endometrial ball is determined by the doctor on an individual basis.

Showing

Endometrial biopsy is indicated for women with the following conditions:

• hyperplastic processes of the endometrium;
• polyps localized near the lining of the uterus;
• endometritis, which occurs in a chronic form;
• endometriosis;
• suspicion of the presence of a plump new creation of a benign or malignant nature (fibroids, brushes, cancerous swellings);
• disruption of the menstrual cycle;
• painful and overwhelmingly painful menstruation;
• problems with conception;
• uterine bleeding during menopause;
• adenomyosis.

Gynecological diagnostics by biopsy method is indicated during the preparation period before individual implantation of the ECZ after interruption of gestation in early terms, weekends, and short-term abortions.

Contraindicated

Endometrial biopsy has a number of absolute contraindications and time-consuming procedures.

This diagnostic procedure is not recommended if:

• ignition processes of the sechostatic system that occur in the acute form;
• decreased indicators of coughing up blood, thrombocytopenia;
• anemia in severe form;
• vagusness;
• gostra form of purulent cervicitis;
• Infectious illnesses that are transmitted by airways.

Investigations with great caution are prescribed for patients who suffer from blood disease, who are taking anticoagulant drugs, and who are associated with high rates of bleeding.

Preparation before diagnosis

Before undergoing endometrial biopsy, in order to identify possible contraindications and encirclements, patients are prescribed laboratory and instrumental diagnostic methods:

• taking a smear for cytology and flora;
• blood test;
• colposcopy;
• Ultrasound examination of the pelvic organs.

To obtain the most accurate and reliable diagnostic results, it is important to correctly determine the day of the procedure.

Most episodes follow this pattern:

1. The phase of the cycle is revealed - 18-24 days before the menstrual cycle.
2. Pathological uterine bleeding – 1 add.
3. Early menstruation – 5-10 days before the menstrual cycle.
4. Suspicion of infertility - first before the cycle or before the beginning of menstruation.
5. Monitoring the effectiveness of the course of hormonal therapy - from 17 to 25 before the menstrual cycle.

If you suspect the presence of a malignant, plump new creation, diagnosis should be carried out immediately, regardless of the day of the cycle.

Several days before the procedure, patients must adhere to the following rules:

1. It is possible to avoid the use of anticoagulants and drugs that reduce blood count.
2. Avoid intimate contacts.
3. Include from your diet foods that promote gas release.
4. Be careful when douching.

Features of the implementation

How is the procedure carried out? A biopsy of the endometrial uterine ball is performed in the clinic, under local anesthesia or without anesthesia. Diagnosis is carried out in the gynecological chair. It is recommended to insert an instrument into the patient’s uterine cavity to collect samples of endometrial tissues, after which the biological material is removed and sent to the laboratory for further histological examination.

The average duration of the procedure is about 2-3 minutes. The biopsy will not require renewal or rehabilitation. After completing the session, the patient can leave the clinic and return to the normal rhythm of life.

The results of the investigation will be ready 1-2 days after the collection of biological material. Decoding the results is a complex process that is directly handled by the gynecologist. Based on the collected information, the doctor makes a diagnosis for the patient and develops the optimal course of treatment for a particular clinical condition.

Update after biopsy

A biopsy of the uterine mucosa does not affect the woman’s fertility. As evidenced by most patients, the procedure was well tolerated, without any untoward reactions. Over the course of the first few days, a woman may experience some pain in the lower abdomen. It can be helped by taking analgesic medications.

Vaginal vision of a bloody nature may also appear, which is considered one of the manifestations of the norm. If such a symptom appears, it is recommended to avoid intimate contact until bleeding occurs.

In the first few days after taking a biopsy, patients must follow the following medication recommendations:

• relax by taking hot baths, relaxing in the sun and sauna;
• use hygienic tampons;
• do not lift heavy things;
• uniqueness of supermundane physical attractions.

The introduction of these simple rules will significantly reduce the risk of complicating and inappropriate reactions.

Inheritance and compilation

In isolated cases, when diagnosing the endometrium using biopsy, the development may be complicated. You should urgently seek help if you experience the following symptoms:

• feverish fever, increased body temperature readings above 38;
• uterine bleeding;
• I am expressing pain syndrome;

• stand untiringly;
• judgment syndrome;
• attack got confused.

