Biopsy

In a biopsy, your doctor removes a small amount of tissue for examination under a microscope to look for precancerous cells or cancer cells. Most women have the biopsy in the doctor's office, and no anesthesia is needed. To do the biopsy, the doctor will insert a speculum to hold the vagina open and take a very small sample. After the sample is taken, it will be sent to a laboratory where a pathologist, a doctor who identifies diseases by studying cells and tissues, checks the tissue using a microscope. You may experience some bleeding and discharge after the exam and discomfort similar to menstrual cramps. Ibuprofen can be taken to relieve these symptoms. After a biopsy, you should not have sex, douche, or use tampons for 24 hours, or longer for biopsies that require local or general anesthesia.

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Different types of cervical biopsies include:

Punch biopsy: The tissue sample is removed from the cervix using biopsy forceps, an instrument used to grasp tissue firmly and then remove it. This procedure is usually performed in your gynecologist's office and does not require anesthesia. You will feel a sharp pinch during the procedure. You may experience slight bleeding after the procedure.

Endocervical curettage (ECC): A tissue sample is scraped from an area just past the opening of the cervix using a curette (small, spoon-shaped instrument) or a thin, soft brush. This can be done in your doctor's office and does not require anesthesia. You will have some cramping and bleeding after the procedure.

LEEP (Loop Electro-Surgical Excision Procedure): The LEEP is performed using a small heated wire to remove tissue and precancerous cells from the cervix. This procedure can be done in your doctor's office and requires local anesthesia. You may have some cramping during and after the procedure. You may have moderate to heavy vaginal discharge that lasts for about three weeks.

Cone biopsy (also called LEEP cone or cold knife cone biopsy): A cone-shaped sample of tissue is removed from the cervix so that the pathologist can see if abnormal cells are in the tissue beneath the surface of the cervix. This specimen is much bigger than the biopsy done in the office without anesthesia. A sample of tissue can be removed for a cone biopsy using a LEEP cone procedure, which can be done in the doctor's office under local anesthesia, or a knife cone procedure, done in an operating room under local or general anesthesia. You may have some vaginal bleeding for about a week and some spotting for about three weeks after the procedure.