How long does it take to make an aspirate? Endometrial aspiration biopsy: how it is performed, indications. What you should know about aspirate

Pipel endometrial biopsy is a procedure during which a doctor, using an instrument of the same name (a pipel is something like a very thin plastic syringe with a diameter of 3 mm without a needle), takes endometrial cells (the inner mucous layer of the uterus) from the patient for analysis. Histological, or more precisely, cytological analysis of a sample of the obtained tissue can show cancerous and precancerous changes in uterine cells, a chronic inflammatory process (of the endometrium), and identify dyshormonal changes.

The material is collected in the gynecologist’s office without the use of anesthesia. Typically this is takes about 10 minutes.

Efficiency this method taking cellular material from the uterus is quite high. However, it is significantly lower than during curettage (scraping) of the uterus, when the entire endometrium is taken for analysis. However, the pipell technique makes it possible to diagnose endometrial cancer in the early stages, hormonal disorders. It is recommended for young and nulliparous women to difficult situations when there is no oncological suspicion, for example, before removal of uterine fibroids. During the procedure, the doctor does not expand the cervix using medical instruments, and therefore does not injure it. This is a big plus.

If we compare pipel biopsy and hysteroscopy, then each method has its own advantages. With conventional hysteroscopy, the doctor can visually examine the uterine cavity and remove tumors in it. Take material from a certain area for analysis. Paypel - the procedure is simpler, faster and does not require general anesthesia, but passes “blindly”.

At the same time, there is a method of office (mini) hysteroscopy, which is performed without dilation of the cervix and without anesthesia, but the doctor sees everything and can take the tissue for histology. This research is deeper and more effective.

Indications and contraindications for endometrial aspiration

Endometrial cell analysis is performed to diagnose uterine abnormalities and rule out various diseases.

Your doctor may take a biopsy to:

find the cause of postmenopausal bleeding or abnormal uterine bleeding;
detect or exclude endometrial cancer;
assess fertility (ability to conceive a child);
check the response of the endometrium to hormonal therapy.

Do not take aspirate from the uterus in the following conditions:

pregnancy;
inflammation of the pelvic organs;
cervical or vaginal infection;
cervical cancer;
cervical stenosis (severe narrowing of the cervix).

What painkillers should you take before the procedure?

Whether or not it is painful to undergo a pipel biopsy depends on the woman’s pain threshold, the skill of the doctor and the presence or absence of pain relief. Since the procedure is performed on an outpatient basis, at any time antenatal clinic, intravenous anesthesia is not advisable.

It is recommended to take a non-steroidal anti-inflammatory drug, for example, 30-60 minutes before the procedure. "Ibuprofen". It will provide an analgesic effect. Some women take it before "No-shpu", since this is a good antispasmodic, the uterus will not contract too much and painfully and will open more easily for insertion of the pipel.

In addition, the doctor may use lidocaine spray, spray the cervix with it, this will also reduce it somewhat painful sensations.

Sometimes there is a need to take a mild sedative. It may cause drowsiness, so you should not drive until the effects have completely worn off. Ask a friend or family member to drive you home after the procedure.

Most strong pain felt at the moment of taking material for research. The uterus reacts to the doctor’s actions with spasm. The pain is similar to what happens shortly before critical days. Some women feel dizzy and have stomach pain. This is called a vasovagal reaction.

How to prepare for an endometrial biopsy and on what day it is performed

Endometrial biopsy during pregnancy can lead to miscarriage. Tell your doctor if you are or are likely to be pregnant. Your gynecologist will ask you to take a pregnancy test before the biopsy to make sure there is no pregnancy.

Sometimes it is necessary to record your menstrual cycles before the biopsy so that your doctor can schedule the procedure on the most appropriate day.

If it's a woman reproductive age, then most often intrauterine biopsy is prescribed on days 25-26 of the cycle, that is, 2-3 days before critical days.

In case of infertility, when abnormalities of the luteal phase are considered to be the culprit, the procedure is recommended for the second half of the cycle. With this pathology, a woman ovulates, but by the time the fertilized egg enters the uterus, the endometrium is too thin and cannot “receive” it. This feature is successfully detected by histological analysis.

After menopause, the test is taken any day.