Interpretation of results

What does endometrial biopsy indicate? In the absence of pathological processes, it will be established that the endometrium remains normal, without atypical manifestations.

For the presence of pathological changes, diagnosis should be based on:

• adenomatosis;
• endometrial hyperplasia;
• hypoplastic processes;
• atrophy of the mucous membrane of the uterine ball;
• endometritis;
• lack of consistency in the indicators of mucous membrane thickness during the flow phase of the menstrual cycle;
• malignant degeneration of endometrial tissues.

From the withdrawal of results, additional restrictions are attributed and therapeutic approaches are divided.

Endometrial biopsy is an important diagnostic procedure that allows us to identify a number of diseases of a gynecological nature, pathological changes in the mucous membrane of the uterine ball. This diagnostic method has a high level of information value, and the use of current methods makes it possible to create a procedure that is as painless and safe for women’s health as possible.

All materials on the site were prepared by scientists in surgery, anatomy and specialized disciplines.
All recommendations are for guidance only and are not valid without consulting a doctor.

Endometrial biopsy is an operation in which the surgeon removes small sections of the mucous membrane of the uterine body for pathohistological examination. The material is sent to the laboratory, and after microscopy, the doctor obtains accurate information about the endometrial system and its changes.

Histological examination of tissue fragments is an invisible step in the diagnosis of various pathologies. In a number of seizures, microscopic tissue analysis makes it possible to accurately determine the nature of the changes and their cause, and, therefore, treatment is determined to determine the specific histological picture, which will be most effective.

In gynecology, biopsy research has been stagnant for almost a decade, during which time the methods for sampling tissue that can be tested for diagnostic purposes have been improved. The skin method has its own indications and contraindications, as determined by the gynecologist based on the diagnosis.

If necessary, initial microscopy can be supplemented with immediate immunohistochemical techniques, which allow one to identify malignant tumors and accurately differentiate their behavior, indicating the stage of differentiation and prognosis for the patient.

endometrial biopsy

Endometrial biopsy is an operation, although minimally invasive, which requires careful preparation, assessment of possible risks, and an important approach to the final indication. This operation is carried out on a wide range of women due to general safety, simplicity and the greatest diagnostic value.

As a rule, the collection of a biopsy is planned, as an independent investigation, but in some cases there may be a need for a biopsy, which arises during the surgical treatment of the pathology of women’s diseases. organs. Head biopsies are diagnostic, although they may also be of a clinical nature, leading to improvement of the patient's self-esteem after removal of pathological decay.

Types of endometrial biopsies

The endometrium is the inner sphere of the body of the uterus, the mucous membrane, which is responsible for cyclical changes under the influx of female hormones. It varies at different phases, and at different days of the menstrual cycle. The pathology of the endocrine system, ovaries, and the uterus itself is inevitably indicated by the structure of the mucous membrane, and the characteristics of each medicine determine the nature of the pathology.

You can only “get” the endometrium by penetrating into the empty uterus. In the first half of the last century, attempts to remove the eye were chewed through the enlarged cervical canal and the scraping of the entire mucous membrane. Current biopsy techniques are characterized by low invasiveness and low pain, as well as a low risk of complications, which allows the expansion of indications before follow-up. The clinic offers several types of endometrial biopsy surgery:

• Classic mucous scraper;
• aspirate-biopsy with vacuum or aspirator;
• Pipelle endometrial biopsy is one of the least traumatic methods;
• CG biopsy;
• The BioPsіya is produced by gysteroscope, permitted to the fabric of the zmіnenikh dilanoka, ale, alerted by the gesture of the self -girster -gysteroscope of the vidsutnosta in the bangoho stalls.

The operation of collecting fragments of the endometrium eliminates the initial stage of the diagnostic test; without microscopy, it is impossible to determine what structural changes occur in the mucous membrane of the uterus. An accurate confirmation will be provided by analysis of histological sections of the endometrium under a microscope.

