Name of the Procedure:

Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)

Summary

A cervical biopsy involves removing a small sample of tissue from the cervix to be examined under a microscope. Local excision of a lesion involves surgically removing an abnormal growth from the cervix. This procedure may use fulguration, which is the use of electric current to destroy abnormal tissue.

Purpose

The procedure is performed to diagnose and treat abnormal tissue in the cervix, such as pre-cancerous lesions, benign growths, or infections. The goal is to identify or remove potentially harmful cells and prevent the progression of cervical disease.

Indications

• Abnormal Pap smear results
• Presence of lesions or growths on the cervix
• Symptoms such as unexplained bleeding or pain
• Suspicion of cervical cancer

Preparation

• Avoid using tampons, douching, or having vaginal intercourse for 24 hours before the procedure.
• Follow specific fasting instructions if general anesthesia will be used.
• Complete any necessary diagnostic tests, such as blood work or imaging.

Procedure Description

1. The patient lies on an examination table with feet in stirrups.
2. A speculum is inserted into the vagina to allow access to the cervix.
3. A local anesthetic may be applied to the cervix to minimize discomfort.
4. A biopsy tool is used to remove a small tissue sample from the cervix.
5. If a lesion is present, surgical tools are used to excise (cut out) the abnormal tissue.
6. Fulguration may be used to destroy remaining abnormal cells and control bleeding.
7. The tissue samples are sent to a lab for pathological examination.

Duration

The procedure typically takes between 10 and 30 minutes.

Setting

The procedure is generally performed in an outpatient clinic or a gynecologist's office.

Personnel

• Gynecologist or trained medical professional
• Nurse or medical assistant

Risks and Complications

• Mild bleeding or spotting
• Infection at the biopsy site
• Pain or cramping
• Rarely, severe bleeding, or cervical stenosis (narrowing of the cervix)

Benefits

• Accurate diagnosis of cervical abnormalities
• Early detection and treatment of pre-cancerous or cancerous lesions
• Prevention of cervical disease progression

Recovery

• Patients may experience light bleeding or spotting and mild cramping for a few days.
• Avoid inserting anything into the vagina (tampons, douching, intercourse) for a period recommended by your doctor, usually a few days to a week.
• Over-the-counter pain relievers can help manage discomfort.
• Schedule and attend follow-up appointments to discuss biopsy results and any further treatment needed.

Alternatives

• Observation and repeat Pap smears
• Colposcopy without biopsy
• HPV testing
• Pros: Less invasive, less discomfort, minimal risks.
• Cons: Potential delay in diagnosis and treatment of cervical abnormalities.

Patient Experience

During the procedure, the patient may feel some pressure and mild discomfort. Local anesthesia helps manage pain during the biopsy, but mild cramping or a pinching sensation may occur. Post-procedure, most patients experience light bleeding and mild cramping, which can be managed with over-the-counter pain medications and rest.