When and how is endometrial biopsy performed?
Endometrial biopsy is a diagnostic method characterized by taking a small volume of tissue for microscopic examinations.
Endometrial biopsy is based on the appearance ofexpressed structural changes in the endometrium in response to hormonal stimulation. Most experts argue that the correct diagnosis of endometrial dysfunction is possible only with close contact between the gynecologist and pathologist. In the history of medicine, endometrial biopsy was first performed in 1937. In order to conduct the correct diagnosis of scrapings from the endometrium, it is necessary to create certain conditions.
To conduct correct diagnosis, the doctor must adhere to certain rules:
- when infertility women with suspicion of anovulatory cycle scraping is taken before menstruation or directly during menstruation;
- repeated dashed scrapings are performed with amenorrhea for four weeks with an interval of one week;
- with menorrhagia scraping is taken on the fifth to the tenth day after the onset of menstruation;
- with metrorrhagia, scraping, as a rule, is taken immediately after bleeding;
- Endometrial scrapings can be taken on any day of the cycle to diagnose tumors.
The purity of the experiment depends on the correct selection of the biomaterial.
If the survey is fragmentedpieces of tissue, it is extremely difficult to restore the structure of the endometrium. Correct scraping involves obtaining large, undivided strips of the endometrium. In the process of curettage after each curettage on the walls of the endometrium is withdrawn from the cervical canal.
An endometrial biopsy can be performed in several ways:
- complete diagnostic curettage of the uterus. Most often, the scraping is done separately (at first from the cervical canal, then from the uterine cavity). In bleeding, especially in the perimenopausal period, scraping of the tube corners of the uterus is carried out with the help of a small curette, as it is in these zones, as a rule, polypous growth of the endometrium is localized. It is in such areas that malignancy begins. If the carcinoma is suspected (with the first curette introductions the soft, crumbling tissue is scraped out), the scraping immediately stops;
- aspiration biopsy of the endometrium is performed with mass examinations of women for the purpose of diagnosing the endometrial cancers;
- dashed scrapings of the endometrium are made with the aim ofdetermination of mucosal reactions to the incremental function of the ovaries, clarification of the causes of infertility, control of the results of hormotherapy. The presented technique is not used for uterine bleeding.
Pipel-endometrial biopsy is performed withthe help of the Paipel tool (a flexible tube with a diameter of three millimeters with a lateral hole at the end). Inside the tube there is a piston, as in a conventional syringe. Indications for this type of biopsy: bleeding in women over forty; bleeding while using hormonal contraceptives; Diagnosis of endometrium in infertility; profuse bleeding in premenopause; bleeding in menopause.
