What is a cervical biopsy?
A cervical biopsy is a procedure to remove tissue from the cervix to test for abnormal
or precancerous conditions, or cervical cancer.
The cervix is the lower, narrow part of the uterus. It forms a canal that opens into
Cervical biopsies can be done in several ways. The biopsy can remove a sample of tissue
for testing. It can also be used to completely take out abnormal tissue. It can also
treat cells that may turn into cancer.
Types of cervical biopsies include:
Punch biopsy. This procedure uses a circular blade, like a paper hole puncher, to remove a tissue
sample. One or more punch biopsies may be done on different areas of the cervix.
Cone biopsy. This procedure uses a laser, electrical loop, or scalpel to remove a large cone-shaped
piece of tissue from the cervix.
Endocervical curettage (ECC). This procedure uses a narrow instrument called a curette to scrape the lining of
the endocervical canal. This is an area that can’t be seen from the outside of the
Why might I need a cervical biopsy?
A cervical biopsy may be done when abnormalities are found during a pelvic exam. It
may also be done if abnormal cells are found during a Pap test. A positive test for
human papillomavirus (HPV) may also call for cervical biopsy. HPV is a type of sexually
transmitted infection (STI). Certain types of HPV can cause cervical cancer and other
less common types of genital cancers. A cervical biopsy is often done as part of a
colposcopy. This is also called a colposcopy-guided cervical biopsy. A colposcopy
uses an instrument with a special lens to look at the cervical tissues.
A cervical biopsy may be done to find cancer or precancer cells on the cervix. Cells
that appear to be abnormal, but are not yet cancerous, are called precancerous. These
abnormal cells may be the first sign of cancer that may develop years later.
A cervical biopsy may also be used to diagnose and help treat these conditions:
Noncancerous growth (polyps) on the cervix
Genital warts. These may mean that you have an infection with HPV. HPV is a risk factor
for cervical cancer.
Diethylstilbestrol (DES) exposure if your mother took DES during pregnancy. DES raises
the risk for cancer of the reproductive system.
Your healthcare provider may have other reasons to recommend a cervical biopsy.
What are the risks of a cervical biopsy?
Some possible complications may include:
In addition, cone biopsies may increase the risk for infertility and miscarriage.
This is because of the changes and scarring in the cervix that may happen from the
Tell your healthcare provider if:
You are allergic to or sensitive to medicines, iodine, or latex.
You are pregnant or think you could be pregnant. Some types of cervical biopsies can
be done during pregnancy, but others can't.
If possible, a cervical biopsy will be scheduled about 1 week after your period.
You may have risks depending on your specific health condition. Be sure to talk with
your provider about any concerns you have before the procedure.
Certain things can make a cervical biopsy less accurate. These include:
How do I get ready for a cervical biopsy?
Your healthcare provider will explain the procedure and you can ask questions.
You will be asked to sign a consent form that gives your permission to do the procedure.
Read the form carefully and ask questions if something is not clear.
You usually don't need to stop eating or drinking before a simple cervical biopsy.
If you need anesthesia, you may need to fast for a certain number of hours before
the procedure. This is usually after midnight.
Tell your provider if you are pregnant or think you could be.
Tell your provider if you are sensitive to or are allergic to any medicines, latex,
tape, or anesthetic medicines (local and general).
Tell your provider about all medicines you are taking. This includes prescriptions,
over-the-counter medicines, and herbal supplements.
Tell your provider if you have had a bleeding disorder. Also tell your provider if
you are taking any blood-thinning medicines (anticoagulants), aspirin, or other medicines
that affect blood clotting. You may need to stop taking these medicines before the
Don't use tampons, vaginal creams or medicines, or douche for 24 hours before the
Don't have sex for 24 hours before the procedure.
Your healthcare provider may tell you to take a pain reliever 30 minutes before the
procedure. Or you may be given medicine to help you relax before the anesthesia is
started. You will need someone to drive you home afterward.
