Endometrial Biopsy EMB Kathryn L Ponto, MD
An Endometrial Biopsy is an office procedure used to sample the lining of the uterus. It is used to evaluate a variety of possible conditions of the lining of the uterus: hormone imbalance, overgrowth, or possible precancerous change.
The procedure is done in the office. If you are not otherwise instructed, the biopsy can be scheduled at anytime of the month. If you are bleeding the day of the biopsy, as long as it is not heavy, you can still have the procedure done. It is best to take 600 mg of Motrin or a similar medication (Advil, Ibuprofen) one hour prior to the scheduled procedure with food, (assuming you have no medical contraindications to this medication). This over the counter nonsteroidal anti-inflammatory medication will help you to notice less cramping from the procedure.
During the procedure, a speculum is placed to visualize the cervix, just like for a pap smear. The cervix is cleaned with a solution and local anesthetic is placed to decrease any cramping that the procedure may cause. Some women feel a bit of cramping or pinching as the anesthetic is placed, but that sensation resolves in moments. The cervix may need to be gently stretched open or dilated, and then a small plastic straw - like sampler is used to obtain the specimen.
Most women feel a little cramping during this office procedure. The procedure and preparation takes about 20 minutes. The sample removed is sent for the pathologist to evaluate. The office should have the report within about one week.
As with nearly any procedure, there are small risks. For this procedure, these include bleeding, infection inside the uterus, a hole in the uterus, being unable to obtain the specimen, or the need for further evaluation. These complications are all very rare.
Mild cramping the day of the procedure is normal, so continue to take about 600 mg of Motrin with meals the day of the biopsy. If you develop infection, cramping will return and worsen 36 or more hours after the procedure, and it may not be improved with Motrin. Fever >100.5, is another sign of potential uterine infection. Bleeding after the procedure should not be more than soaking a maxi pad an hour, and is more likely to be normal flow for you or some unscheduled spotting. Please do not use tampons for 5 days after the procedure, in order to minimize infection risk. If you have any problems or concerns after the procedure, call the office.