What to check for endometrium

An endometrial biopsy is a test in which the endometrium is removed and then examined. This examination is mainly closely related to the existence of various diseases of the endometrium. Of course, not everyone is suitable for endometrial extraction examination. In addition, when doing endometrial extraction examination, you must make appropriate preoperative preparations. Below, we will introduce in detail the indications, contraindications, preoperative preparations and specific surgical procedures of endometrial removal surgery.

Endometrial harvesting is suitable for:

1. For the diagnosis of endometrial tuberculosis, samples should be obtained before menstruation.

2. To understand whether ovulation has occurred and whether the corpus luteum is healthy, the sample should be obtained within 6 to 8 hours of the onset of menstruation or 2 to 3 days before menstruation. If you are infertile, you must use contraception that month.

3. Understand the cyclical changes of the endometrium and obtain samples at different stages of the menstrual cycle. For those with incomplete endometrial exfoliation, samples should be obtained on the 5th day of the menstrual period.

4. Endometrial cancer can be sampled at any time.

5. Observe the therapeutic effect of endometrial hyperplasia.

2. Contraindications

1. Acute vaginitis and cervicitis caused by Trichomonas, fungi, sexually transmitted diseases or other reasons.

2. Acute and subacute pelvic inflammatory disease.

3. Those with body temperature exceeding 37.5℃.

4. Those who have had sexual intercourse within the last 3 days.

5. Pregnancy cannot be ruled out.

6. Those who have stopped taking sex hormone drugs for less than 1 to 2 cycles.

1. Check blood routine, platelets, leucorrhea routine, and measure body temperature. For those over 45 years old, blood pressure and pulse should be measured. Patients suspected of having heart disease should undergo an electrocardiogram.

2. Sexual intercourse is prohibited for 3 days before surgery.

3. Understand the menstrual cycle carefully.

4. Patients with IUDs should undergo fluoroscopy or B-ultrasound examination before surgery.

5. For hydatidiform mole and choriocarcinoma, B-ultrasound examination and blood drawing and matching should be performed before surgery, and an infusion channel should be established to be ready for blood transfusion at any time. If necessary, the operation can be performed under B-ultrasound monitoring.

6. For patients with inflammation who require surgery, antibiotics should be used starting before surgery and continuing until 3 to 5 days after surgery.

1. Empty the bladder, take the lithotomy position, disinfect the vulva and vagina, and lay a sterile surgical towel.

2. Bimanual examination to understand the size, position, texture, mobility, shape of the uterus and its relationship with surrounding organs, and whether there are any abnormalities in the appendages on both sides.

3. Place the speculum, expose the cervix, disinfect the vagina and cervix, clamp the anterior lip with a cervical clamp, and pull it outward to make the uterus horizontal. 

4. Use the uterine probe to gently probe the uterine fundus along the direction of the uterus, measure its depth and confirm whether the curvature and size are consistent with the examination. Do not force the probe if there is resistance. Change the direction to find a uterine cavity position without resistance and with variations. Determine whether there is any unevenness or adhesion of the inner wall of the cavity, or any obstruction of the probe caused by tumor compression.

5. Move the small endometrial scraper to the fundus of the uterus, close to the uterine wall, and scrape a small piece of tissue from the front and back walls and both sides of the uterus from top to bottom. For those suspected of tuberculosis, samples can be obtained from the uterine horns, or from the uterine fundus and lower uterine segment. If you plan to take cervical tissue at the same time, you should scrape the cervical canal first and then the uterine cavity.

6. The collected specimens are placed in fixative bottles according to the location and needs. After checking the name and number on the application form and the specimen label, they are sent for pathological examination.

5. Postoperative treatment

The following treatments are done after endometrial extraction:

1. Patients suspected of having tuberculosis should receive anti-tuberculosis treatment after surgery.

2. For patients with long-term vaginal bleeding, antibiotics should be used after surgery.

3. Pay attention to cleanliness and hygiene after the operation and avoid sexual intercourse within 2 weeks.