24 hours before diagnosis you cannot:

use sanitary tampons;
insert vaginal suppositories and tablets;
douche;
have sex.

Before the manipulation begins, you will be asked to sign a consent form stating that you understand the risks and agree to this.

Talk to your doctor about the need for a biopsy, its risks, what results may be obtained, and what they mean for you specifically.

How it all happens

You will be asked to lie down on a gynecological chair. The doctor will perform a manual examination of the uterus. Then he will insert a speculum into the vagina to straighten its walls and open access to the cervix. It will be fixed in a comfortable position using a clamp. Everything will be treated with antiseptic. After fixing the cervix, you will feel discomfort; pressure on the rectum is normal.

Your doctor will insert a thin, flexible tube into your cervical canal. It will go a few millimeters into the uterus. It will then pull the piston towards itself to create a suction effect. The entire procedure usually takes about 10 minutes.

The tissue sample will be placed in a liquid and sent to a laboratory for analysis. Results will be ready in approximately 7-10 days.

After the procedure you will have bloody issues from the vagina. Don't forget to take a sanitary pad with you. Blood may appear for several days, until the start of menstruation, if the biopsy was taken shortly before its expected start.

For several hours, pulling sensations in the uterine area and spasms are considered normal. You are allowed to take a painkiller.

Consequences and complications of the procedure

Sometimes a woman never gets results histological examination because too few endometrial cells were submitted for analysis. This happens when the endometrium is thin or the material collection technique is violated. In this case, you will have to agree to curettage of the uterine cavity.

Rarely, an inflammatory process provoked by taking an aspirate can occur. It can be avoided if you take the test when you are healthy and get good result gynecological smear for flora. A very rare complication is perforation of the uterus with an instrument.

Signs of trouble are:

increased body temperature;
increased bleeding;
severe abdominal pain;
vaginal discharge with a putrid odor.

For duration menstrual cycle taking a biopsy has no effect. Does not lead to delayed menstruation and infertility. You will be able to get pregnant almost immediately after the procedure, unless your attending physician has a different opinion on this matter.

On the day of the aspiration biopsy, you should not expose yourself to severe physical activity, play sports, lift weights. Until the bloody and spotting discharge disappears completely, you should avoid taking a bath. At the same time, sexual activity should be interrupted.

Endometrial aspiration biopsy results - transcript

We present here some of the terms that doctors write in their conclusions.

Normal endometrium in the proliferation phase- corresponds to the first phase of the menstrual cycle.

Normal endometrium in the secretory phase- corresponds to the second half of the cycle.

Endometrial atrophy- thin endometrium due to age-related changes(decreased production of sex hormones) or injury to the germ layer as a result of rough.

Hyperplasia without atypia- excessive growth of the uterine mucosa (normally, its maximum thickness in women of reproductive age on days 19-23 of the cycle is 21 mm), there is no risk of cancer at this time.

Endometritis- acute or chronic inflammatory process of the uterine cavity, one of the causes of infertility.

Hyperplasia with atypia- not yet cancer, but there is a bad trend, treatment and further observation are required.

Adenocarcinoma- malignant tumor, cancer.

Real reviews

Diagnosis of many gynecological diseases requires histological and cytological studies of the endometrium - the inner mucous membrane of the uterus. Previously, mechanical biopsy was used for this by scraping out a piece of tissue under anesthesia. Modern medical developments have made diagnosis less painful and unpleasant. One such method is uterine cavity aspirate. It can be used to take a sample of endometrial tissue with minimal risk to a woman's health.

What is uterine cavity aspirate?

Uterine cavity aspirate is the collection of endometrial cells by creating negative pressure on the surface of the mucous membrane for cytological examination. The test is done on days 6-9 or 20-25 of the menstrual cycle, depending on the direction of the diagnosis. Endometrial cells are examined for compliance with a certain phase of the menstrual cycle and the presence of atypical shaped elements. Analysis allows you to detect pathological processes of various nature And malignant neoplasms on early stage development.

Indications

Endometrial aspiration biopsy is prescribed for diagnosis in the following cases:

disturbances in the cyclicity and nature of menstrual flow;
uterine bleeding and pathological discharge of unknown etiology;
infertility;
pathological changes in the endometrium (hyperplasia, hypoplasia);
suspicion of cancer;
control of hormonal therapy.

