Table of ContentsView AllTable of ContentsPurpose of ProcedureRisksContraindicationsBefore the ProcedureDuring the ProcedureRecoveryInterpreting ResultsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Purpose of Procedure
Risks
Contraindications
Before the Procedure
During the Procedure
Recovery
Interpreting Results
Frequently Asked Questions
A cervicalbiopsyis a minor surgical procedure in which a sample of tissue is taken from the cervix, the cylinder-shaped structure connecting the vagina and the uterus. A cervical biopsy may be needed if you had an abnormalPap smear, if your healthcare provider noted an abnormality during a routine pelvic exam, or if you are at high risk of cervical cancer.
This article will review the use of cervical biopsy, why it’s needed, how it is performed, and what happens with the results.
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A cervical biopsy is important for thedetection of cancerorprecancerous cells. Indications for a cervical biopsy include:
In addition, a cervical biopsy sometimes is done to diagnosegenital wartsorcervical polyps. A healthcare provider also may choose to do a cervical biopsy on a woman whose mother took diethylstilbestrol (DES) while pregnant.
DES was prescribed from 1938 until 1971 to prevent miscarriage, premature labor, and related complications. The drug was discontinued in the U.S. in 1971 when researchers discovered it increased the risk of reproductive cancers in the daughters of women who took it during pregnancy.
Once a cervical biopsy has been ordered, it is important to know which type you will have. There are a few different types of biopsies, including:
Cramping From Bruised Cervix: How to Manage Pain
A cervical biopsy is usually safe for most women. Serious complications include:
A cone biopsy, in particular, can result in heavy bleeding and (though rare) infection, injury to tissue, vaginal tears, perforation of the uterus requiring surgical repair, or impaired menstrual flow (cervical stenosis due to scarring).
Pregnancy-Related Risks
Some cervical biopsy procedures may be associated with an increased risk of premature birth due to an incompetent cervix. This is primarily a concern when more than 1 centimeter (roughly 1/2 inch) of tissue is cut out and is more common if a woman gives birth within one year of the procedure.
Incompetent CervixIf you have a procedure that may raise your risk of preterm labor, your healthcare provider will monitor you closely during pregnancy. In some cases, your healthcare provider may recommend acervical cerclagewhere the cervix is sewn closed. This procedure can help prevent preterm labor.
Incompetent Cervix
If you have a procedure that may raise your risk of preterm labor, your healthcare provider will monitor you closely during pregnancy. In some cases, your healthcare provider may recommend acervical cerclagewhere the cervix is sewn closed. This procedure can help prevent preterm labor.
Women who have acute pelvic inflammatory disease or inflammation of the cervix will usually need to wait until their condition has subsided before having a cervical biopsy.
Tell your healthcare provider if you’re allergic or sensitive to any medications or to latex. It’s also important to tell your healthcare provider what medications you’re taking, as some can increase the risk of bleeding. These medications include:
Your healthcare provider will tell you if you should stop taking these medications before your cervical biopsy and how soon.
Don’t use tampons, vaginal creams or medicines, or douche for 24 hours before the procedure, and refrain from sexual intercourse for 24 hours before a cervical biopsy.
Location
The place a cervical biopsy is performed may vary, depending on your condition and your healthcare provider’s practices. Usually, it is done in the healthcare provider’s exam room or in an outpatient facility. In rare instances, a biopsy may be scheduled in an operating room if surgery is anticipated due to any further complications.
What to Wear
You will need to remove your clothing from the waist down and put on a hospital gown for your biopsy, so choose a skirt or pants with a comfortable top rather than a dress or other one-piece garment.
Exam rooms can be chilly, so it’s advisable to wear or bring socks to keep your feet warm during the procedure.
Food and Drink
You do not have to make any special changes regarding food or drink before a cervical biopsy. However, if you will be having a cone biopsy, in which general anesthesia is necessary, you likely will be instructed to not eat or drink for at least eight hours before your procedure.
Cost and Health Insurance
Most health insurance plans cover the cost of a cervical biopsy. Confirm that this is the case with your insurance company, and find out if you will need to bring a copay with you to your appointment.
What to Bring
You may experience light bleeding after the procedure. The healthcare provider’s office or clinic will likely have sanitary napkins, but you may want to bring your own just in case.
When you arrive for your cervical biopsy, you will check in at the front desk. If you’re having a cone biopsy, your healthcare provider may come out to greet you.
Pre-Procedure
In the waiting room, you will be asked to fill out paperwork consenting to the biopsy and agreeing to pay, if you haven’t done so already. When it’s time for your procedure, a nurse will have you empty your bladder and then escort you to the room where it will take place. They will give you a gown and leave the room to give you privacy after instructing you to undress from the waist down. They may check your blood pressure, pulse, and temperature before or after you change.
Your healthcare provider may prescribe a pain reliever 30 minutes before the procedure.
Throughout the Procedure
Here are the steps you will most likely go through for a cervical biopsy:
Bleeding from the biopsy site may be treated with medication, and if necessary, they may also use a probe (electrocauterization) or stitches to stop the bleeding.
After the Procedure
After the speculum is removed, the healthcare provider or a nurse will provide you with towels to wipe any discharge or blood, and you may need to use the toilet. You may also need a sanitary napkin if you have discharge or bleeding.
Recovery will depend on the type of biopsy done and if you had anesthesia.
You will be taken to the recovery room and monitored with general anesthesia until you’re fully awake and no longer groggy. Once your blood pressure, pulse, and breathing are stable, you will be taken to a hospital room or discharged. If you had the procedure done at an outpatient facility, you should arrange for someone to pick you up.
After a simple biopsy, you may rest for a few minutes before going home.
It’s normal to have mild pain, cramping, spotting, and dark or black-colored discharge for several days after a cervical biopsy. The dark discharge is from the medicine applied to your cervix to control bleeding.
Most healthcare providers recommend avoiding sex or using tampons for up to two weeks after a cervical biopsy. Certain activities may also be restricted. Full recovery from a cone biopsy may take several weeks.
Managing Side Effects
You may experience some pain after the cervical biopsy. Be sure to have pain relievers such as ibuprofen, naproxen, or acetaminophen available to help manage the pain. Call your healthcare provider if you experience any of the following signs of infection:
Your healthcare provider will send your cervical sample to a pathology lab immediately after the procedure, and it can take a few weeks to get results. The pathologist will send a report describing whether the cells are normal or abnormal and detailing their appearance. The healthcare provider will then call you to share the results.
If they’re normal, it most likely means you do not have cervical cancer. Abnormal results can indicate low-grade dysplasia (mild), high-grade dysplasia (moderate to severe), or cervical cancer.Cervical dysplasiameans there are precancerous changes to the cervix.
Adenocarcinoma in situ(AIS) means that cancer cells are present but may still be localized to the area where they originated (pre-invasive). Though the cells appear cancerous, they do not yet have the potential to spread.
The terminology and treatment approaches for cervical dysplasia can be very confusing. Make sure to talk to your healthcare provider about any questions you may have.
Untreated cervical dysplasia may lead to cervical cancer in some cases. However, having cervical dysplasia does not mean you have cancer or will develop the disease.
It can take years forcervical cancerto develop. Depending on how extensive or advanced the dysplasia is, your healthcare provider may decide that you need surgical resection of the dysplasia before it develops into cancer. Treatment options may include cryotherapy, laser therapy, loop electrosurgical procedure (LEEP), or conization.
Recommendations for follow-up and treatment will depend not only on your biopsy results but on your history of Pap smears, HPV testing, age, and past biopsies.For example, suppose you have a biopsy that suggests CIN2 and a history of a high-grade intraepithelial lesion (HSIL) in the past. In that case, recommendations may differ for someone who has a CIN2 biopsy with no history of Pap smear abnormalities.
Recommendations for follow-up and treatment will depend not only on your biopsy results but on your history of Pap smears, HPV testing, age, and past biopsies.
