When to Explore a Channel
Colposcopy and biopsy evaluate the surface of the cervix, but the glandular epithelium of the canal and the upper parts of the transformation zone remain invisible, especially in menopausal women; in case of abnormal glandular cells in the smear or discrepancy between cytology and colposcopy, the only way to exclude canal pathology is its curettage. The procedure is often combined with a cervical biopsy and curettage of the uterine cavity (separate diagnostic curettage) if endometrial pathology is suspected. Afterwards - spotting for several days, sexual rest for 7-10 days.
Indications
- abnormal colposcopic picture, HSIL/ASC-H in cytology, HPV 16/18 with changes - cervical biopsy;
- endometrial hyperplasia by ultrasound, bleeding, bleeding in menopause, control of treatment of hyperplasia - endometrial biopsy;
- infertility, unsuccessful IVF - assessment of chronic endometritis and receptivity;
- atypical glandular cells, suspicion of canal pathology - curettage of the cervical canal;
- breast formation by ultrasound/mammography (BI-RADS 4–5) - breast biopsy.
Why is histology needed?
Only examination of the tissue under a microscope gives a final diagnosis: the degree of cervical dysplasia (CIN 1–3) or carcinoma, the type of endometrial hyperplasia (with or without atypia), chronic endometritis, benign or malignant breast formation. Tactics depend on the result - observation, conservative treatment, conization, hormonal therapy, surgery. Modern methods (pipel, vacuum and core needle biopsy, colposcopic targeted biopsy) make it possible to obtain material on an outpatient basis in minutes with minimal trauma.