Most often the analysis cellular structure uterine mucosa is prescribed to women planning pregnancy, especially if previous attempts at conception have had an unfavorable outcome and poor performance Ultrasound examinations.

Contraindications

In order to avoid complications and not put a woman’s health at additional risk, it is prohibited to perform a biopsy in the following conditions:

pregnancy;
infectious inflammatory diseases genitourinary system;
acute inflammation of the external and internal genital organs;
pathologies in the development of the uterus;
bleeding disorders associated with chronic diseases or taking medications.

Carrying out the procedure during anticoagulant therapy requires temporary withdrawal of drugs.

Types and methods of the procedure

The technique for taking an endometrial sample involves creating a vacuum in the uterine cavity and then sucking out the tissue sample. For this purpose, Brown syringes and disposable cannula catheters are used. The procedure technique differs depending on the chosen instrument. There is no need to dilate the cervix before diagnosis, which significantly reduces painful sensations and reduces the risk of complications. To prepare for the test, a woman needs to consult a gynecologist to determine if there are contraindications and carry out standard hygiene procedures, as before a regular visit to the doctor.

Aspiration biopsy

Aspiration biopsy is performed after pre-treatment genitals antiseptic solution and fixation of the cervix with bullet forceps. Biomaterial is collected using two methods:

Manual. It is performed with a Brown syringe - a plastic cylinder with a piston at the end, 300 mm long and 3 mm wide. Together with a flexible uterine probe, it is inserted into the uterine cavity to the very bottom, the piston is pulled back and tissue particles are removed for analysis.
Electric. A uterine tube is attached to a small compressor to create negative pressure and inserted into the uterus. Turn on the device and take a sample of the aspirate.

After taking the biomaterial, the movement of the piston is stopped so that tissue samples from the cervix and vagina do not get into the syringe. For elimination discomfort when the probe passes through the cervical canal, 1-2 hours before the procedure, the woman is prescribed Drotaverine or an analgesic.

Pipelle biopsy

The simplest and quick way To perform a biopsy, an aspirate is collected using a pipel - a special disposable sterile catheter with a blunt tip and a built-in piston. The sampling technology consists of several stages:

Treatment of the external genitalia with an antiseptic solution.
Visualization of the cervix using a speculum.
Insertion of pipel to the fundus of the uterus.
Aspirate is collected by retracting the piston and creating negative pressure on the surface of the endometrium.
Removing the catheter from the uterine cavity.
Repeated treatment of the genitals with an antiseptic.

The procedure lasts no more than 10 minutes and can be performed in a antenatal clinic as part of a standard gynecological office.

Evaluation of results

A sample of endometrial tissue is examined according to several parameters, changes in which indicate a pathological process:

appearance(color, structure);
morphological structure;
growth and functionality.

If atypical cells or disturbances in the development of the endometrium are detected, the patient is referred for additional histological examination.

Although aspiration biopsy is a harmless procedure, for 3 days after the test a woman should adhere to the following recommendations:

Do not have sexual intercourse.
Do not swim in open waters and pools.
Do not use tampons.
Avoid hypothermia.
Regularly perform genital hygiene and change underwear.

According to the indications of the gynecologist, the patient may be prescribed antibacterial agents local or systemic action. Compliance with such preventive measures helps to avoid infection and unwanted consequences after the procedure.

Possible complications

Taking an aspirate from the uterine cavity does not require invasive intervention into the mucous membrane. But, despite all the precautions, the professionalism of the gynecologist, the safety and sterility of the instruments, sometimes minor injury to the endometrium is possible. It manifests itself with the following symptoms:

lower abdominal pain;
bleeding from the vagina;
general weakness;
low-grade fever.

Damage to small blood vessels may cause intrauterine bleeding, which is accompanied by a decrease in blood pressure, dizziness and nausea. Trauma to the mucous membrane often leads to infection of the uterine cavity with further development inflammatory process. Outwardly it manifests itself pathological discharge, pain and discomfort in the lower abdomen. If any suspicious symptoms appear within a few days after the procedure, you should immediately consult a gynecologist.