Indications and contraindications before biopsy

Pathomorphological examination of the mucous membrane of the body of the uterus is carried out in women of different age, regardless of whether they have chewed the smell of children before. The reasons for the procedure may include:

1. Dysfunctional bleeding;
2. Intense uterine bleeding and scanty blood;
3. Amenorrhea (number of menses) due to unidentified reasons (you must turn off your vaginosis!);
4. Mozhlive is plump and growing;
5. internal endometriosis;
6. Suspicion of a chronic inflammatory process in the mucous membrane of the uterus;
7. There is no need to clarify the reasons;
8. Planning the EKZ procedure;
9. Weekdays, pathology of vaginosis of the small term (after medical abortion).

Contraindications before endometrial biopsy:

• Vaginism is absolutely contraindicated until further investigation;
• Pathology of hemostasis through the rhizic bleeding;
• Treatment with anticoagulants and antiplatelet agents, anti-inflammatory drugs (important in advance);
• Severe anemia;
• Infectious diseases (GDV, intestinal infections, etc.);
• Gastrointestinal problems of chronic infections in state towns;
• Allergy to anesthetics.

Since a biopsy is not performed for vital indications, then in cases of serious contraindications it may be possible to rely on other, safer diagnostic methods. If there is a change, the doctor will try to choose the most optimal method of tissue collection, which includes folding.

Preparation before investigation

Preparation before endometrial biopsy includes clinical tests (blood, cross-section), laryngeal examination, determination of blood group and Rh factor, tests for VIL, hepatitis, syphilis. During a gynecological examination, the doctor takes smears from the neck for cytology and microflora from the skin. If it is impossible to turn off vaginosis, a test for human chorionic gonadotropin is performed.

After completing the procedure and marking the date of the biopsy, the patient is required to undergo restless daily living, douching, and sponge tampons 2 days before the procedure, and 7-10 days before the procedure, begin taking normal medications. . If you are planning to undergo surgery under general anesthesia, then the day before the 6th birthday you will start taking the same medicine.

On the day of examination, the patient takes a shower, removes hair from the existing hairline, for the presence of varicose veins, the doctor can use elastic bandaging to prevent thromboembolic conditions. yen.

Terms and techniques of biopsy

The fragments of the endometrium clearly respond to the hormonal influx, so the information value of the analysis depends on what day the cycle was taken off. With different pathologies, the terms for performing a biopsy may vary. Thus, for young women, when diagnosing the causes of infertility, anovulation, disruption of another phase of the cycle, it is recommended to carry out a biopsy the day before their menstruation or on the first day of their period.

In case of light menstruation, the operation should be carried out on days 5 to 10 of the cycle. If the bleeding is not associated with menstruation, then a biopsy is indicated in the first 2 patients due to his guilt. During one cycle, the procedure can be performed several times – in case of disrupted hormonal levels, for example.

In the other half of the cycle, from days 17 to 25, a biopsy is indicated to assess the effectiveness of conservative hormone therapy. If a malignant process is suspected, follow-up should be carried out independently of the day of the cycle and without delay.

The result of pathomorphological examination of a woman can be determined 7-10 days after the operation, but if additional methods are required, the definition of this term may increase. According to the report, the investigation will proceed to a gynecologist, who will either diagnose the pathology or refer to an oncologist if a malignant neoplasm is detected.

The technique of sampling the endometrium for microscopic observation varies across different procedures. You can turn on the stage of widening the cervical canal, after which sharp instruments are introduced into the empty organ to cut the sections or the entire mucous membrane. This path is the most traumatic, although it provides the greatest amount of information, which is given priority in cases of suspected oncopathology or diagnosed with diffuse hyperplasia using ultrasound. In another case, the procedure will become licious.

A diagnostic biopsy is often carried out using gentle methods that can be carried out without dilating the neck canal - the most important stage of the entire operation, which improves the tolerability of follow-up in women and reduces rizik ukladneni.

Vishkrіbannya

scraping with a curette

The most radical method of collecting endometrial tissue is scraping with a curette - a classic technique that takes a long time to settle. To penetrate into the empty organ, it is necessary to expand the neck, for which special expanders are taken from the smallest diameter to the maximum, the neck is fixed with forceps, and then the surgeon pulls out the mucous membrane with a sharp curette. The method is traumatic, it requires great care through the risk of damage to the basal ball of the endometrium and the uterine wall.

