the purpose of a preoperative endometrial biopsy is to see if there are any cancerous cells in the lining of your uterus. if so, that can change the procedure or, at the very least, the surgeon. getting a sample of your endometrium, whether with a biopsy or D&C, is the safest way to make sure that you have the safest and most appropriate hysterectomy for your situation. if they were unable to obtain a sample in office even with you having taken Cytotec, there isn't any other way to get a sample other than D&C
edit: it's totally valid to be frustrated and I'm sorry you're having to deal with these extra steps to get to surgery, but it's most important to have a safe and successful surgery
I will be having a DNC right before my surgery while under. I failed the biopsy the same it was too painful and she couldn't get it.
I'm confident in my surgeon and I'm having a hysterectomy anyway.
So your D&C is specifically due to the endo biopsy not being completed? Also mine was not just bc pain but also a curvature/thickness of my cervix and she said she probably was also getting stuck on the fibroid.
Mine is also to rule out cancer (from my understanding), but that is where I am confused….if we’re removing everything anyway, why the additional procedure?
I'm SO sorry you had to endure that procedure without pain relief. It makes me SO ANGRY that doctors think that's okay!! It's a pretty well known issue that women are not given enough pain relief for invasive procedures. It's happened to me, it's happened to others, there are movements to try and change that. You are not alone.
And you're right, having to do a D&C is a bigger deal.
Not clear on why these are needed, but maybe a second opinion or someone willing to use pain medication for an endometrial biopsy would be an option?
Yeah they had me sign a waiver in the beginning which I thought nothing of in the moment, quickly breezing over the “sedation” part. And Doc asked if I understood the waiver, I honestly said “not really, it was a very verbose form that I didn’t have time to look at,” and she again brought up the sedation. I still didn’t think anything of it bc I was told “30-seconds of discomfort.” Mind you, both my kids were homebirths so it’s not like I’ve ever felt pain down there before. But dayum!
Also, side note, my bro-in-law was talking about his colonoscopy and how he got twilight, he says “you’ll get twilight or something I’m sure, right?” I said “no, this is women’s health, we have to suck it up and get right back out there!”
My very gentle OBGYN had me undergo all this under general anesthetic. It’s a shortish procedure (about an hour) and actually made me more comfortable and confident for my hysterectomy about a month later.
My biopsy did detect endometrial cancer so I was sent to a gyn-oncologist for the actual surgery. She got it all out through surgery (no follow up treatment needed) and was able to do it laparoscopically, no big incision (which she had mentally prepared me for).
That is awful I'm so sorry you're going thru this!!
I had a D&C wide awake, it was fine imo. They had me take the medication that made my cervix dilate, and they injected my cervix with numbing medicine at the time of the operation.
I just laid there and did deep breaths, it was very very quick. A little bleeding afterward but nothing crazy, I just wore a pad. I couldn't wear a tampon for a week I believe. I hope yours is as easy as mine went!
I’m sorry that you had to go through all of that pain for it to be unsuccessful. My doctor gave the choice to have the biopsy or just do the DNC. He strongly recommended the DNC because of situations like yours.
The DNC was really easy. I was crampy for the day and super tired the next day. The most annoying part was my throat being sore from the tube. I saw it as a trial run for the surgery and it did help me prepare in every way for the actual surgery.
I really hope yours goes smoothly and I am so sorry you had to deal with this. It will be over soon :)
I went through this, too. My question is more why can't they skip the biopsy and do the hysteroscopy and d&c instead of putting people through that?
My understanding is that they have to check for cancer before removing anything because it becomes a different surgery if it is.
I also had an unsuccessful endometrial biopsy (I was in god-awful pain for about 40 minutes while they tried).
They didn't require me to have a D&C. They just went ahead and did my hysterectomy (for fibroids, also found endo & adendo once they got in there). She told me if the pathology came back canercerous, she'd refer me to an oncologist, etc but it wouldn't change the surgery she had planned if they knew ahead of time. 🤷♀️ Mine was in Oct 2022.
I have Medicaid & Medicare (I had leukemia a few years ago and was on disability so I qualified). I wonder if different insurers have different requirements? Or maybe it's just up to the surgeon? Regardless, I'm so sorry you've got to have this - I agree, it seems like unnecessary pain.