You may want to bring a sanitary pad to wear home after the procedure.
Follow any other instructions your provider gives you to get ready.
What happens during a cervical biopsy?
You may have a cervical biopsy in a healthcare provider’s office, as an outpatient,
or during a hospital stay. Some biopsy procedures only need local anesthesia. Other
need regional or general anesthesia. The way the test is done may vary depending on
your condition and your healthcare provider's practices.
Generally, a cervical biopsy follows this process:
You will need to undress completely or from the waist down and put on a hospital gown.
You will be told to empty your bladder before the procedure.
You will lie on an exam table, with your feet and legs supported as for a pelvic exam.
Your healthcare provider will put an instrument called a speculum into your vagina.
This will spread the walls of the vagina apart to reach the cervix.
Often the healthcare provider will use a colposcope. This is an instrument with a
special lens like a microscope to help see the cervical tissues. The provider will
put colposcope at the opening of your vagina. It won't enter your vagina.
Your healthcare provider will look through the colposcope to find any problem areas
on the cervix or in the vagina.
They may clean and soak the cervix with a vinegar solution (acetic acid solution).
This solution helps make the abnormal tissues turn white so they are easier to see.
You may feel a mild burning sensation. An iodine solution may be used to coat the
cervix. This is called the Schiller test.
The type of biopsy done will depend on the size and shape of the abnormal cells, as
well as where they are.
The healthcare provider may numb the area using a small needle to inject medicine.
They may use forceps to hold the cervix steady for the biopsy. You may feel some cramping
when it's put in place.
The amount of tissue removed and where it's removed depend on the type of biopsy.
For a simple cervical biopsy, one or more small samples of tissue will be removed
using a special type of forceps. When this is done, you may feel a slight pinch or
cramp. Cells from the inside of the cervical canal may be removed with a special tool
called an endocervical curette or an endocervical brush. This may also cause some
For a cone biopsy, the provider may use a loop electrosurgical excision procedure
(LEEP) or the cold knife cone biopsy procedure. With the cold knife cone biopsy, a
laser or a surgical scalpel may be used to remove tissue. This procedure needs regional
or general anesthesia.
Bleeding from the biopsy site may be treated with a paste-like topical medicine. The
provider may also use a probe (electrocauterization) or stitches (sutures) to stop
After a cone biopsy, the provider may pack the cervix with a pressure dressing. Your
provider will tell you how to remove this packing.
The provider will send the tissue to a lab for testing.
What happens after a cervical biopsy?
Your recovery will depend on the type of biopsy done and if you had anesthesia.
If you have regional or general anesthesia, you will be taken to the recovery room
to be watched. Once your blood pressure, pulse, and breathing are stable and you are
alert, you will be taken to your hospital room or discharged home. If you had the
procedure done as an outpatient, you should plan to have someone drive you home.
After a simple biopsy, you may rest for a few minutes after the procedure before going
You may want to wear a sanitary pad for bleeding. It's normal to have some mild cramping,
spotting, and dark or black-colored discharge for several days. The dark discharge
is from the medicine put on your cervix to control bleeding.
Take a pain reliever for cramping as recommended by your healthcare provider. Aspirin
or certain other pain medicines may increase the chance of bleeding. Be sure to take
only recommended medicines.
You may be told not to douche, use tampons, or have sex for 1 week after a biopsy,
or for a period advised by your healthcare provider.
After a cone biopsy, you should not put anything into your vagina until your cervix
has healed. This may take several weeks. You may also have other limits on your activity,
including no heavy lifting.
You may go back to your normal diet unless your healthcare provider tells you otherwise.
Your healthcare provider will tell you when to return for further treatment or care.
Generally, women who have had a cervical biopsy will need more frequent Pap tests.
Tell your healthcare provider if you have:
Your healthcare provider may give you other instructions after the procedure, depending
on your situation.
Before you agree to the test or procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure