Table of ContentsView AllTable of ContentsHow It WorksHow to PrepareProcedureRisksInterpreting the Results
Table of ContentsView All
View All
Table of Contents
How It Works
How to Prepare
Procedure
Risks
Interpreting the Results
Anendocervical curettageis a procedure performed after abnormal results from aPap test. A sample of tissue is taken from the lining of the cervical canal, using a curette, a spoon-shaped tool. The tissue sample is taken to a lab to be checked under a microscope to determine if there is any indication of disease.
This article discusses why you may need an endocervical curettage, the procedure, risks, and how to interpret the results.
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Why You May Need an Endocervical Curettage
An endocervical curettage has been increasingly used incolposcopy/biopsy exams each year in the United States in approximately three million women who have had abnormal Pap tests and require colposcopies.
Studies show that colposcopy biopsies may not detect 30% to 50%of common high-gradecervical precancers. For better accuracy in detecting cervical precancers, medical experts recommend taking multiple lesion-directed biopsies and endocervical curettage.
If any abnormalities turn up in your Pap test or if a positive test indicates the presence of high riskhuman papillomavirus(HPV), yourgynecologistmay recommend a colposcopy, which may include acervical biopsythat may be a:
Once the sample is taken to the lab, the results may show precancerous changes on the cervix that may indicate an HPV infection, which can increase the risk for cervical cancer, anddiethylstilbestrol(DES) exposure if your mother took DES when pregnant. DES, a synthetic form of estrogen (no longer prescribed), raises the risk for cancer of the reproductive system.
How to Prepare for an Endocervical Curettage
After you receive the results of yourPap test, your gynecologist will explain what follows if the lab results showed any abnormalities. They will discuss the procedure and answer any questions you may have.
If you are pregnant or think you’re pregnant, inform your doctor. Also tell your doctor:
Avoid having sex, using tampons, vaginal creams or medicines, and douching for 24 hours prior to the procedure.
Your healthcare provider may suggest that you take a pain reliever 30 minutes before the procedure or your doctor may give you medicine to help you relax. Ifanesthesiais used, you will need someone to drive you home afterwards. There may be some bleeding so make sure to bring a sanitary pad to wear home.
What to Expect During and After
Like a pelvic exam, a speculum with be inserted into your vagina so that your healthcare provider has a better view of your cervix and will proceed to clean the area with a solution of either vinegar or iodine, which may burn or sting.
To hold the cervix in place, your doctor may usetenaculum, a slender, sharp-pointed hook with a handle used for grasping and holding parts used in surgery. With the curette inserted in the cervical canal, your healthcare provider will scrape a thin layer of tissue. Once the tissue is removed it will be sent to a lab to determine if there are any abnormalities, like cancer.
Once the procedure is completed, you may have some spotting and also some discharge from the solution used. Your healthcare provider may recommend that you don’t insert anything in the vagina and abstain from sexual intercourse for at least 48 hours.
Like many medical procedures there are a few risks that may include:
Possible infection may require antibiotic treatments with a possible stay in the hospital. Cervical injury may require surgery.
If you experience any heavy bleeding, pelvic pain, fever, or foul-smelling discharge, call your healthcare provider immediately.
Tissue taken from endocervical curettage may show abnormal changes to the cells in the cervix. The lab will use the Bethesda reporting system that provides a breakdown of grades of abnormal cells from normal cells. This system includes the designation of low-grade squamousintraepitheliallesion (LSIL),high-grade squamous intraepithelial lesion (HSIL)and adenocarcinoma in situ (AIS). Other systems refer tocervical intraepithelial neoplasia (CIN)and cervicaldysplasia.
Abnormal Squamous Cells
Abnormal squamous cells are classified as squamous intraepithelial lesion (SIL) and are either low grade or high grade:
Cervical intraepithelial neoplasia (CIN) can also describe abnormal changes to squamous cells in the cervix. Neoplasia is an abnormal and uncontrolled growth of cells.
CIN is graded 1 to 3 based on how abnormal the cervical tissue looks under a microscope:
Dysplasia means that cells are different from normal cells in size, shape, and organization within tissue. Dysplasia usually refers to a precancerous condition and categorized as:
Adenocarcinoma in situ (AIS) are cancer cells found in the glandular tissue of the endocervix. The cancer hasn’t spread into the deeper tissues of the cervix or surrounding tissue.
Next Steps
Once your healthcare provider has received the lab results, he will contact you and discuss treatment options. Depending on the severity of the diagnosis, some changes in the cells may not need any type of treatment. In some cases abnormal cells can change back to normal on their own, while other abnormal cells or precancerous changes to cells may develop into cancer if they aren’t treated.
Summary
Endocervical curettage is a procedure used after you receive the results of an abnormal Pap test. The procedure involves taking tissue sample from the cervical canal’s wall, using a curette, an instrument shaped like a spoon. Once your healthcare provider has the tissue sample, it will be sent to a lab to be examined under a microscope to determine if there is any indication of disease. If there is disease, your healthcare provider will let you know the next steps.
A Word from Verywell
An endocervical curettage is another biopsy procedure used after you receive the results of an abnormal Pap exam. While receiving news of a questionable Pap test can cause anxiety, be aware that many conditions are treatable, including cervical cancer, when you receive an early diagnosis and receive prompt treatment.
5 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.
Johns Hopkins Medicine.Cervical Biopsy.
Saint Luke’s Health System.Understanding endocervical curettage.
Canadian Cancer Society.Abnormal Cervical Biopsy Results.
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