Endometrial Biopsy

Chapter 243 Endometrial Biopsy



DESCRIPTION


Endometrial biopsy is an office technique for obtaining tissue samples from the lining of the uterus.



INDICATIONS


Dysfunctional uterine bleeding, postmenopausal bleeding, menorrhagia, infertility (selected cases), endometrial or pelvic infections (e.g., tuberculosis), or other situations in which a tissue diagnosis is indicated. Because it is associated with some discomfort and a small but not insignificant risk of perforation or infections and carries not only the cost of the procedure but also the cost of histologic diagnosis, this procedure is best suited for diagnosis, not screening.



CONTRAINDICATIONS


Pregnancy, active pelvic inflammatory disease, significant vaginal infection, profuse bleeding, blood dyscrasia. Endometrial biopsy should generally be performed during the first 14 to 16 days of the menstrual cycle to avoid inadvertent disruption of an undiagnosed pregnancy. (Biopsies performed within 10 to 14 days beyond a temperature rise or luteinizing hormone surge will generally not interfere with implantation during that cycle.)



REQUIRED EQUIPMENT



• Disposable endometrial sampling device (e.g., Accurette, Explora, Gynocheck, Pipelle, Z-Sampler, and others) or reusable curette (Novak or other curette)

• Sterile single-tooth tenaculum (optional)

• Sterile uterine sound (optional)

• Sterile lacrimal duct probe (optional)

• Skin preparation materials (generally an iodine-based antibacterial solution such as Betadine)

• Suitable tissue preservation/transportation medium (10% formalin solution or similar)

• Pelvic examination equipment (examination gloves, lubricant, speculum, light source)


TECHNIQUE


The discomfort of endometrial biopsy may be decreased by premedicating with a single oral dose of a nonsteroidal anti-inflammatory agent given in doses usually used to treat dysmenorrhea.

Related posts:

  1. Anemia
  2. Toxic Shock Syndrome
  3. Uterine Anomalies: Bicornuate, Septate, and Unicornuate Uterus
  4. Cervical Cancer

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Endometrial Biopsy

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