Excision (extended) biopsy of the cervix

Excision biopsy is a modern and accurate diagnostic method that allows you to obtain and study possible pathological changes in the tissues of the cervix.

What is excision biopsy

An excision (extended) biopsy is a diagnostic procedure in which a doctor excises tissue within the lesion area, that is, over the entire surface of the cervix. The resulting biopsy is then sent for histological examination to identify atypical cells. This method allows you to identify precancerous or malignant pathological processes.

The advantages of the procedure are its high information content. Unlike other types of biopsy, excision allows you to obtain a sufficient amount of tissue for a full-fledged histological analysis. This makes it possible to accurately determine the histological type of the disease.

What diseases does it detect

Excision biopsy makes it possible to diagnose a number of diseases and pathological conditions of the cervix. Using this procedure, you can identify:

• Dysplasia. This is a pathological cell change that can lead to the development of cancer, that is, precancerous.

• Carcinoma in situ (cancer at the initial stage). This is a malignant neoplasm that has not yet penetrated into the deep layers of tissues.

• Cervical cancer. This is a malignant neoplasm in which pathological cells penetrate into the deep layers of tissues.

• Polyps of the cervical canal. These are benign growths that can cause bleeding or painful sensations.

• Cervicitis. This is an inflammation of the cervix, which can cause discomfort, as well as problems with reproductive function.

Indications and contraindications

The procedure is used for extensive sizes of the pathological site when it is necessary to obtain material for histological examination. The indications for a cervical biopsy are as follows:

• suspected cervical cancer;

• abnormal PAP test results;

• visible changes on the cervix during examination;

• symptoms, the cause of which cannot be determined by other diagnostic methods: pain in the lower abdomen, bleeding or painful sensations during sexual intercourse.

An extended cervical biopsy is a minimally invasive surgical procedure. Although the method is considered safe enough, it has contraindications:

• pregnancy;

• acute inflammatory process in the pelvic organs;

• severe systemic diseases (cardiovascular, decompensated diabetes mellitus, thyroid disorders);

• blood clotting disorders.

The decision to perform an excision biopsy is made by the doctor based on the general condition of the patient, the results of preliminary studies and taking into account possible risks.

Preparation for the procedure

The preparation includes performing a number of tests necessary to exclude contraindications. The patient needs to take:

• a general blood test, as well as a coagulogram, an analysis for HIV, syphilis, hepatitis B and C;

• urine analysis;

• a smear for oncocytology;

• a swab for the degree of purity and STDs.

If a woman has a chronic illness, is taking medications or supplements, she needs to discuss preparations for surgery with her doctor.

How the study is performed

A cervical biopsy is performed in the first half of the cycle. The optimal time for the study is immediately after the end of menstruation and before ovulation, usually 6-13 days of the cycle. In the vast majority of cases, the procedure is performed under local anesthesia. Tissue sampling is performed by vaginal access under the control of a colposcope.

Depending on the patient's medical history, the doctor may use various methods of tissue collection. The radio wave method is more often used. It eliminates damage to healthy tissues, provides a bloodless and painless incision, and also has an antiseptic effect, reducing the likelihood of infection. The radio wave technique can be used in young women who have not given birth, since there is practically no risk of postoperative complications.

The procedure takes an average of 15-30 minutes. After its completion, the collected material is sent for histological examination. The patient can go home immediately.

Recovery after biopsy

A cervical biopsy is a surgical procedure after which the body needs time to recover. The recovery period is usually about 2-3 weeks. It is important to strictly adhere to the doctor's recommendations:

• Do not use tampons (only pads are allowed);

• abstain from sexual activity;

• exclude visits to swimming pools, reservoirs, baths and saunas, as well as taking hot baths;

• avoid physical activity, including lifting heavy objects and exercising.

These recommendations should be followed for two weeks or until undergoing a follow-up examination with a gynecologist. Rehabilitation is usually completed by the time of the next menstruation. If there are no complications in the new cycle, all restrictions are lifted.

At the EMC Clinic, we take care of the health and well-being of every patient and support you every step of the way to recovery. Make an appointment with a gynecologist today and be convinced of the high professionalism and empathetic attitude of our specialists.

List of sources and references

1. Zarochentseva Nina Viktorovna, Dzhihihiya Lela Konstantinovna, Bashankaeva Yulia Nikolaevna, Nabieva Vusala Nazim Kyzy Excision methods of treatment of cervical intraepithelial neoplasia // Obstetrics and Gynecology: News. Opinions. Training. 2020. №4 (30). 
2. Dobrokhotova Yulia Eduardovna, Borovkova Ekaterina Igorevna International algorithms for the management of patients with cervical dysplasia // Gynecology. 2018. №5.
3. Bassiouni M, Kang G, Olze H, Dommerich S, Arens P. The Diagnostic Yield of Excisional Biopsy in Cervical Lymphadenopathy: A Retrospective Analysis of 158 Biopsies in Adults. Ear Nose Throat J. 2023 Oct;102(10):645-649. doi: 10.1177/01455613211023009. Epub 2021 Jun 7. PMID: 34098767.
4. Mandic A, Knezevic-Usaj S, Nincic D, Rajovic J, Popovic M, Kapicl TI. Comparsion the histopathological findings after cervical biopsy and excisional procedures. Acta Medica (Hradec Kralove). 2013;56(1):19-22. doi: 10.14712/18059694.2014.33. PMID: 23909050.
5. Kinney W, Hunt WC, Dinkelspiel H, Robertson M, Cuzick J, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Cervical excisional treatment of young women: a population-based study. Gynecol Oncol. 2014 Mar;132(3):628-35. doi: 10.1016/j.ygyno.2013.12.037. Epub 2014 Jan 4. PMID: 24395062; PMCID: PMC3992337.