Traditionally, the removal of the uterus is more painful and will require anesthesia; it is optimal to use external anesthesia - masked or internal. Due to the need for anesthesia, women are advised to undergo preparation similar to that for any other surgical procedure (fastening, handling of certain groups of drugs, fluids and water from the evening before the operation tsії).

Scrubbing the empty uterus should be carried out in case of hyperplastic processes in the mucous membrane, non-development of vaginity, trivial and clear bleeding, suspicion of oncological illness. The extraction of mucous from the walls of the organ and the area of ​​​​the tubal cuticles in a number of cases allows not only to make an accurate diagnosis, but also to immediately remove the pathological process itself, which is a medical procedure.

Aspiration biopsy

Aspiration biopsy of the endometrium involves exfoliation of the mucous membrane under vacuum. The method is not as traumatic as scrubbing, The enlargement of the cervical canal does not affect the swelling and deterioration of the neck, which is significantly lower. In patients who have not been chewed, aspiration may cause subjective discomfort; for especially sensitive women, the surgeon may administer a short-term general anesthesia.

In the hour of preparation before the examination by vacuum aspiration, the woman must switch off the state of life, douching and vicinity of tampons 3 days before the date of biopsy, and beforehand an enema is indicated to cleanse the intestines. Due to the risk of infection when penetrating into the empty uterus, it is important to turn off the ignition and infectious processes in the uterus at the preparation stage.

Aspiration biopsy can be performed for any pathology in the mother, and is also indicated in case of doubtful ultrasound findings. In the short term, less aspirate can be used with curettage, through which the diagnosis of a malignant neoplasm may be complicated, so if cancer is suspected, it is better to perform a diagnosis.

Video: aspiration biopsy of the endometrium

Pipelle biopsy

pipel biopsy

Pipelle biopsy suggests aspiration, but there is also an advantage - tissue is collected using a thin tube, the diameter of which is approximately 3 mm. The method is low-traumatic, it widens the neck, and gives little compression.

Pipelle biopsy can be performed on an outpatient basis, at a women's consultation; you need to prepare for it in the same way as before aspiration. During the procedure, the doctor places the Pipel tip into the uterus, then pulls the piston, adding a small fragment of the endometrium using a negative pressure in the syringe.

Pipelle biopsy does not cause injury to the mucous membrane, does not cause damage to the open wound surface with the risk of infection, is practically painless, which is advantageous for young patients, as it does not harm children , in case of endometrial pathology, infertility, for tissue sampling for immunohistochemical identification of receptors for hormones .

CG biopsy

A CUG biopsy is carried out without dilating the cervical canal, using a special small curette, with which the surgeon scrapes out the narrow layers of the mucous membrane, starting from the fundus and up to the internal os of the uterus. This type of biopsy is the main indication for determining the effectiveness of hormone therapy, the stage of maturation of the endometrium with the natural balance of hormones at different phases of the cycle, which can include a number of procedures throughout one menstrual cycle.

A CG biopsy is considered to be a safe and low-traumatic procedure, the fragments are visible in just a small section of the mucous membrane in the appearance of “strokes”. The information content of the investigation is promoted by several mucous membranes from different parts of the organ.

Evaluation of biopsy results

For an adequate assessment of the endometrium, the pathologist must know the exact day of the patient’s menstrual cycle, so that direct follow-up will indicate the date of the remaining menstruation. It is important to indicate the age of the woman, the nature of the treatment she is taking (especially hormonal medications), the diagnosis based on the results of ultrasound and other methods of treatment.

Deciphering the results of an endometrial biopsy can show the norm, and then the pathologist will determine each specific phase of the cycle and the stage that corresponds to the day of the menstrual cycle. These parameters are determined based on the tissues, peculiarities of the vessels and the stroma of the endometrium.

The pathology that is most often detected after biopsy is:

1. Hyperplastic processes are simple or complex non-atypical, and there is hyperplasia after atypia;
2. Endometrial polyp with or without atypia epithelium;
3. Malicious fluff;
4. Atrophic processes (in women of advanced age - a variant of the age-old norm);
5. Inflammation (hospital or chronic).

