Aspiration biopsy of the endometrium (pipelle-diagnosis of the endometrium) is currently one of the most common diagnostic manipulations in gynecological practice.
The method of pipette endometrial biopsy is recognized as the safest and painless, as well as the shortest in time. During the procedure, the gynecologist uses a special plastic tube with a small piston, which is called a pipette. With the help of a piston, the gynecologist takes the material for histological examination.
Pipelle biopsy of the endometrium: indications for the procedure
Aspiration biopsy is prescribed in cases when, after a gynecological examination and ultrasound, the doctor assumes that the patient has pathological changes in the condition of the inner layer of the uterus – the endometrium. The obtained tissue samples allow histological analysis of the uterine mucosa and make a correct diagnosis.
Aspiration biopsy of the endometrium is prescribed in the following clinical cases:
- endometrial hyperplasia;
- menstrual disorders (acyclic scanty bloody discharge, menometrorrhagia, scanty menstruation, amenorrhea of unknown origin);
- chronic endometritis;
- polyps in the body of the uterus;
- suspicion of infertility;
- heavy bleeding in menopausal women;
- suspected benign or malignant tumor (uterine fibroids, endometrial cancer).
The procedure can be performed not only to diagnose endometrial pathology, but also to assess the effectiveness of hormone therapy.
In which cases, endometrial biopsy is not recommended
The procedure cannot be performed in the following cases:
- inflammatory diseases of the genitourinary system in the acute phase;
Diagnosis before the procedure
To rule out possible contraindications to performing an aspiration biopsy, a medical diagnosis is made:
- gynecological examination;
- smear on the microflora;
- cytological smear from the cervix (PAP test);
- ultrasound of the pelvic organs;
- general blood test;
- blood test for hCG;
- blood test for hepatitis B and C, syphilis and HIV;
- colposcopy (preferably).
When prescribing a pipelle biopsy, the doctor must obtain from the patient all the information about the drugs she took. Particular attention is paid to taking blood-thinning drugs (Clopidogrel, Aspirin, Warfarin, etc.). If necessary, the doctor may change the order of their reception a few days before the procedure.
Particular attention is paid when choosing an aspiration biopsy of the endometrium to the choice of the date of the study, if the woman has not yet entered menopause. Usually aspiration biopsy of the endometrium is performed on the following days:
- 18-24 days – to establish the phase of the cycle;
- on the first day with pathological bleeding – to identify the cause of bleeding;
- on day 5-10 of the cycle – with excessive menstruation (polymenorrhea);
- on the first day of the cycle or the day before menstruation – if infertility is suspected;
- once a week – in the absence of pregnancy and lack of menstruation;
- for 17-25 days – to monitor the effectiveness of hormone therapy;
- any day of the cycle – if a malignant neoplasm is suspected.
Direct preparation for the procedure is carried out 3 days before the study. These days, a woman needs to follow the doctor’s recommendations:
- Refuse sexual intercourse.
- Do not douche, do not insert candles, ointments and creams into the vagina.
- Exclude from the menu products that contribute to increased flatulence.
- In the evening before the study to conduct a cleansing enema.
For aspiration biopsy use a flexible plastic tube – pipette. The diameter of the pipelle reaches 3 millimeters, and at the end has a side hole, inside the tube is a piston. As a rule, the procedure does not require the use of local anesthesia, but sometimes this method of analgesia is performed for particularly sensitive patients.
The procedure lasts about 1 minute. After 7-10 days, the results of the study become known. After the pipette biopsy, the patient feels well, has a positive ability to work, and therefore can immediately leave the walls of the clinic, there is no need for hospitalization. Further tactics of treatment are determined by the doctor after the results of histological examination.