Cervical biopsy

introduction

A biopsy describes the removal of tissue from an organ in order to examine the cells. It is carried out if it is suspected that the cells are degenerate or that there is a special disease.

If a gynecologist has noticed suspicious changes in previous examinations, he will order a biopsy of the cervix to clarify. The tissue is usually removed under local anesthesia and then examined under a microscope.

The indication

A biopsy is usually used to clarify suspicious changes in the uterus. This can become noticeable through a noticeable tactile finding, such as a hardening during a gynecological examination. But changes can also be noticed in the context of imaging (sonography, X-ray).

The biopsy is necessary to examine the cells in the abnormal area microscopically and molecularly - this is the only way to find out whether the change is benign or malignant. In addition, you can see what type of tumor it is and how far it has progressed. This is crucial for the therapy, as it varies depending on the stage and has to be adjusted accordingly.

Find out more about the topic here: Symptoms of cervical cancer.

The preparation

First of all, the doctor treating you should explain the necessity of the procedure. You should also be informed about the possible risks and complications. Depending on whether you decide to have the procedure carried out under short or local anesthesia, there are different things that you should be aware of.

In the case of anesthesia, you should not have eaten or drunk anything six hours beforehand. If the biopsy is performed under local anesthesia, you can eat and drink normally. In addition, the doctor should also explain to you what to do and what to look out for afterwards. Whether the treatment will be carried out on an outpatient basis or whether you will be admitted to the hospital as an inpatient should also be clarified before the procedure.

You might also be interested in these articles: The local anesthetic

Do you need anesthesia?

Anesthesia is usually not necessary for the procedure. The biopsy is usually performed under local anesthesia. The tissue to be examined is previously numbed by a local anesthetic so that no pain can be felt. If you are particularly afraid of the procedure or if the doctor recommends anesthesia for certain reasons, it can still be performed. However, one should always be aware that anesthesia has more side effects than local anesthesia.

You can find more information on this topic at: The anesthesia.

The sequence

If the examination is performed under anesthesia, it must be initiated prior to the procedure. This is prepared and carried out by an anesthetist. If the biopsy is performed under local anesthesia, the local anesthetic must be injected shortly beforehand into the area to be examined so that it can take effect.

After these measures, the genital area is sterile washed and covered. Special instruments are then inserted into the vagina so that the surgeon has a better view. With the help of a colposcope, the mucous membrane of the vagina, the cervix and the cervix can be viewed. A colposcope is a special microscope that is used for gynecological examinations. The surgeon then removes a piece of tissue with special forceps, which are also inserted through the vagina. Alternatively, an abrasion (scraping of the uterus) can be performed. The mucous membrane of the cervix is ​​scraped off with a curette.

How painful is that?

The tissue removal does not cause any pain, as the tissue is first locally anesthetized. Local anesthetics are used for this, which lead to a nerve block. This means that any stimuli can no longer be passed on and the patient can no longer feel anything. If anesthesia is performed, the patient is sedated anyway and will not notice the procedure or the associated pain.

The duration of the investigation

The duration of the examination varies depending on whether an anesthetic or local anesthetic is performed. The induction and discharge of anesthesia takes about an hour. Local anesthesia takes about five minutes. The duration of the examination itself - i.e. the assessment of the cervical mucosa and the tissue removal - takes about 15 minutes.
The time required to wash and cover the genital area sterile should also be taken into account. It is about 15 minutes.

It can therefore be said that the duration of an examination under anesthesia is around one and a half hours and the duration of an examination under local anesthesia is around 35 minutes.

The risks

A biopsy is a minimally invasive examination. This means that the tissue is only slightly injured by the examination. For this reason, the biopsy is a low-risk examination. However, complications or risks can arise. For example, there may be bleeding at the site of the tissue removal. This area can also become infected and no longer heal properly. Surrounding tissue, nerves and blood vessels can also be injured. In addition, in rare cases, tumor cells can be carried over. This can promote the development of metastases.

Find out all about the topic here: The biopsy.

The secondary bleeding

After the examination, the tissue sample site may bleed again. This can be due to various causes. The area may have become infected after the biopsy and may not heal properly. Wound healing disorders occur, which can also lead to bleeding. In addition, rebleeding is not uncommon in tumorous changes, as they are better vascularized - i.e. contain more blood vessels than healthy tissue. In addition to the causes mentioned, it can also be that you suffer from a bleeding tendency that does not cause any symptoms in everyday life. The wounds usually only bleed a little longer than other people.

How much pain do you have afterwards?

As a rule, you should hardly feel any pain afterwards, as only small samples are usually taken. However, if complications occurred during the examination, pain may well occur afterwards. In this case, however, you should be informed accordingly and also contain painkillers.

The evaluation

The removed tissue is sent to the pathology department, where it is examined accordingly. The pathologists look at the cells and pay attention to the size of the cells, the cell nuclei and assess the degree of differentiation of the cells. In the case of malignant abnormalities, the cells are hardly differentiated and one can no longer recognize which cells are involved. In addition, special stains are carried out so that one can judge which cell type it is and how much it is multiplying.

If there is a tumorous change, molecular biological tests can be carried out. Here you can possibly see which mutation in the genetic information contributed to the development of the tumor. However, a lot of research is still going on on this topic and many mutations are not yet known.

How long does it take to get the result?

How long it takes to get a result depends on the pathological institute that evaluates the tissue. If you would like to receive a precise estimate of the time for this, you can ask your doctor.

The costs

The cost of the examination can vary. They depend on the type of examination, i.e. whether it is carried out under anesthesia or local anesthesia. However, since there is a medical indication, the costs are covered by the health insurance.

What are the alternatives?

There is no real alternative to a biopsy. Only the histological, i.e. the histological, examination provides information about the type of cells and the extent to which they have multiplied. This is especially important in determining whether the tumor is benign or malignant. Therapy also varies, depending on how far the tumor has progressed.

Imaging, such as a CT scan or ultrasound of the abdomen, can also be performed. All they can do is show whether there is any suspicious change and how big it is. Unfortunately, they do not provide any information about the type of cells that are multiplying.

Also read the article: The CT of the abdomen.