Endocervical curettage (ECC) is a medical procedure that involves gently scraping tissue from the endocervical canal, the inner part of the cervix. This tissue is collected for laboratory analysis of cellular abnormalities.
Why Endocervical Curettage is Performed
Endocervical curettage is primarily used for diagnostic purposes when initial screening tests, such as a Pap test, indicate potential issues within the cervical canal. It targets the endocervix, an area often not fully accessible through direct visualization or a standard Pap smear, allowing for a more detailed examination of potentially precancerous or cancerous cells.
The procedure is commonly performed to investigate abnormal Pap test results, particularly if atypical glandular cells, high-grade squamous intraepithelial lesions, or carcinoma are identified. It is also indicated for unexplained vaginal bleeding or to evaluate the endocervical canal for abnormal growths like polyps. Additionally, ECC can be a follow-up procedure after an inconclusive colposcopy or in cases of persistent human papillomavirus (HPV) infection, especially high-risk types like HPV 16 or 18, to detect changes that could lead to cervical cancer.
How the Procedure is Performed
Endocervical curettage is performed in an outpatient setting and takes 5 to 10 minutes. The patient is positioned on their back with feet in stirrups, similar to a standard pelvic exam. A speculum is then inserted into the vagina to hold the vaginal walls apart and provide a clear view of the cervix.
The healthcare provider cleans the cervix with a special solution. In some cases, a tenaculum, a tool used to grasp the cervix, may be used to hold it steady. A small, spoon-shaped instrument called a curette is gently inserted through the cervical opening (os) into the endocervical canal. The provider then carefully scrapes a thin layer of tissue from the wall of the cervical canal using small strokes. The collected tissue sample is immediately placed into a preservative solution or on a cotton pad for microscopic analysis.
What to Expect After the Procedure
Following an endocervical curettage, patients may experience cramping similar to menstrual cramps, and light spotting or bleeding for a few days. Some individuals might notice a dark discharge, often from medication used to stop bleeding at the biopsy site.
Recovery time is short; most individuals can resume normal activities within 1 to 2 days. Strenuous activities should be avoided for 24 to 48 hours. To prevent infection and allow the cervix to heal, patients should refrain from using tampons, douching, and sexual intercourse for about 2 to 3 days. Laboratory results are available within a few days to a week, and a follow-up appointment will be scheduled to discuss findings and determine next steps. Contact a healthcare provider if symptoms such as heavy vaginal bleeding (soaking more than one sanitary pad per hour), severe lower abdominal pain, fever, chills, or foul-smelling vaginal discharge occur, as these could indicate a complication like infection.