Aspiration biopsy– a modern non-invasive method for diagnosing gynecological pathologies. It is as safe as possible for a woman’s health and allows you to quickly collect biomaterial for cytological analysis. This greatly simplifies diagnosis and makes it possible to begin treatment of oncological and inflammatory diseases in a timely manner.

Histological examination of the endometrium is the most informative method diagnosis of most gynecological diseases. But to carry it out, it is necessary to directly obtain a sample taken from inner shell uterus. Therefore, such procedures were previously performed quite rarely, since in all respects they resembled a full-fledged surgical intervention.

This was due to manipulation technology, since literally fifty years ago doctors obtained a section of the endometrium only mechanically - with the help of scraping. The procedure was somewhat reminiscent of a surgical abortion, only performed for a different purpose. Even the instruments for performing a biopsy of the inner membrane were similar - cervical dilators, as well as a sharp small curette.

Everything changed with the active introduction of the aspiration version of manipulation, which makes it possible to collect material for analysis blindly. In gynecological practice, a polymer uterine probe has appeared that easily penetrates the cervical canal without preliminary expansion. Nowadays, taking aspirate from the uterine cavity is carried out in two ways - using a syringe or pipette biopsy.

Varieties

Before moving on to the description modern techniques, the technique of mechanically obtaining a section of the endometrium should also be considered. The emergence of aspiration options did not exclude their implementation in practice, but only significantly limited:

Complete diagnostic curettage allows you to completely remove the surface layer of the inner lining of the uterus, as well as the epithelium of the cervical canal. At the same time, the technique of the procedure is practically no different from the final stage. surgical abortion. Then the resulting material is assessed externally, after which it is sent for histological examination.
Separate diagnostic curettage involves alternately performing endometrial scrapings in different parts of the uterus. In this case, the resulting material is immediately sorted and examined in this order. The method allows you to immediately localize the area of pathological changes.
The most modern mechanical method is a zug biopsy - a line scraping. It is the most gentle and produces much fewer complications than its predecessors. A small probe is inserted into the uterine cavity, with the help of which a strip of tissue is locally isolated, which is then subjected to histological examination.

These methods require lengthy and complete preparation for implementation, which requires a large time period to perform just one procedure.

Aspiration biopsy

Obtaining small fragments of endometrial tissue using a catheter by creating a vacuum in the uterine cavity has become a diagnostic breakthrough. Since the procedure requires virtually no preparation, it was possible to increase the number of women examined at one time. The performed manipulations no longer require preliminary dilatation of the cervix, also reducing the risk of possible complications.

Currently, two types of aspiration biopsy are used, depending on the instrument that creates a vacuum in the uterine cavity. There are practically no significant differences in efficiency between them:

The first option involves manual aspiration using a Brown syringe. This device is a large cylinder equipped with a piston and additional handles for holding and fixing. A flexible uterine probe is attached to it, which is inserted through the cervical canal. When it reaches the fundus of the uterus, a piston creates negative pressure, which helps to obtain small areas of the endometrium.
Now the electrical method is beginning to be actively introduced. vacuum aspiration carried out using a small compressor. The probe is inserted into the uterine cavity in a similar way. It is then connected to the device, after which it is started by the doctor. Certain parameters of its operation are set, and a little tissue is also sucked into the catheter.

To increase the information content, a little is often introduced into the uterine cavity first. saline solution. In this case, the washings - liquid containing endometrial particles - are then examined for histological examination.

Aspiration is not a highly accurate diagnostic method - it only allows you to quickly identify existing changes and refer the woman for additional examination.

Pipelle biopsy

The previous procedure, despite its relative simplicity, still requires the creation of certain conditions for implementation. But how to carry out the manipulation on an outpatient basis, so as not to go beyond the usual appointment? For this purpose, a standardized device was created - pipel:

The instrument is a thin, flexible catheter with a built-in piston to create negative pressure. It is intended for single use and is packaged under aseptic conditions.

The procedure is performed as part of a routine gynecological examination - to begin it only requires visualization of the cervix using speculum. Its fixation with forceps, which causes pain, unlike previous diagnostic methods, is not required.
After treating the cervix with antiseptics, the pipel is easily inserted into the uterine cavity through the cervical canal. The soft tip eliminates the possibility of accidental perforation of the wall.
The instrument reaches the fundus of the uterus, after which the controlled removal of the piston begins. This action releases aspirate into the catheter, which is necessary for further research.

