What is cervical biopsy?
Nature has rewarded women with beauty, charm,sensuality, tenderness. She also created an unusually complex system of sexual organs in their bodies, thanks to which life on our planet continues. For various reasons, dozens of diseases can arise in any part of these organs. Some of them are less serious, others are more, but everyone needs to be treated. If you do not, even a very simple ailment can grow into a big problem.
One of the most dangerous to dateis cancer. It is possible to defeat this deadly disease if the malignant cells have not yet spread throughout the body. Cancer can occur anywhere in the body, including the reproductive system. Timely diagnosis helps women to avoid very unpleasant consequences of this and other diseases. One of the basic research methods in our time is biopsy of the cervix.
If you are appointed to it, you do not need to think that you havecertainly cancer. This analysis is relevant for many problems that arise in the mucous membranes of a very small but important organ - the cervix. What does the biopsy show? How is it conducted? Do we need special training for it? What are the consequences of this analysis? In this article, you will find answers to your questions concerning the conduct of this study.
Every woman has heard of the existence of such aorgan, but not everyone knows what he is. The cervix, figuratively speaking, is a corridor along which sperm move, hastening to fertilize the ovum. It connects the vagina and the uterine cavity and is a short tubule 2.9-4.2 cm long. Its width in nulliparous girls is 2.6-2.9 cm, and in those giving birth it is about 5 mm larger. From both ends, the cervix has so-called throats. One opens into the vagina, the other into the uterus. In a normal position (menopause, there are no pathologies) they are closed.
In addition to the two yawns, the cervix is secreted by the vaginal and supravaginal parts, as well as the cervical canal opening into the uterus.
From inside, this small connecting tubelined with several layers of cells. In the vaginal part they are represented by a nonkeratinous epithelium, having a superficial, prickly and basal layers. The epithelium is updated every 5 days. It consists of several types of cells:
Cylindrical. Are located in one layer, bright red color, have papillary surface. These cells play an important role - they secrete a secret that moistens the genital tract.
Metaplastic. Are located under cylindrical, are formed from them by transformation. It is in them most often there are oncological diseases. That is, for cervical biopsy, these cells are mainly taken.
Epithelial cells lie on a thin basal membrane that separates it from the connective tissue.
The concept of biopsy
This term means taking a biopsy specimen (tissues orindividual cells) in a living person. There is also an autopsy - a study of the tissues of the dead. Biopsy is the most accurate method of examining tissue cells. It is carried out with the help of powerful microscopes. Studies can be carried out in two ways:
- Histological. For this method, organ tissues are taken. They are first dehydrated with a special solution, then made fat-soluble, impregnated with paraffin, which after hardening is cut into strata with a width of about 3 μm. Samples prepared in this way are placed on a laboratory glass and, by means of various technologies, reveal the presence or absence of pathological changes.
- Cytological. This is a more sparing and less traumatic method of taking a biopsy, in which only cells are taken from a suspicious area of the body, and not pieces of tissue. It is the cytological examination that is most often performed with cervical biopsy. The procedure is to take a smear-print from the mucosa of this organ. The morphologist performs the analysis. The cytoscopy is less informative and not as accurate as histology.
Indications for biopsy
Every woman must visit at least once a yearat a gynecologist's appointment. As a rule, the doctor conducts instrumental examination (with the help of mirrors and colposcope), takes a smear. If necessary, he will give the patient the delivery of tests.
Cervical biopsy is a procedure that is performed in exceptional cases. Indications for this study are such pathologies in the cervix:
- Ectopia (changes in the pathological nature of the mucous membrane of the cervix).
- Dysplasia (disruption of tissue and cell structure). It is considered a precancerous condition.
- A biopsy of the cervix is often administerederosion. Suspicion should occur if they are crumbling or bleeding. However, for the purpose of reinsurance, doctors often prescribe a procedure for taking a biopsy with erosions of any type.
- Leukoplakia (cornification, thickening of the epithelium).
- Condylomas (warts on the genitals).
- There are areas that are not stained with iodine (called iodine-negative).
