What is a Cervical Biopsy?

A cervical biopsy is a medical or surgical procedure where a small sample of cervix tissue is taken for microscopic exam and analysis. Cervix is the narrow end of the womb found at the end of the vagina.

A cervical biopsy is usually performed when a certain abnormality is found during a routine pap smear or pelvic examination. Abnormalities in the cervix may be caused by the human papilloma virus that may cause cervical cancer.

Biopsies of the cervix are performed in different ways you should know. A biopsy can either remove the abnormal tissue completely or remove a sample of tissue for microscopic examination. Biopsy may also be used to treat cells that may later develop into cancer.

The types of cervical biopsies include:

• Cone Biopsy- In this procedure, a scalpel or laser is used to extract a large cone-shaped sample tissue from the cervix
• Punch Biopsy- The procedure involves use of a circular blade to punch-remove a sample cervix tissue. Many punches can be made on different parts of the cervix.
• Endocervical curettage- In this procedure, a narrow tool called curette is used to get through the endocervical canal. A curette has a hook-shaped tip that is used to remove a biopsy sample.

Why should I need a cervical biopsy?

Biopsy of the cervix is important when some abnormalities are found on the cervix during pelvic examination. This procedure is even required after your doctor realizes abnormal cells during a pap test.  If human papilloma virus (HPV) is found in your cervix, your doctor may also call for a cervix biopsy. Some types of HPV have been found to cause cervical cancer plus other less common types of female reproductive system cancers. Cervical cancer is done in form of a colposcopy which is also referred as colposcopy-guided cervical biopsy. Colposcopy is a tool with lens that is used to view cervical tissues.

Cervical cancer may be used to pre-cancer and cancerous cells of the cervix as well. The cells that look abnormal but are not cancerous are referred to as pre-cancer cells. Pre-cancerous cells are the first sign of a cervical cancer that may develop after many years.

Other reasons why your doctor may go for cervical cancer include:

• Polyps or non-cancerous cell growth on the cervix
• Presence of genital warts that shows that your cervix is infected with human papilloma virus
• Diethylstilbestrol (DES) exposure - in case a mother takes DES during pregnancy, her female child may be at risk of developing cervical cancer

Your health care provider may also have other reasons to opt for a cervical biopsy.

Preparation for cervical biopsy

• Your doctor will first explain how cervical biopsy is performed and its risks. You will then be allowed to ask questions.
• You will be required to sign a consent form to be sure that you have understood how cervical cancer is performed and its known risks.
• For a simple cervical biopsy, you do not need to stop drinking or eating anything. However, if the biopsy require use of a general anesthesia, you will be required to fast for about 8 hours before the procedure.
• You may discuss with your surgeon in case you are pregnant or expecting pregnancy.
• In case you are allergic to certain medicines, such as anesthesia, latex and tape, you should let your doctor know before hand.
• You should also inform your doctor about the type of drugs you are taking. This includes over-the–counter medications, prescribed drugs, and nutritional supplements.
• If you have a history of bleeding problems or you are taking blood thinners such as aspirin, you should let your doctor know. You are required to stop taking these medications one week before cervix biopsy.
• You are not supposed to have sex 24 hours before cervix biopsy.
• You are required to have a sanitary pad to wear after the procedure.
• You may be given pain relievers by your doctor 30 minutes before cervix biopsy. You may also have an injection of anesthesia to make you relaxed during the procedure.
• You are required not to use any vaginal crams, tampons, or douche 24 hours before a cervix biopsy procedure.

You should make sure that you follow any other instructions given by your healthcare provider so as to get accurate results.

What to expect during the procedure?

Cervical biopsy is always provided in a hospital setting. While some biopsy may need a local anesthesia, others may need a general anesthesia.

Below are steps followed during a cervix biopsy:

• You will first remove all your clothes and wear a hospital gown.
• Before the procedure, you should empty your bladder.
• You will then lie on a biopsy table with your feet and legs supported.
• Your doctor will then put a surgical instrument known as a speculum into your vagina. This instrument helps put the vaginal walls apart to reach the cervix properly.
• A colposcope will then be inserted at the vaginal opening but will not be allowed to enter the vagina.
• Your doctor will then view the cervix with the use of a colposcope to find any abnormal areas of your cervix.
• The cervix is cleansed with an acetic acid solution to make the abnormal cells turn white for easier viewing. An iodine solution is then used to coat the cervix.
• The biopsy type to be used will depend on the shape and size of the abnormal cells.
• The area around the cervix is then numbed with an anesthesia.
• Forceps are used to hold the cervix for biopsy.
• Cells are removed from the cervix with the use of an endocervical cuvette or a thin-hooked needle.
• Bleeding on the site of biopsy is stopped by the use of a paste-like medicine. Your doctor may also use a probe or stitches to stop the bleeding.
• Your biopsy samples will then be sent to a pathologist for a microscopic exam.

Risks and Complications

The most common complications associated with cervix biopsy include excessive bleeding and infection. Cone biopsy of the cervix may also increase your risk of getting infertile or miscarriage. This may be due to the scarring changes on your cervix during the procedure.

Bottom Line

Cervix biopsy is a procedure that is aimed to check any abnormalities with your cervix. Samples of your cervix are taken for microscopic examination to check for cancer or pre-cancer cells. Thorough preparation for cervix biopsy will give you more accurate results.