What Is an Endocervical Curettage?

The Basics of the ECC Biopsy Procedure

An endocervical curettage, or ECC, is a type of biopsy. It is a procedure where a curette—a narrow, spoon-shaped medical instrument—is used to scrape the mucous membrane (or lining) of the endocervical canal (the passageway between the cervix and uterus). This procedure obtains a small tissue sample, which is then sent to a pathology lab to be examined to see if it contains any abnormal cells (such as precancerous or cancerous cells).

An endocervical curettage is performed during a colposcopy, a procedure that is usually ordered by an OB/GYN doctor if you have abnormal or inconclusive results from a Pap test, if something possibly abnormal was noticed during a pelvic exam, or if you have a history of prenatal exposure to DES (diethylstillbestrol, a synthetic form of estrogen). 

Preparing for the Endocervical Curettage Procedure

It is preferable that you not be menstruating when you have your endocervical curettage procedure because menstruation makes it harder for your doctor to get a good view of your cervix and can make the results of the procedure less accurate. So keep that in mind when you're scheduling the appointment.

Before your procedure, make sure that you follow these important guidelines:

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

Be aware that you will need to have someone escort you home after the procedure, and plan accordingly. 

During the ECC Procedure

An ECC takes just a few minutes. In fact, in most cases, the tissue sample can be taken in a matter of seconds.

 During the endocervical curettage, you'll lie on an exam table and put your feet into stirrups. Your cervix and vagina will be moistened with either a vinegar or iodine solution to remove mucous and highlight the area that's being biopsied. Some women report a brief pinch and moderate-to-severe discomfort during the biopsy.

After the Biopsy

Women can expect to experience some mild symptoms in the days following the procedure, such as cramps that feel like menstrual cramps. Ask your doctor whether taking an over-the-counter pain reliever might help relieve any discomfort. There may be some vaginal bleeding and a dark discharge, so be sure to wear a sanitary pad over your underwear. You will have to limit some of your activities so that your body can heal. You should not engage in sexual intercourse, use tampons, or douche. If you have heavy vaginal bleeding, severe lower abdominal pain, fever, or chills, contact your doctor right away.

It is normal to feel some amount of anxiety as you wait for your endocervical curettage results. But keep in mind that the majority of abnormal Pap smears are caused by inflammation or a vaginal infection. If you are having trouble handling any stress related to the procedure or the results, talk to your doctor about healthy coping mechanisms, such as talking to a counselor, joining a support group, exercising at least most days of the week, eating more nutritious foods, and establishing a regular bedtime routine that can help you get the sleep that you need.

 

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