- Changes in the epithelium, called coarse mosaic.
- Identified with the help of a smear on cytology atypical cells.
- Koilocytes (cells in which the papilloma virus is detected.
- There are segments of the epithelium, clarified with acetic acid.
- Epithelial changes found during colposcopy.
- Atypical cells in the epithelium.
- Atypical vessels, not reacting at all to contact with acetic acid.
It should be said that biopsy of the cervix is preceded by a serious preparatory stage, during which it is necessary to pass the following tests:
- On HIV.
- On chlamydia, mycoplasma, ureaplasma.
- On hepatitis.
- On syphilis (RW).
- The blood is common.
- Blood for clotting.
- Smear on the microflora of the vagina and cervix.
- A smear on cytology (called PAP).
- Go through colposcopy.
If the investigation reveals the presence of pathogenic microbes, the biopsy is postponed until the cured disease is cured.
A woman should inform the physician of such information about her health:
- There is or is not an allergy to food, medicine.
- Does she or her family have periodic spontaneous bleeding.
- What were the previous surgical interventions.
- The presence in the history of hypertension, diabetes, heart failure.
- Previous transfer of venous thrombosis and / or thromboembolism of pulmonary arteries.
One day before the upcoming biopsy you need to stop sex, douching, use of tampons and vaginal medications.
On the day of the analysis, you should not smoke, drink alcohol, use any means for personal hygiene.
If the procedure is planned under anesthesia, 12 hours before this, it is forbidden to eat or drink any beverages other than water.
When is it better to do a biopsy
Consider how the cervix behaves in different periods of the cycle?
On the 5th-7th days it is low-lying, firm and elastic, clogged with a mucous stopper.
From the 7th and to the 12th days, the neck gradually rises, becoming softer supple.
From the 13th to the 15th days, the cervix becomes loose, slippery and damp.
From the 16th day, it again descends, becomes firm and elastic.
Many gynecologists believe that the most successfultime for biopsy is the period from the 7th to the 12th days. You can capture the 13th. Then the outer cervix is ajar, which helps to reduce the pain sensations of a woman when she enters the organ of the instrument.
Some doctors prescribe the analysis immediately after the end of the month, and also from the 5th to the 8th day of the cycle.
To conduct a study, the physician has toopen the external yawn (from the side of the vagina) so that you can enter into the organ colposcope. That's why many women with a cervical biopsy are hurt. In this case, when taking a biopsy specimen, the patients feel drawn, sometimes giving in the stomach, in the legs and in the ovaries, unpleasant sensations. Only among women who have already given birth several times, there are many who do not experience any negative symptoms when they insert into the instrument.
This may depend on the pain threshold of each patient, on the professionalism of the gynecologist and on what day of the menstrual cycle an analysis is made.
How is cervical biopsy done?
The standard process (without complications) takes about 30 minutes. In this case, the following actions are performed:
1. The patient is conveniently arranged on a gynecological chair.
2. The doctor provides access to the cervix by inserting a special medical mirror into the vagina.
3. Prepares the surface of the mucosa, for which it performs some manipulations:
- a tampon with saline solution cleans the cervical area from mucus;
- it causes iodine (the problem zone is not colored in the characteristic brown color);
- Apply acetic acid (problem areas are whitish);
- introduces a colposcope and carefully examines the surface (the device has a light at the end, allows an increase of 40 times).
These preparatory manipulations can cause the patient unpleasant feelings, but they need to be done.
4. The biopsy sampling is performed. How cervical biopsy is performed depends on the type of instrument. This question will be considered below. Now we note that the biopsy is taken from all problem areas (if several are found).
5. After treatment, the cervix, the vagina and the genitals are treated externally with an antiseptic.
The results are prepared 2 weeks.
In the arsenal of gynecologists there are several typesa tool used for taking a biopsy. Which one to use depends on the equipment of the clinic and on the nature of the problem area that needs to be investigated.
1. Biopsy needle. With this type of material intake, anesthesia is not done. The patient feels short-term pain, as during injection. After a biopsy of the cervix performed in this way, the woman does not feel any discomfort. Allocations are minimal.
