CERVICAL BIOPSY

CERVICAL BIOPSY – Indications, Types of Cervical Biopsy, General Instructions, Preliminary Assessment, Preparation of the Patient and Environment, Equipment, Procedure and Post-Procedure Care

A cervical biopsy is a surgical procedure in which a small amount of tissue is removed from the cervix. The cervix is the lower, narrow end of the uterus located at the end of the vagina.

INDICATIONS

  • Pap smear, Pap test yielded positive results
  • The cervical ectropion is diagnosed (bilateral cervical gap develops after giving birth, especially as a result of multiple micro-breaks)
  • The mucosal pathology of the cervix is detected (erosion, polyps, hypertrophy, suspected oncological-cervical tumor)
  • Cervical dysplasia stage of II-IV (should be diagnosed and treated in time, it will prevent the development of cancer cells)
  • There are serious gaps after childbirth; the cervix is deformed, visible severe scarring on the uterine tissue

TYPES OF CERVICAL BIOPSY

Punch biopsy: one or more small pieces of tissues are removed from the cervix with a punch biopsy forceps

Cervical conization: it is done by taking a cone-shaped section of the cervix with a scalpel or cervitone or by diathermy conization

GENERAL INSTRUCTIONS

  • These procedures are frequently performed on an outpatient basis
  • The biopsy is usually taken one week after the end of menstruation when the cervix is least vascular
  • The patient usually experiences no pain during the cervical biopsy because the cervix does not contain nerve endings for pain

PRELIMINARY ASSESSMENT

  • Doctor’s order for any specific instructions
  • Written informed consent of the patients or the relatives
  • General condition and diagnosis of the patient
  • Mental status of the patient to follow instructions
  • Articles available in the unit

PREPARATION OF THE PATIENT AND ENVIRONMENT

  • The patient is prepared as for routine gynecologic examination
  • Shave and clean the perineum
  • Explain the procedure to the patient
  • Obtain written consent from the patient
  • Maintain privacy with screen
  • Give lithotomic position to the patient
  • There should be good light in the room
  • Remain with the patient through the procedure

EQUIPMENT

A sterile tray containing:

  • Sponge holder
  • Vulsellum
  • Biopsy forceps
  • Sims vaginal speculum
  • Gali pot for lotion
  • Gloves, mask and gown
  • Leggings
  • Specimen bottles with formalin
  • Dressing material

An unsterile tray containing:

  • Mackintosh and draw sheet
  • Kidney tray
  • Cautery with its tips sterilized
  • Antiseptic for cleaning

PROCEDURE

  • Usually, it is done in outpatient department
  • The cervix is visualized in a good light and biopsy is taken with a cervical biopsy forceps
  • The bleeding from the site is controlled by cauterization
  • Patient may have foul smelling discharge for few days
  • The patient may be discharged on the same day

POST-PROCEDURE CARE

  • To avoid any strenuous activity for the next 24 hours
  • To report any bleeding immediately
  • To abstain from sexual activities and douching until the doctor gives the permission
  • To avoid using tampons until the doctor gives permission. Use clean pads
CERVICAL BIOPSY – Indications, Types of Cervical Biopsy, General Instructions, Preliminary Assessment, Preparation of the Patient and Environment, Equipment, Procedure and Post-Procedure Care
CERVICAL BIOPSY – Indications, Types of Cervical Biopsy, General Instructions, Preliminary Assessment, Preparation of the Patient and Environment, Equipment, Procedure and Post-Procedure Care

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