![]() ![]() The paracervical block with local anaesthetic agents is one of the most common procedures used since 1925 6. Lichtenberg et al 5 showed that only 10 per cent of clinics use general anaesthesia, so local anaesthesia becomes a dominant method with 58 per cent use in clinics and 32 per cent use of intravenous sedation with local anaesthesia. General anaesthesia provides analgesia, amnesia and a hypnotic effect and provides adequate operating conditions for cervical dilatation and uterine intervention but it is associated with increased mortality and morbidity. ![]() Other factors are related to the patient's and physician's preferences. The choice of anaesthesia and analgesia is dependent on effectiveness, cost, safety, and side effects. Pain on VAS more than six suggests the need of pain relief. Endometrial biopsies have shown VAS scores ranging from five to seven 3, 4. Most patients can tolerate pain to complete necessary procedures but studies show that pain scores with cervical biopsy and cervical curettage range from four to six on a 10-point visual analogue scale (VAS) 1, 2. Patients frequently experience moderate to severe pain during these gynaecologic procedures and in some cases the severity of pain makes it impossible to take adequate sample in biopsy. The major limitation in successful completion of the procedure is pain management. Other minor procedure which can be conducted in outpatients settings are suction termination, cervical biopsy, saline infusion sonography, etc. The D&C has been substituted by outpatient procedures like endometrial suction curette biopsy, aspiration by Karman's cannula or fractional curettage or hysteroscopically guided biopsy. Call your doctor if you have excessive vaginal bleeding (more than a period), severe abdominal pain, or fever greater than 100.4.Common gynaecological problem as abnormal uterine bleeding and postmenopausal bleeding require evaluation by sampling of the endometrial tissue which was initially done by dilatation and curettage (D&C). Do not place anything into the vagina until advised by your doctor. You will need to use a menstrual pad for bleeding or spotting. Results are usually available in 7-10 days.Īn endometrial biopsy usually causes some vaginal bleeding. After the sample is collected, the device is removed from the uterus and vagina, and the clamp and speculum are removed. The instrument used to collect the sample of the endometrium is guided through the cervix. After being swabbed with an antiseptic solution, the cervix may be grasped and held in place with a clamp called a tenaculum. The doctor will insert an instrument with curved blades (speculum) into your vagina, which will gently spread apart the vaginal walls so the doctor can see the cervix. You will be asked to lie on your back with your feet supported by stirrups. You will need to sign a consent form that says you understand the risks of the procedure and agree to have the test done.ĭuring the procedure, the cervix may be numbed by using an anesthetic spray or an injection of local anesthetic. You may want to take a pain reliever containing ibuprofen (such as Advil or Motrin) 600-800 mg 30-45 minutes before having the biopsy. It may also be done to evaluate the cause of abnormal uterine bleeding, to check for excessive growth of the endometrium (endometrial hyperplasia), to help determine the cause of a Pap test showing glandular cell abnormalities, evaluate the cause if abnormally heavy, prolonged or irregular uterine bleeding,īefore the endometrial biopsy, do not use tampons, vaginal medications/spray or powders for at least 24 hours. When a woman is having difficulty becoming pregnant and endometrial biopsy may be done to determine whether the lining of her uterus is being properly prepared by hormones (estrogen and progesterone) to support pregnancy. The most common technique uses a thin, pliable instrument to suction a small amount of endometrial tissue from the uterus. An endometrial biopsy helps your physician evaluate whether the endometrium is going through its normal changes during the menstrual cycle and to determine whether precancerous conditions are present. An endometrial biopsy is a procedure to remove a small sample of the lining of the uterus (endometrium). ![]()
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