Pipelle biopsy is ideal for carrying out in a antenatal clinic, when there is no time to perform rather labor-intensive research methods.

Indications

Why is a gynecological examination performed on all women without exception, but an endometrial biopsy is performed on only a few? The fact is that its implementation requires certain data obtained as a result of a survey and inspection. Therefore, aspiration of material is indicated only in the following cases:

For various disorders of the menstrual cycle, when the cyclicity or duration of its course changes. In this case, complaints of absent or rare menstruation, as well as menstruation accompanied by painful sensations, are taken into account.

A change in the amount or nature of menstrual flow also becomes a reason for additional examination. A woman may complain about scanty or copious discharge, as well as the clots present in them.
Much attention is paid to acyclic discharge - that is, bleeding from the uterine cavity that is not associated with physiological menstruation.
If there is a suspicion of any voluminous benign or malignant process inside the uterus. In this case, the woman’s lack of complaints is not taken into account.

It is also possible to perform a biopsy for preventive purposes - in this way it is often possible to identify hidden pathology.

Contraindications

Some conditions sometimes become an obstacle to carrying out diagnostic method. If aspiration is carried out against the background of their course, then the likelihood of complications increases sharply:

In the first place are inflammatory diseases of the genital organs - both acute and chronic. Aspiration biopsy can lead to upward spread of infection, which is facilitated by trauma to the uterine mucosa. But the contraindication is temporary and is removed after adequate treatment.
Pregnancy and suspicion of pregnancy also exclude the possibility of performing the procedure. Inserting a catheter into the uterine cavity and creating negative pressure will cause damage and rejection of the fertilized egg. The result will be a complete abortion or a non-developing pregnancy.
The high risk of bleeding is a temporary limitation due to the woman's use. special drugs– anticoagulants. Preliminary preparation, including temporary withdrawal of the medication, will allow the manipulation to be performed without consequences.

Aspiration biopsy, unlike surgical removal of a piece of tissue, is safe in terms of the development of early complications.

Grade

Now we should talk about aspirate from the uterine cavity - what is it? In fact, the inner surface is a mucous membrane consisting of several rows of cells. During the procedure, the superficial functional layer of the endometrium enters the catheter, which is then sent for histological examination:

Initially, the appearance of the aspirate is assessed, since in some pathological processes a change in its color or structure is noted.
Then it is carried out morphological study under a microscope - it begins with assessing the structure of the endometrium itself. All cell characteristics are described and immediately compared with normal values.
In pathology, it can be observed as signs of reduced activity of the endometrium - atrophy, or excessive growth and increased function - hypertrophy and hyperplasia.
Sometimes atypical cells are found - their structure differs from normal parameters. Their detection is a sign of a malignant neoplasm.

The conclusion of the study contains much more information, but the patient does not need to decipher it - the results must be interpreted by the attending physician.

After the procedure

Although modern procedures are not accompanied by gross manipulations in the uterine cavity, after them it is still necessary to follow some recommendations. Their implementation reduces the likelihood of developing infectious complications:

Preventive measures must be carried out within three days after performing aspiration biopsy.
General rules include limiting sexual activity during this period, as well as excluding swimming in pools and open water. In the cold season, a woman needs to prevent hypothermia.
Hygiene measures consist of local toileting of the genitals. Requires regular washing and changing daily underwear, use vaginal antiseptics in various forms.

The question of the use of pads and tampons remains controversial - can they become a source of ascending infection? Since the procedure is carried out outside of menstruation, the use of daily hygiene products It's better to refuse.

Taking an aspirate from the uterine cavity or aspiration biopsy is a technique for obtaining contents from the uterine cavity in a non-surgical manner for study cellular composition- cytological examination. The process of taking an aspirate is called aspiration, and the resulting material is, accordingly, aspirate.

In what cases is aspirate taken from the uterine cavity?

Taking an aspirate from the uterine cavity is a screening test, that is, simple, cheap and quick method identifying organ pathology, which can be performed for preventive purposes for early detection malignant tumor mainly endometrial cancer.