Hyperplastic changes are more often diagnosed in patients who are approaching menopause, since during this period there is an influx of steroids, and many cycles may be anovulatory in nature. Endometrial cancer occurs both in young and elderly women, and mucosal atrophy is a variant of normal life during the menopausal period.

One of the key points in assessing the morphological features of the endometrium is the detection or exclusion of cellular atypia, which can indicate a high risk of malignant transformation. Atypia can be detected in sections of the endometrium, which grow, with hyperplasia, in polyps.

The evidence of a dysplastic process and a high risk of cancer is indicated by the strengthening of the cells with an increase in their number, polymorphism of the nuclei of the epithelial cells of the endometrial cells, and the appearance of pathological mitoses. In cell cancer, malignancy develops (polymorphism, hyperchromia of nuclei, without abnormal mitoses), characteristic necrosis (death), hemorrhage, altered tissue grows into structures that support and judge, o serve as the basis for metastasis.

Head nutrition, as you often have to confirm to the morphologist, who is following up the biopsy, is cancer, or it can be completely turned off. If there is swelling, then the stage of differentiation is indicated (highly differentiated adenocarcinoma, for example).

A biopsy in case of infertility is carried out not only to create a morphological picture of the day of the cycle, set after the date of the last menstruation, but also for the immunohistochemical search of receptors for state hormones, or possibly dates and a chance to identify the genesis of infertility and choose a way to combat it.

Inherits of biopsy of the endometrium and possible complications

Regardless of how the mucous membrane is taken, the procedure inevitably injures the tissue, which will result in bloody vision in any case. Their intensity and severity are determined by the method of manipulation.

After pregnancy, bleeding is most severe, often painful, but still milder, even during primary menstruation, since the mucous membrane is almost completely removed. It is not the fault of the woman to remove large clots, putrid fragments, the stench is not to blame for the unpleasant odor, otherwise the woman will have to go to the doctor again to turn off the post-operative ignition. E If the temperature has risen, you must contact the gynecologist immediately.

The first menstruation after a biopsy may arrive at the same time or a little later, either clear or miniscule. Most often, a delay is required after a pipe biopsy, but to turn off the sensitivity, you just need to take a test and go to the doctor.

If a woman plans to be pregnant, then she can take advantage of her insurance already at the beginning of her cycle. The functional sphere will soon be restored, the work of the ovaries will not be damaged, and the fertilized egg will be able to be successfully implanted in the mother. Prosecutors are advised to avoid contact with articles until the appointment is resumed, and in the next cycle to protect themselves using barrier methods.

Further data from the patient and doctor will depend on the data from the morphological analysis. If cancer or atypical changes are diagnosed, a consultation with an oncologist is indicated with the possibility of repeated surgical treatment, or radical surgery. In case of inflammation, prophylactic and antibiotic therapy is indicated; dyshormonal processes may be affected by the effects of state hormones.

Negative results after rare biopsy. Most often, patients complain of irregularities in the menstrual cycle, poor menstruation, and discomfort during physical contacts. The most dangerous type of treatment is acute endometritis, which occurs with fever, abdominal pain, symptoms of intoxication, putrid spots that smell bad. This plant requires a warm bath with repeated scraping of the empty uterus.

For the presence of chronic inflammation in women, holidays or abortions, for medical indications for the prevention of endometritis, broad-spectrum antibiotics are prescribed before surgery.

To protect the complexioned women, they should maintain stately calm until they become tired of the vision, carefully carry out the hygiene of their body organs, avoid going to the swimming pool, sauna and lazna, as well as hot ones at home. Ann.

Endometrial biopsy should be carried out cost-free, at women's consultations or on an inpatient basis, otherwise paid diagnostics are also possible. The average cost of the procedure is 3-5.5 thousand rubles depending on the qualifications of the personnel, the knowledge of experience, the use of the method and additional qualifications.

If histological examination of the uterine mucosa is indicated, then it is impossible to determine anything without certain reasons. The risk of complications with continued medical advice is minimal, but the information that can be obtained with a biopsy cannot be matched with other non-invasive methods. Only an accurate diagnosis will help determine the truly effective treatment, healing, normalization of health and avoiding the legacy of malignant swelling.