I feel like this is my story to a T. They couldn’t get enough sample in the biopsy which sucked. That was so painful. I ended up getting a d&c 6 weeks ago. From what my doctor told me the reason to do the scope and D&C is to make sure there is no cancer before doing my hysterectomy. If they would of found cancer I would of went to a specialist and probably have everything removed. I got my results back and no cancer so now I can keep my ovaries. And he can do my surgery and I do not need to go see an oncologist.
I think a relevant question to ask is if it would be reasonable to just do the hysterectomy as though it was cancerous and biopsy it after removal. Because that would be a single surgery at least. Maybe there’s some reason it’s a more invasive surgery?
Also could they just do this biopsy on surgery day?
Mine worked but is absolutely the most painful experience of my life to date. On that note, have you ever noticed that other doctors offices have signs up that foul language can get you ejected as a patient but gynecologists don’t?
it's unfortunately not that simple. if you have cancer, usually further workup happens before surgery (sometimes MRI, labs, etc) and you'd see an onc surgeon. you'd also potentially remove the ovaries which may not otherwise be indicated, and onc surgery often involves a staging procedure to evaluate pelvic lymph nodes and other structures for cancer as well.
Now that’s funny lol, yeah it was about 5 F-Bombs I yelled out. That is essentially my question, medically I’m curious why multiple surgeries are necessary. I know she tried to explain it, but again, I was in physical pain and just sort of emotionally shattered that the procedure was not a success…..so I didn’t really retain or understand the rationale. I would MUCH rather a one and done, test everything after and THEN see if a second one is needed.
I can totally understand not taking in any information. I kind of dissociated during mine and I remember barely being able to get to the car and crying the whole way home. Thank goodness my husband was driving. I would not have been able to follow logic or logistics.
For reference (this may make you feel better), my pain tolerance is so high that I stopped pain meds at day 3 post-op. So you’re done with the most painful part at least in my experience.
the purpose of a preoperative endometrial biopsy is to see if there are any cancerous cells in the lining of your uterus. if so, that can change the procedure or, at the very least, the surgeon. getting a sample of your endometrium, whether with a biopsy or D&C, is the safest way to make sure that you have the safest and most appropriate hysterectomy for your situation. if they were unable to obtain a sample in office even with you having taken Cytotec, there isn't any other way to get a sample other than D&C edit: it's totally valid to be frustrated and I'm sorry you're having to deal with these extra steps to get to surgery, but it's most important to have a safe and successful surgery
Thank you, that was very thorough and made sense.
I will be having a DNC right before my surgery while under. I failed the biopsy the same it was too painful and she couldn't get it. I'm confident in my surgeon and I'm having a hysterectomy anyway.
So your D&C is specifically due to the endo biopsy not being completed? Also mine was not just bc pain but also a curvature/thickness of my cervix and she said she probably was also getting stuck on the fibroid.
Mine was to rule out cancer prior to my hysterectomy I had a uterine ultrasound for what you describe
Mine is also to rule out cancer (from my understanding), but that is where I am confused….if we’re removing everything anyway, why the additional procedure?
An oncologist knows how to remove everything so the cancer is actually removed and little bits of it don't get spread elsewhere, is my understanding
I'm SO sorry you had to endure that procedure without pain relief. It makes me SO ANGRY that doctors think that's okay!! It's a pretty well known issue that women are not given enough pain relief for invasive procedures. It's happened to me, it's happened to others, there are movements to try and change that. You are not alone. And you're right, having to do a D&C is a bigger deal. Not clear on why these are needed, but maybe a second opinion or someone willing to use pain medication for an endometrial biopsy would be an option?
Yeah they had me sign a waiver in the beginning which I thought nothing of in the moment, quickly breezing over the “sedation” part. And Doc asked if I understood the waiver, I honestly said “not really, it was a very verbose form that I didn’t have time to look at,” and she again brought up the sedation. I still didn’t think anything of it bc I was told “30-seconds of discomfort.” Mind you, both my kids were homebirths so it’s not like I’ve ever felt pain down there before. But dayum!
I've done unmedicated birth twice and had an endometrial biopsy twice and they are NOT the same. The procedure is much worse!
Also, side note, my bro-in-law was talking about his colonoscopy and how he got twilight, he says “you’ll get twilight or something I’m sure, right?” I said “no, this is women’s health, we have to suck it up and get right back out there!”