But taking an aspirate solves the issue not only of diagnosing cancer; in case of infertility or menstrual irregularities, studying the cellular structure of the endometrium - the mucous membrane lining the internal cavity of the uterus - can tell a lot.

If there is a suspicion of an inflammatory process - endometritis in a woman wearing an intrauterine device, or she suffers from endometriosis, then this quick test will confirm or reject the suspicions.

Bleeding in an elderly woman can be caused by both cancer and endometrial hyperplasia, and aspiration biopsy will differentiate the process, which is completely impossible with ultrasound, which reveals pathology but does not distinguish its nature.

In all cases of suspected intrauterine pathology, this is the simplest and most harmless diagnostic method.

When can I take an aspirate?

Aspiration of the contents of the cavity is a simple procedure, but it should not be in vain; the most informative analysis will be a little less than a week after the 20th day from the start of menstrual bleeding, when blood will not be mixed with the endometrial cells. If you do not observe the deadline for taking the microscope into the eyepiece, you risk seeing continuous fields of red blood cells, overshadowing all other cells.

In a postmenopausal woman, aspiration can be performed at any time, but again, outside of uterine bleeding.

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How should a woman prepare for an aspirate?

No special preparations are required from the patient, banal hygiene procedure and that’s all, because although the uterine cavity communicates with the vagina through the cervical canal, and sperm pass into it, it is a very clean place. Cervical mucus prevents pathological flora from penetrating into the uterus; when douching, liquid does not get there and vaginal medicinal suppositories do not penetrate.

Before the procedure, inflammatory and infectious processes of the external genital organs must be identified and treated.

Is it painful to give aspirate from the uterine cavity?

The manipulation does not require pain relief, much less hospitalization for anesthesia; everything is performed in a gynecological office.

How is the manipulation carried out?

It begins with a standard gynecological examination of the cervix in the speculum, the vagina and cervix are treated with an antiseptic solution. The cervix is fixed with special forceps, and then two manipulation options are possible.

The first method: cellular material is drawn through the cervical canal from the uterus with a catheter into an empty syringe.
The second method: several milliliters of physiological solution are injected into the cavity with a catheter, which washes the entire uterine cavity, and the solution is pulled back with a syringe, resulting in a washout from the endometrium.

The aspirated material is applied to glass slides, which, after staining, are sent for analysis to a cytologist. The waiting time for a response is about two days.

What complications are possible?

A biopsy is a study of the morphological (cellular) composition of a certain area of tissue. In gynecology, this research method plays a very important role, as it helps to diagnose changes occurring in tissues, both oncological, inflammatory and viral in nature. A variety of tissue sections are taken for biopsy, depending on what diagnosis the specialist needs to confirm or refute. Among other things, aspirate from the uterine cavity is also examined. What it is and how its research is carried out is described later in the article.

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Definition

What is aspirate? Strictly speaking, it is material taken for research, i.e., a biopsy. Why does it have this particular name? This is due to the method by which tissue is removed from the uterine cavity. If they are taken by aspiration-vacuum biopsy, then the resulting material is called aspirate. Whereas, if the material was collected using the pipell biopsy method, then it cannot have such a name, although the composition of the sample and its characteristics may be completely similar.

During this study, sections of the endometrium consisting of several functional layers are taken from the uterine cavity. The advantage of the study is that it is relatively low-traumatic and completely safe, but, nevertheless, it is prescribed by a gynecologist strictly according to indications, like any invasive methods. Currently, this approach is a good alternative to diagnostic curettage, which causes significant damage to the endometrium (although there are situations when it cannot be avoided).

Another advantage of this approach is that it allows the study to be carried out as precisely as possible, i.e., to take a small (but sufficient for study) section of tissue from precisely the part of the uterine wall that causes the lesion.

One of the disadvantages of the approach is that with this method, the sample will, in any case, contain cells that are not involved in pathology. But the natural ratio of cells (even healthy ones) in this case will be disrupted. Therefore, such material is examined not histologically (as usual, with a biopsy), but cytologically.

Why carry out analysis?

Why is it carried out? this study? Its goals are the same as for any histological or cytological study, regardless of the method used. Such a study of tissue composition helps to establish the presence of a sign pathological process inflammatory, infectious, fungal and even viral in nature. It is also possible to identify signs of pathology associated with tissue proliferation, both malignant and benign.

