To sample tissue from the lining of the uterus for microscopic examination, while avoiding a general anaesthetic.
Indications. Abnormal menstrual bleeding, and to assess the hormonal state of the endometrium.
Method. This procedure is performed without anaesthetic, usually in the gynaecologist’s surgery, rather than in a hospital operating theatre. In some ways it is more like a pap smear than a D and C. The cervix is viewed, using a vaginal speculum, as for a pap smear, and a narrow disposable instrument is inserted into the uterus. This sampling device is rotated, touching the walls of the uterus, and small fragments of endometrium are caught in it. The device is withdrawn and the tissue fragments are put onto a microscope slide, and sent to the pathologist for reporting.
The accuracy of the test will vary with the amount of tissue obtained, and there may be areas of the uterus lining which are not sampled. Therefore it is not totally reliable, but has a role to play in gynaecological investigation.
Complications. The procedure may be a little uncomfortable, either at the inserting stage, or during rotation, but the discomfort is usually mild. Some women may experience bleeding following the procedure, but this is rarely severe. Perforation or damage to the uterus seems very uncommon, and as it is performed without anaesthetic, there are no anaesthetic risks involved.
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