2. Conchot. Some women call this tool forceps because of their external resemblance. How is a cervical biopsy performed by the conchotome? This tool simply pinch off the pieces of flesh. The procedure should be performed with an anesthetic injection into the cervix, then it is practically painless. Without anesthesia, women feel nagging pains that extend to the lower abdomen. The doctor burns wounds after the procedure. If there is abundant bleeding, insert a tampon. If the blood is not strong, women are treated with a conventional gasket. Discharges may be observed for several days.
3. Radio wave biopsy of the cervix. Most often for this procedure using the device "Surgitron". It should be carried out under local anesthesia, but in a review women report that not all clinics comply with this requirement. The biopsy is performed on a gynecological chair. Before the procedure is required to perform the grounding. Without anesthesia, the process is quite painful, since the apparatus with the help of high-frequency radio waves removes the mucosal surface. Radioactive biopsy after a biopsy of the cervix is always significant, lasting a week or more. Also, women feel pain (as before menstruation) pain in the lower abdomen.
4. Electron. It is a wire heated by electric current. The procedure should also be performed under local anesthesia.
Types of biopsy performed under general anesthesia
Such procedures are carried out in cases where you need to take a large amount of material for research. As a rule, the patient is offered to lie down for a couple of days in the hospital.
1. A wedge biopsy of the cervix. How do the procedure in this way? It is performed with a scalpel. Spinal or epidural anesthesia. Specialist cuts biopsy in the form of a triangular fragment of flesh. If the area of material intake is significant, the doctor puts a suture on the wound surface of the cervix. Biopsy taken from the most suspicious in relation to the pathology of sites. Sensations after the procedure in many women were complicated by the recovery period after anesthesia. Abdominal pain 7-10 days can be felt. Excretions are observed up to two weeks.
2. Laser knife. The procedure is fast. Sensations after it are similar to those that are present after a wedge biopsy, but the way out of anesthesia is easier.
3. Circular biopsy. Differs in that it captures a very extensive area for research (the mouth of the cervical canal, the vaginal and supravaginal areas). After such a biopsy of the cervix, discharge in the form of blood is always significant, especially in the early days. In moderation, excretions are observed up to three weeks.
4. Endocervical curettage. It involves scraping the mucous. The instruments used in the procedure are brushes (they are turned in the neck) and a curettage spoon. In some cases, this type of research is conducted on an outpatient basis under local anesthesia. However, more often endocervical curettage is performed in the hospital under general anesthesia. Blood after a biopsy of the cervix by this method is very abundant, especially during the first hours. It can be observed on gaskets for up to two weeks.
After the procedure
There are certain rules that a woman must follow after a cervical biopsy. The consequences in this case will be minimal.
What not to do after the procedure:
- Use tampons.
- Having sex.
- To visit a sauna, swimming pool, beach, solarium.
- Do douching.
- Use vaginal suppositories and other drugs.
- Actively play sports.
- Lift and carry weight.
- Take blood thinners. Their list includes and familiar to all "Aspirin."
What to do after the procedure:
- On the first day, ensure your peace. Ideal would be bed rest. In the future, a few days should avoid prolonged sitting position.
- With pain, drink "Ibuprofen", "Paracetamol".
- Be sure to wash the genitals every day (outside).
- Change gaskets every 2 hours.
- Drink decoctions of chamomile, calendula, yarrow, willow-tea.
- Consult a doctor if such effects are noticed:
-y discharge has an unpleasant smell;
- in them blood clots, pus are noticed;
- general condition worsened, temperature rose, pain intensified;
- after scanty discharge, abundant recurrence began;
-Color of secretions scarlet, they are abundant, similar to bleeding.
Some women ask whether it is possible to take medication after a biopsy of the cervix to relieve their condition.
This question is decided only by the attending doctor. To prevent infection, prescribe:
- "Ornidazole" or analogues course 5 days.
- Rectal candles "Genferon".