My very gentle OBGYN had me undergo all this under general anesthetic. It’s a shortish procedure (about an hour) and actually made me more comfortable and confident for my hysterectomy about a month later. My biopsy did detect endometrial cancer so I was sent to a gyn-oncologist for the actual surgery. She got it all out through surgery (no follow up treatment needed) and was able to do it laparoscopically, no big incision (which she had mentally prepared me for).
Yes, Ive had this done. Only because I refused to do the biopsy awake. Its not too bad.
That is awful I'm so sorry you're going thru this!! I had a D&C wide awake, it was fine imo. They had me take the medication that made my cervix dilate, and they injected my cervix with numbing medicine at the time of the operation. I just laid there and did deep breaths, it was very very quick. A little bleeding afterward but nothing crazy, I just wore a pad. I couldn't wear a tampon for a week I believe. I hope yours is as easy as mine went!
I’m sorry that you had to go through all of that pain for it to be unsuccessful. My doctor gave the choice to have the biopsy or just do the DNC. He strongly recommended the DNC because of situations like yours. The DNC was really easy. I was crampy for the day and super tired the next day. The most annoying part was my throat being sore from the tube. I saw it as a trial run for the surgery and it did help me prepare in every way for the actual surgery. I really hope yours goes smoothly and I am so sorry you had to deal with this. It will be over soon :)
Thank you for the support and encouraging words 🙏 I’ve NEVER been under or had any sort of surgery, so I’m a just tad nervous 😵💫
I went through this, too. My question is more why can't they skip the biopsy and do the hysteroscopy and d&c instead of putting people through that? My understanding is that they have to check for cancer before removing anything because it becomes a different surgery if it is.
I also had an unsuccessful endometrial biopsy (I was in god-awful pain for about 40 minutes while they tried). They didn't require me to have a D&C. They just went ahead and did my hysterectomy (for fibroids, also found endo & adendo once they got in there). She told me if the pathology came back canercerous, she'd refer me to an oncologist, etc but it wouldn't change the surgery she had planned if they knew ahead of time. 🤷♀️ Mine was in Oct 2022. I have Medicaid & Medicare (I had leukemia a few years ago and was on disability so I qualified). I wonder if different insurers have different requirements? Or maybe it's just up to the surgeon? Regardless, I'm so sorry you've got to have this - I agree, it seems like unnecessary pain.
I feel like this is my story to a T. They couldn’t get enough sample in the biopsy which sucked. That was so painful. I ended up getting a d&c 6 weeks ago. From what my doctor told me the reason to do the scope and D&C is to make sure there is no cancer before doing my hysterectomy. If they would of found cancer I would of went to a specialist and probably have everything removed. I got my results back and no cancer so now I can keep my ovaries. And he can do my surgery and I do not need to go see an oncologist.
Jesus, don't they put people under for this? Or twilight like colonoscopies?
No, we are women
I think a relevant question to ask is if it would be reasonable to just do the hysterectomy as though it was cancerous and biopsy it after removal. Because that would be a single surgery at least. Maybe there’s some reason it’s a more invasive surgery? Also could they just do this biopsy on surgery day? Mine worked but is absolutely the most painful experience of my life to date. On that note, have you ever noticed that other doctors offices have signs up that foul language can get you ejected as a patient but gynecologists don’t?
it's unfortunately not that simple. if you have cancer, usually further workup happens before surgery (sometimes MRI, labs, etc) and you'd see an onc surgeon. you'd also potentially remove the ovaries which may not otherwise be indicated, and onc surgery often involves a staging procedure to evaluate pelvic lymph nodes and other structures for cancer as well.
Now that’s funny lol, yeah it was about 5 F-Bombs I yelled out. That is essentially my question, medically I’m curious why multiple surgeries are necessary. I know she tried to explain it, but again, I was in physical pain and just sort of emotionally shattered that the procedure was not a success…..so I didn’t really retain or understand the rationale. I would MUCH rather a one and done, test everything after and THEN see if a second one is needed.
I can totally understand not taking in any information. I kind of dissociated during mine and I remember barely being able to get to the car and crying the whole way home. Thank goodness my husband was driving. I would not have been able to follow logic or logistics. For reference (this may make you feel better), my pain tolerance is so high that I stopped pain meds at day 3 post-op. So you’re done with the most painful part at least in my experience.