What is an endometrial Pipelle biopsy?

This is the name of the procedure, which takes a small sample of tissue from the lining of the womb (endometrium). The sample is then sent to the laboratory to check if you have any abnormal cells, pre-cancerous cells or cancer in the lining of your womb.

The biopsy may give answers to:

 • Why you are having abnormal vaginal bleeding (heavy, prolonged or irregular periods, or bleeding in between periods).

 • Why you are having some bleeding after the menopause.

 • Why an ultra sound scan shows you have a thickened lining of your womb.

If you need to have the biopsy taken it will be as part of your outpatient appointment with either a doctor or a nurse specialist.

Who is the biopsy not suitable for?

• If you are pregnant

• If you have an infection in the vagina or pelvis

What is the benefit?

The benefit of having the biopsy taken is to check for any abnormal cells or signs of cancer so that treatment can be offered for your condition.

What are the risks?

The procedure is generally very safe. You may experience period type pain during the procedure. Very occasionally, you may need some simple painkillers like paracetamol after the biopsy, but most women feel little discomfort for only a short time whilst the biopsy is being taken.

In rare cases, patients may be at risk of:

• Prolonged bleeding

• Infection

• Uterine perforation (making a hole in the womb) but this is extremely rare

• Feeling faint

What are the risks of not having the biopsy?

If you do not have the biopsy, then we cannot check for any abnormal cells or signs of cancer. Sometimes it can be difficult to get the biopsy, especially if you have not had any children or have had treatment in the past to your cervix – in this case, we may have to consider taking you to theatre and giving you a general anaesthetic so that we can get a biopsy. If this were the case, it would be arranged to take place on a different date after your outpatient appointment. As an alternative, you may be suitable for an outpatient hysteroscopy. These options will be discussed in more detail with you during your appointment.

Preparing for the biopsy

You don’t need to do anything in preparation for your Pipelle biopsy. You are still able to have the procedure carried out if you are on your period or experiencing some postmenopausal bleeding.

During the biopsy

• If you need the biopsy, it will be taken as part of the examination that the doctor or nurse specialist will carry out. They will explain to you the procedure and gain your consent.

• A chaperone (nurse or healthcare assistant) will be with you throughout.

 • Firstly, the clinician will insert a speculum into the vagina (an instrument used to open the vagina) which enables them to examine the walls of the vagina and cervix to see if they appear healthy.

• The clinician will then attempt to take the Pipelle biopsy by passing a thin plastic straw through the cervix into the womb. The biopsy is obtained by slight suction as the inside of the straw is pulled out. This part of the procedure can cause the cramp like period type pain that is often experienced. This pain generally settles once the procedure is finished, but some women may feel like they want some simple pain killers.

• Sometimes this procedure is carried out more than once to ensure an adequate amount of tissue is obtained to send to the laboratory to be tested.

 • Occasionally the position of the cervix is at an angle (which is completely normal), but this can make it difficult for taking the biopsy. If this is the case, an instrument might be used to hold onto your cervix enabling it to be held in a better position to make it easier to take the biopsy.

• After taking the Pipelle biopsy, the speculum will then be removed and the sample will be sent for testing.  

After the biopsy

If you experience any abdominal discomfort after the biopsy, you can take some Paracetamol or Ibuprofen that you may have at home. You can then leave the clinic appointment and carry on with whatever you have planned for the rest of the day. You can continue with normal activities such as having a bath or shower, exercise and driving. You may experience some vaginal bleeding for the next day or so after having the biopsy taken and this is completely normal. It is advisable to wear a sanitary towel just in case this happens. We recommend that you do not have sex until the bleeding has stopped completely. If you have had the biopsy for prolonged heavy bleeding or post-menopausal bleeding, the bleeding is likely to continue until diagnosis and treatment.

How do I get the results?

Your biopsy sample is sent to the Pathology department for testing. We will write to you and your GP with the results which could take between two to four weeks. If you require further treatment or a follow-up appointment, we will send you an appointment letter with the date and time to attend the Gynaecology Outpatient Clinic. In some cases, we may call instead of writing a letter.

Symptoms to report

If you start experiencing some heavy vaginal bleeding, especially associated with some offensive smelling discharge then we advise you to contact your GP as you may have an infection and need some medication.

Contact details

If you have any concerns or in case of emergency, please contact Women’s Outpatients Carlisle)on 01228 814264 or Women’s Outpatients Whitehaven 01946 523211

Confidentiality

‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.

For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302