- After completion of heavy discharge, the doctor may attribute the Betadine vaginal suppositories.
- 2 weeks after taking the biopsy, vaginal plugs "Depantol" are prescribed.
What a cervical biopsy shows
We repeat, the analysis is prepared for at least two weeks. Many women are waiting for it with impatience and great excitement, because a biopsy is a serious study that is not appointed, if there are no good reasons. We offer decoding of cervical biopsy:
1. The result is negative. This is the best that can be. Such a response means that the cells of the cervix are not altered or very little altered, which is often a consequence of trivial inflammation.
2. Background benign metamorphosis in cells. This means that a woman has a pathology that is not life-threatening, but requires treatment. These include:
- Papilloma. May be caused by hormonal disorders.
- Polypous growths. The reason for their appearance also lies in hormonal disruptions.
- Pseudo-erosion (ectopia). In adolescents is considered normal. Without treatment, disappears by 25 years. In the future, ectopia causes are birth injuries (women under the age of 25 are also affected) and genital infections.
- Benign epithelial changes. As such, they are considered if no cancer cells are found in the biopsy.
- Endometriosis. Means the growth of cells that make up the endometrium. A frequent cause of this is hormonal disruption.
- Endocyrvicitis. Indicates that the cervical canal is inflamed.
- Chronic cirvicitis. Increased leukocytes and degeneration of epithelial cells are found in the biopsy specimen.
3. Pre-cancerous condition. This is not fatal yet, but without treatment, about 65% is converted to cancer. Name of pathologies:
- Cervical dysplasia.
All these readings in decoding analysis meanthat atypical cells are found in the biopsy specimen. They can be in large or small quantities, affect one or more layers of the epithelium, proliferate or not, but in any case, apoptosis is still relevant for them.
4. Cancer. This means that cancer cells are found in the biopsy. They have multiple changes in structure, divide rapidly, do not undergo apoptosis, and are able to penetrate into neighboring structures. Possible diagnoses:
- Leukoplakia proliferating. With this diagnosis, epithelium areas are thickened and keratinized.
- In the atypical epithelium there is a papillary zone.
- Atypical transformation in the zone of cylindrical epithelium cells (more than 1/3 of the total).
- The site of atypical vascularization. Abnormal proliferation of blood vessels. As a rule, they do not respond to stimuli (vasoconstrictor drugs, acetic acid).
- Intraepithelial carcinoma. In another way it is called preinvasive cancer. There is no metastasis yet, malignant cells do not extend beyond the edge of the basement membrane. Such a diagnosis means the first stage of uterine cancer. Treatment involves the removal of only the abnormal area and drug therapy.
- Microcarcinoma. This means non-aggressive cancer. With such a diagnosis, there are invasions of malignant cells in neighboring tissues, but so far they are small, up to 7 mm. During surgery, a uterus, a third of the vagina, and regional lymph nodes are removed.
- Invasive cancer. A cancerous tumor may be large or small, but metastasis is always observed. During surgery, the uterus and all areas with metastases, regional lymph nodes, appendages are removed. Next, conduct radiation and drug therapy.
If you are prescribed a cervical biopsy, do not needto be afraid of This procedure is performed daily by hundreds of women, and all after it remain alive. Remember: this analysis is needed first and foremost by you. You can perform the procedure in the usual female consultation or in a private clinic. There is a greater likelihood that you will hold it with anesthesia. This will not affect the results, but the process itself will be transferred more easily.
Prices of cervical biopsy in differentmedical facilities vary widely, depending on the complexity of the procedure and on the category of the clinic. If we talk about Moscow, then here is the lowest cost - 1225 rubles. At this price, this study is carried out in IMMA network clinics. The highest cost of this procedure in the capital is 12,000 rubles. In St. Petersburg, prices are more affordable and start from 600 rubles.
Fighting any disease is much easier if itrevealed in time. Lost time sometimes costs patients life. Even if you have very unfavorable results of a cervical biopsy, do not panic and despair. Treatment of malignant tumors in the organs of the female reproductive system has good predictions, especially in the early stages of their detection.