What Is an Endocervical Curettage?

In-Office Procedure Used to Diagnose Cervical Cancer

stirrups in gynecology office with woman in background
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An endocervical curettage (ECC) is a type of biopsy in which a narrow, spoon-shaped device called a curette is used to scrape the lining of the endocervical canal (the passageway between the cervix and uterus). The procedure is used to obtain a small tissue sample which the lab will use to determine whether there are either precancerous or cancerous cells.

An endocervical curettage is performed during a colposcopy wherein a lighted scope provides your doctor an up-close look at the cervix.

An ECC is usually ordered if you have had an abnormal or inconclusive Pap test result or have been previously exposed to diethylstilbestrol (DES), a discontinued form of synthetic estrogen linked to the certain types of cancer.

Preparing for the Procedure

In preparing for the ECC, it is preferable that you not be menstruating as it makes it harder for the doctor to view of your cervix and obtain a good sample.

Before arriving for the procedure, there are a number of things would be asked to avoid. Among them:

  • Avoid taking aspirin or blood thinners before the procedure.
  • Do not douche or use tampons for at least three days before the procedure.
  • Avoid sexual intercourse for at least three days before the procedure.

Because an ECC may cause pain, you would be asked to bring someone with you to drive you home.

What Happens During an ECC

An ECC takes only a few minutes once you have disrobed, put on a hospital gown, and taken your place on the examining table.

During the procedure, you would lie back and place your feet in the stirrups. Your cervix and vagina would then be moistened with either a vinegar or iodine solution to remove mucous and highlight the area being biopsied. The ECC would be guided by the colposcope which is usually no more uncomfortable than an ordinary speculum.

The biopsy itself takes only a couple of seconds. Some women report feeling a brief pinch or discomfort ranging from moderate to severe.

Post-Biopsy Care

Women can expect to experience mild symptoms in the days following the procedure, including localized pain and cramping. An over-the-counter pain reliever can usually help alleviate some of the discomfort.

In addition to pain, there may be vaginal bleeding or a dark discharge, so be sure to wear a sanitary pad. You would need to limit your activities for a day or two and avoid sexual intercourse, tampons, or douching until you have fully healed.

If you experience heavy bleeding, severe lower abdominal pain, fever, or chills, contact your doctor immediately or go to your nearest emergency room.

A Word From Verywell

While it is normal to feel anxiety as you await the results of your ECC, keep in mind that cancer is only one of the many causes of an abnormal Pap smear. And, even if it is cancer, early diagnosis is almost always associated with better outcomes and less debilitating treatments.

So, try not to assume the worse, and, when you do get the results, ask as many questions as you need so that you fully understand what the doctor is telling you.

Source:

Gage, J.; Duggan, M.; Nation, J. et al. "Detection of cervical cancer and its precursors by endocervical curettage in 13,115 colposcopically guided biopsy exams." Am J Obstet Gynecol. 2010; 203(5):481 e1–481.e9. DOI: 10.1016/j.ajog.2010.06.048.