Endometrial Biopsy / Endosee
An endometrial biopsy is a simple and brief in-office procedure performed by a gynecologist on women with abnormal bleeding by which a small sample of the inside lining of the uterine cavity (called the endometrium) is obtained for examination under a microscope. The removed endometrial tissue sample is analyzed for the presence of cancer, pre-cancer, or other cell abnormalities.
Office hysteroscopy (using the EndoseeR System) is a brief and safe procedure by which the inside of the uterine cavity is looked at directly through a thin, lighted scope. It is recommended for women who have abnormal bleeding, suspected asymptomatic uterine pathology seen on imaging, or a suspected structural anomaly that needs further clarification. For women with abnormal bleeding, it is the most accurate way to help diagnose the cause.
An endometrial biopsy is “blind,” meaning the gynecologist cannot see or choose from what part of the endometrium the biopsy is taken. Because of this, an endometrial biopsy can miss over 30% of focal endometrial abnormalities, including cancer. When performed together, the hysteroscopy and biopsy enable the direct sampling of suspect areas thereby allowing for an accurate diagnosis of a variety of uterine pathologies.
- Heavy or long menstrual periods
- Irregular periods
- Postmenopausal bleeding
- Abnormal bleeding in women taking breast cancer medication tamoxifen
- An abnormal endometrial appearance or thickness on pelvic sonography
- Suspicion of a uterine cavity mass as seen on pelvic sonography (such as an endometrial polyp or a fibroid)
- Abnormal uterine bleeding (in pre- or postmenopausal women)
- Abnormal endometrial thickening seen on pelvic sonography
- Suspicion of congenital uterine structural anomaly (such as a uterine septum or a unicornuate/bicornuate uterus)
- Suspicion of uterine cavity adhesions or scar tissue
- It can be useful for locating (and removing) an IUD whose strings are missing or which may be displaced or embedded
A speculum is inserted into the vagina to expose the cervix. A very narrow hysteroscope with an internal camera is carefully passed through the cervical canal and into the uterine cavity. The entirety of the uterine cavity and endometrial surface is visualized on a small screen attached to the outside of the hysteroscope. A directed biopsy of any abnormality seen is then performed. If there is no a focal abnormality to directly biopsy, a “blind” endometrial biopsy is performed once the hysteroscope is removed.
The endometrial biopsy is performed using a very narrow tubular plastic suction device that is inserted through the cervix into the uterine cavity. Endometrial tissue is collected, and the device is removed. The endometrial sample is then sent to a laboratory where it is examined under the microscope for any pathology.
The procedures takes between 10-15 minutes and no anesthesia is required. Menstrual-like cramping may be experienced during and after either procedure. Any discomfort can be minimized with over-the-counter ibuprofen or TylenolR taken two hours before the procedure.
Women who undergo hysteroscopy and endometrial biopsy in the office can resume their daily activities immediately (with the exception of sexual activity) and avoid the added risks of anesthesia and the inconvenience of the operating room.
We at Adaptive Gynecology are ready to safely perform your Endosee office hysteroscopy and/or endometrial biopsy when needed.
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