A cervical biopsy is usually ordered after an abnormality has been found during a routine pelvic exam or Pap smear. Abnormalities can include presence of the human papillomavirus (HPV) virus, or cells that are precancerous. These conditions can put you at risk for developing cervical cancer.
A cervical biopsy can detect precancerous cells and cervical cancer. Your gynecologist may perform a cervical biopsy as a diagnostic tool or a treatment method for benign polyps on the cervix or genital warts.
Three different methods are used to remove tissue from your cervix. They are:
- punch biopsy—small pieces of tissue are taken from the cervix with an instrument called “biopsy forceps.” Your cervix might be stained with a dye to help the doctor more easily detect abnormalities
- cone biopsy—large, cone-shaped pieces of tissue are removed with a scalpel or laser. This type of biopsy is performed under general anesthetic
- endocervical curettage (ECC)—cells are removed from the endocervical canal with a hand-held instrument with a tip shaped like a small scoop or hook called a “curette".
The underlying reason for your biopsy as well as any other medical conditions you have may determine which method is used for your procedure.
Schedule your cervical biopsy for the week following your period. This will make it easier for your doctor to get a clean specimen. Discuss any medication you take with your gynecologist.
You may be asked to stop taking medications that could increase your risk of bleeding, such as:
Avoid using tampons, douches, or medicated vaginal creams for 24 hours before your biopsy. You should also refrain from having sexual intercourse during this time.
If you are undergoing a cone biopsy or another form of cervical biopsy that requires a general anesthetic, you will need to fast after midnight, or at least eight hours before the procedure.
On the day of your appointment, your doctor might suggest you take acetaminophen or another pain reliever before you come to the office. Pack some feminine pads to wear after the biopsy in the event of light bleeding. Bring a family member or friend to drive you home.
The appointment will begin as a normal pelvic exam. You’ll lie on an exam table with your feet in stirrups. Your doctor will administer a local anesthetic. In the event of a cone biopsy, a general anesthetic that will put you to sleep.
Then, the doctor will insert a speculum into the vagina to keep the canal open during the procedure. The cervix is first washed with a solution of vinegar and water, and may be swabbed with iodine. This is called a Schiller test, and is used to help your doctor identify the abnormal tissues. The cleansing process may burn a bit, but should not be painful.
The doctor will remove the abnormal tissues with forceps, a scalpel, or a curette. You might feel a slight pinching sensation as the tissue is removed during a punch biopsy.
After the biopsy is finished, your doctor may pack your cervix with absorbent material to reduce the amount of bleeding you experience. Not every biopsy requires packing.
Expect some mild cramping and spotting as you recover from your cervical biopsy. Cramping and bleeding can run for as long as a week in some cases. Simple punch biopsies are outpatient procedures, meaning you can go home the same day. Other procedures may require you to remain in the hospital overnight.
Activities may be restricted, depending on the type of biopsy you have undergone. Heavy lifting, sexual intercourse, and the use of tampons and douches are prohibited for several weeks after a cone biopsy. Adhere to the same restrictions for punch biopsies and ECC procedures, but for only one week.
Let your doctor know if you:
- feel pain
- develop a fever
- experience heavy bleeding
- foul-smelling vaginal discharge
These symptoms can be signs of infection.
Your medical care team will notify you of your biopsy results and discuss next steps with you. Findings of cancer or precancerous cells may require further treatment. A negative test means that everything is normal, and most often no further action is required.