Excisional Biopsy for Abnormal Cervical Cell Changes

Surgery Overview

An excisional biopsy of the cervix is a type of procedure. It removes a cone-shaped piece of tissue from the cervix. The cervix is the lower part of your uterus. It opens into your vagina.

There are a few ways the doctor can remove the tissue. One way is to use a surgical knife called a scalpel. Another way is to use a thin wire loop that's charged with electricity. This is called a loop electrosurgical excision procedure (LEEP). Or the doctor can use a laser.

You may be asleep during the procedure. But it is usually done while you are awake. Either way, you will be given medicine to help with pain during the procedure. The doctor removes the tissue through the vagina. The procedure won't leave a scar on the outside of your body.

After the procedure, another doctor will look at the tissue under a microscope. The doctor will check it for abnormal cells.

Most people go home 1 to 4 hours after the procedure. You can probably return to your normal routine in about a week. But be sure to wait to have vaginal sex until your doctor says it's okay.

What To Expect

Some vaginal bleeding is normal for up to 1 week. Some vaginal spotting or discharge (blood or dark brown) may occur for about 3 weeks.

Most people can return to their normal activity level in 1 week. How long it takes you to recover will depend on how much was done during the procedure.

Depending on your biopsy results, you will have regular follow-up testing with HPV tests, Pap tests, or colposcopic examinations. Your doctor will tell you what follow-up tests you should have and when you need to have them done.

• You may have some light vaginal bleeding or discharge for about a week. You may also have some spotting for about 3 weeks. Wear sanitary pads if needed. Do not douche or use tampons.
• Do not have vaginal sex or place anything in your vagina for 2 to 4 weeks after surgery, or until your doctor tells you it is okay.
• If you have cramps after your procedure, try placing a hot water bottle or heating pad on your lower belly.

Why It Is Done

An excisional biopsy of the cervix may be done after a cervical cancer screening test found a problem. It may be done:

• To remove and examine the abnormal tissue.
• To diagnose the cause of the abnormal cell changes and remove the abnormal tissue at the same time.
• To determine the extent, depth, and severity of the abnormal tissue.

Learn more

How Well It Works

The excisional biopsy may remove all of the abnormal cervical tissue. If this happens, you won't need more treatment. But if some abnormal cells are left in the cervix after the biopsy, more tissue may need to be removed. If follow-up tests show normal cells, then no further treatment will be needed. If abnormal cells remain, you and your doctor may discuss other treatments, such as removal of the uterus (hysterectomy).

The biopsy may show cancer that has grown deep into the cervical tissue (cervical cancer). Further treatment, such as surgery, radiation, or chemotherapy, will be recommended.

Risks

An excisional biopsy of the cervix is a procedure with some risks.

• A few people may have serious bleeding that requires further treatment.
• Infection of the cervix or uterus may develop (rare).
• Narrowing of the cervix (cervical stenosis) that causes infertility may occur (rare).
• Inability of the cervix to stay closed during pregnancy (incompetent cervix) may occur. Having an excisional biopsy may increase the risk of miscarriage or preterm delivery.