Diagnostic curettage (endometrial biopsy): what it is
What a diagnostic curettage is, when it is needed for abnormal bleeding or a thickened womb lining, how the procedure is done and what to watch for afterwards.
Diagnostic curettage — also called probe curettage or endometrial biopsy — is one of those procedures women tend to approach anxiously, even though it matters a great deal for protecting women's health and for picking up disease early.
In everyday speech the word "curettage" is often confused with ending a pregnancy. A diagnostic curettage is something else entirely: it is an investigation, carried out to assess the health of the womb and to put a name to what is going on. What follows sets out what it is, when it is used, and what to pay attention to during recovery.
What is a diagnostic curettage?
A diagnostic curettage means taking small cellular samples from the tissue that lines the inside of the womb — the endometrium, the layer shed each month as a menstrual period.
It is less a treatment than an investigation: the samples go to a pathology laboratory, where the structure of the cells is examined under the microscope so that any abnormality can be identified.
When is it needed?
The lining of the womb changes continuously with age and with hormonal state. After a gynaecological examination and an ultrasound scan, a doctor may need a diagnostic curettage to reach a definite diagnosis in situations such as these:
- Abnormal uterine bleeding: irregular bleeding outside the menstrual cycle, or periods that are much longer or much heavier than usual.
- Bleeding after the menopause: any vaginal bleeding or spotting after the menopause is a medically important warning sign and calls for a sample from inside the womb.
- A thickened womb lining (endometrial hyperplasia): when ultrasound measures the lining as thicker than it should be for the woman's age and point in her cycle.
- Suspected polyps or fibroids: to examine the cellular structure of benign growths inside the womb that are prone to bleeding — polyps — and to remove them.
- Bleeding that does not respond to treatment: to find the underlying cause of bleeding that continues or recurs despite hormonal medication.
How is the procedure carried out?
A diagnostic curettage is a short procedure, generally done in a clinic or an operating theatre setting. To keep the woman comfortable, it may be performed under local anaesthesia or light sedation, depending on the circumstances. During the procedure the cervix is gently dilated, and fine instruments — cannulas or curettes — are used to take an adequate tissue sample from the wall of the womb. The samples are then sent to pathologists for examination of the cell structure.
What to pay attention to during recovery
Recovery after a diagnostic curettage is quick for most women. There are, however, some rules worth keeping to, in order to avoid infection and let healing go smoothly:
- Bleeding and cramps: for a few days afterwards it is normal to have mild cramps similar to period pain, and light spotting.
- Avoiding infection (pelvic rest): because the cervix is opened slightly during the procedure, sexual intercourse, vaginal douching, swimming pools and the sea should all be avoided until healing is complete — generally 1-2 weeks, unless your doctor advises otherwise.
- Pads rather than tampons: for any bleeding afterwards, use sanitary pads; tampons can increase the risk of infection.
It is worth remembering that a diagnostic curettage is a well-established procedure which, by allowing early diagnosis, helps many conditions to be dealt with while they are still at an early stage. The definitive diagnosis and the treatment plan are worked out with your doctor once the pathology results are back.
Frequently asked questions
Is a diagnostic curettage painful?
Because the procedure is carried out under local anaesthesia or light sedation, no marked pain is felt during it. Mild cramps may follow afterwards.
How long do the pathology results take?
Pathological examination of the endometrial tissue sample generally takes between 3 and 7 days.
Is a diagnostic curettage the same as ending a pregnancy?
No. A diagnostic curettage is a tissue biopsy carried out solely to diagnose conditions inside the womb; it is entirely different from a procedure to end a pregnancy.
This page is for information. It does not replace an examination or individual medical advice.