Introduction
A biopsy describes a tissue removal from an organ to examine the cells. It is carried out if one suspects that the cells are degenerate or if a special disease is present. If a gynaecologist has noticed suspicious changes in previous examinations, he or she will order a biopsy of the cervix for clarification. The tissue is usually removed under local anaesthetic and then examined under a microscope.
The indication
A biopsy is usually used to clarify suspicious changes in the uterus. This can be indicated by a conspicuous palpation, such as a hardening during a gynaecological examination. However, changes can also be noticed during imaging (sonography, X-ray).
The biopsy is necessary to examine the cells at the conspicuous location microscopically and molecularly – only in this way can it be determined whether the change is benign or malignant. In addition, it is possible to identify the type of tumour and how advanced it is. This is crucial for the therapy, as it varies according to the stage and must be adapted accordingly.
The preparation
First of all, the doctor treating you should explain the necessity of the procedure. You should also be informed about the possible risks and complications. Depending on whether you decide to have the procedure performed under short anaesthesia or local anaesthesia, there are different things you should be aware of.
If you are under anesthesia, you should not have eaten or drunk anything for six hours before the procedure. If the biopsy is performed under local anaesthetic, you may eat and drink normally. The doctor should also explain to you how you should behave afterwards and what you should pay attention to.
You should also find out before the procedure whether the treatment will be carried out on an outpatient basis or whether you will be admitted to hospital as an inpatient. Anesthesia is not usually necessary for the procedure. The biopsy is usually performed under local anaesthetic.
The tissue to be examined is anaesthetised beforehand with a local anaesthetic so that no pain can be felt. If you are particularly afraid of the procedure or if the doctor recommends an anaesthetic for certain reasons, it can still be performed. However, one should always be aware that an anaesthetic has more side effects than a local anaesthetic. You can find more information on this topic under: Anaesthesia.
The procedure
If the examination is performed under anaesthesia, it must be initiated before the procedure. This is prepared and performed by anaesthetists. If the biopsy is performed under local anesthesia, the local anesthetic must be injected shortly before the procedure so that it can take effect.
After these measures the intimate area is washed and covered sterilely. Special instruments are then inserted into the vagina to give the surgeon a better view. With the help of a colposcope, the mucous membrane of the vagina, the cervix and the cervix can be viewed.
A colposcope is a special microscope used for gynaecological examinations. The surgeon then removes a piece of tissue with special pliers, which are also inserted through the vagina. Alternatively, an abrasio (removal of the uterus) can also be performed.
In this procedure, the mucous membrane of the cervix is scraped off with a curette. The removal of tissue causes no pain, as the tissue is first locally anaesthetised. Local anaesthetics are used for this, which lead to a nerve blockage. This means that any stimuli can no longer be transmitted and the patient can no longer feel anything. If an anaesthetic is used, the patient is sedated anyway and does not experience the procedure or the associated pain.