The analysis shows the actual condition of the endometrium. Based on the results of the study, one of the following diagnoses can be made:

Normal endometrium in the secretion/proliferation/menstruation phase;
Atrophied endometrium (sometimes the degree of atrophy is also indicated);
Hyperplastic endometrium with or without atypical cell changes;
Oncological or precancerous processes;
Endometritis;
Endometrial metaplasia (squamous or otherwise).

Some other diagnoses are also possible. In particular, it is possible to determine the presence of pathogenic microorganisms and fungi and establish their type.

Indications and contraindications

In what cases is it necessary to examine uterine aspirate? Doctors prescribe this study in the presence of negative pathological symptoms, provided that other studies (less traumatic) have not revealed any disease, or their results contradict each other. Symptoms for which aspiration biopsy is recommended are:

Uterine bleeding occurring after menopause;
Uterine bleeding occurring outside the menstrual cycle;
Changes in the endometrium that are noticeable on ultrasound, but have an unclear cause;
Pain in the lower abdomen of varying intensity;
Signs of an inflammatory process - uncharacteristic vaginal discharge, swelling of the external genitalia (rare), etc., with elevated temperature body, intoxication;
Infertility due to the inability to become pregnant or as a result of frequent miscarriages, etc.

The research is quite informative. In more than 90% of cases, the volume of material collected in this way is sufficient to conduct an adequate study and make a diagnosis.

Relative contraindications are poor blood clotting and menstruation (although during menstruation, research can still be carried out as a last resort). It is prohibited to use it during pregnancy and in the first three months after childbirth.

Progress of the procedure

In order for the doctor to obtain endometrial aspirate for examination, the patient must undress from the waist down and sit in a gynecological chair. The specialist installs the dilator on the vagina and sanitizes it and the cervix. Once debridement is complete, anesthesia is applied or injected into the cervical area. After this, you need to wait a few minutes for the anesthesia to take effect.

After this, a cannula, a blunt-ended needle, is inserted into the uterine cavity, through the vagina and cervix, to collect aspirate. As soon as it is installed in the place from which the material needs to be taken, negative pressure is created at the second end of it (the one on the doctor’s side). Under the influence of this pressure, a section of the endometrium is separated and “sucked” into the needle. Thus, the entire device operates on the principle of a syringe.

Suction tool

The doctor immediately places the collected material on a glass slide and treats it with a preservative, or places it in a preservative, depending on the method of examination and storage of the material. After this, the patient’s cervix and vagina are re-sanitation, and the dilators are removed. The patient can get dressed and leave the medical facility. The results of the study are available to the doctor, on average, after 3-7 days, although this largely depends on the workload of the laboratory.

Does it hurt?

Taking an aspirate from the uterine cavity is not a painful, but unpleasant procedure. It is performed under some type of anesthesia. In some cases, doctors only recommend local anesthesia cervix with external antiseptics; in other cases, it is better to inject anesthesia into the cervical area. In any case, such anesthesia does not last long and ceases to act on its own within 30-40 minutes after the procedure. For this reason, the patient does not even require temporary hospitalization.

The procedure is carried out completely on an outpatient basis, in a gynecological office of a clinic or medical center and takes no more than 10-15 minutes (full time spent in the office).

Complications

When the study is performed correctly, there are practically no complications. Theoretically, during the first 24 hours after the intervention, there may be mild pain in the lower abdomen. Bloody vaginal discharge is also acceptable for several hours. If they do not disappear or are intense enough, you should consult a doctor.

Price

Where can such an analysis be done? For many patients, the deciding factor, in addition to the quality of the laboratory and the professionalism of the doctor, is the cost of the study. The cost depends on many factors and differs not only depending on the city or region, but also depending on the medical institution.

The price may or may not include the cost of consumables, anesthesia, pre-intervention examination, etc.

Conclusion

Sometimes there is an opinion that it is not worth collecting aspirate from the uterine cavity, that this is not very informative and does not replace a full histological examination. This is true, since it makes sense to examine the aspirate only cytologically. But this is one of the most non-traumatic methods of collecting material for cytology. In addition, if the indications are unclear, histology may be additionally prescribed. Therefore, it is impossible to neglect such a study if it was prescribed by a doctor.