For example, suppose you have a biopsy that suggests CIN2 and a history of a high-grade intraepithelial lesion (HSIL) in the past. In that case, recommendations may differ for someone who has a CIN2 biopsy with no history of Pap smear abnormalities.
Remember, there are many factors that healthcare providers consider when recommending treatment. Two biopsies that look the same under the microscope may be treated very differently depending on age, history of Pap smears, pregnancy, and more.
Summary
Your healthcare provider may recommend a cervical biopsy if your Pap smear results are abnormal. A biopsy can be done in a few different ways to remove abnormal cells and have them tested for cancer.
This procedure is often done in a healthcare provider’s office, with results available in a few weeks after the pathologist reviews the sample.
The results will help your healthcare provider determine the best treatment options if needed.
A Word From Verywell
Having a biopsy and waiting for the results can be very anxiety-producing. But the procedure may be the best way to stave off cancer or illness before it becomes a severe and full-blown disease. That’s why it’s important to get regular screenings and, if necessary, a biopsy. When cervical cancer is caught in its earliest stage, there is a 93% five-year survival rate.
There are other causes of abnormal cells, including:Yeast infectionInflammationHormonal changes
There are other causes of abnormal cells, including:
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tarney CM, Han J.Postcoital bleeding: a review on etiology, diagnosis, and management.Obstet Gynecol Int. 2014;2014:192087. doi:10.1155/2014/192087Weinmann S, Naleway A, Swamy G, et al.Pregnancy outcomes after treatment for cervical cancer precursor lesions: an observational study.PLoS One. 2017;12(1):e0165276. doi:10.1371.journal.pone.0165276Robson J, Merwe C van der, Walters L, Noack L, Giles SM.The occasional cervical biopsy.Can Journal Rural Med. 2022;27(2):72. doi:10.4103/cjrm.cjrm_13_21Medline Plus.Colposcopy-directed biopsy.American College of Obstetrics and Gynecology.Colposcopy.Burd EM.Human papillomavirus and cervical cancer.Clin Microbiol Rev. 2003;16(1):1-17. doi:10.1128/CMR.16.1.1-17.2003Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.J Low Genit Tract Dis.2020;24(2):102-131. doi:10.1097/LGT.0000000000000525National Cancer Institute.HPV and Pap test results: next steps after an abnormal cervical cancer screening test.
Tarney CM, Han J.Postcoital bleeding: a review on etiology, diagnosis, and management.Obstet Gynecol Int. 2014;2014:192087. doi:10.1155/2014/192087
Weinmann S, Naleway A, Swamy G, et al.Pregnancy outcomes after treatment for cervical cancer precursor lesions: an observational study.PLoS One. 2017;12(1):e0165276. doi:10.1371.journal.pone.0165276
Robson J, Merwe C van der, Walters L, Noack L, Giles SM.The occasional cervical biopsy.Can Journal Rural Med. 2022;27(2):72. doi:10.4103/cjrm.cjrm_13_21
Medline Plus.Colposcopy-directed biopsy.
American College of Obstetrics and Gynecology.Colposcopy.
Burd EM.Human papillomavirus and cervical cancer.Clin Microbiol Rev. 2003;16(1):1-17. doi:10.1128/CMR.16.1.1-17.2003
Perkins RB, Guido RS, Castle PE, et al.2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.J Low Genit Tract Dis.2020;24(2):102-131. doi:10.1097/LGT.0000000000000525
National Cancer Institute.HPV and Pap test results: next steps after an abnormal cervical cancer screening test.
Fontham ETH, Wolf AMD, Church TR, et al.Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society.CA Cancer J Clin.2020. doi:10.3322/caac.21628
Yalcin I, Sari ME, Sahin H, Gultekin M, Gungor T, Meydanli MM.Colposcopic biopsy findings among women with either HPV-16 only or HPV-18 only who have normal cervical cytology.Int J Gynaecol Obstet.2018;143(3):300-305.doi:10.1002/ijgo.12652
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