Endocervical Curettage

• Endocervical Curettage (ECC) is a diagnostic procedure to collect tissue from the endocervical canal.
• It is primarily performed to investigate abnormal Pap test results, identify precancerous cells, or diagnose certain conditions.
• The procedure involves gently scraping the lining of the endocervical canal to obtain tissue for laboratory analysis.
• Common side effects include mild cramping and spotting, with recovery typically involving temporary activity restrictions.
• While generally safe, potential risks include infection or excessive bleeding, though these are rare.

What is Endocervical Curettage?

Endocervical Curettage (ECC) is a medical procedure that involves the removal of tissue from the endocervical canal, which is the inner part of the cervix. This canal connects the uterus to the vagina. The primary purpose of ECC is diagnostic, allowing healthcare providers to obtain tissue samples for microscopic examination by a pathologist. This examination helps in identifying abnormal cells, precancerous changes, or cancerous conditions that may not be visible during a routine visual inspection or colposcopy.

ECC is often performed in conjunction with a colposcopy, especially when a Pap test indicates glandular cell abnormalities or when the transformation zone (the area where most cervical cancers originate) is not fully visible during colposcopy. It is a vital tool for a comprehensive evaluation of cervical health, ensuring that potential issues within the canal are not overlooked.

Endocervical Curettage Procedure: Steps and Purpose

The endocervical curettage procedure explained typically takes place in an outpatient setting, often immediately following a colposcopy. The patient lies on an examination table similar to a gynecological exam. A speculum is inserted into the vagina to hold the vaginal walls apart and allow the cervix to be visualized. The cervix may be cleaned with an antiseptic solution, and in some cases, a local anesthetic may be applied to minimize discomfort, though it is not always necessary.

A small, spoon-shaped instrument called a curette, or a brush, is then carefully inserted into the endocervical canal. The healthcare provider gently scrapes the lining of the canal to collect tissue samples. These samples are immediately placed into a preservative solution and sent to a pathology laboratory for analysis. The entire procedure usually takes only a few minutes.

The purpose of endocervical curettage is multifaceted and includes:

• Diagnosing Abnormalities: To detect precancerous lesions (dysplasia) or cancerous cells within the endocervical canal, especially when a Pap test shows glandular abnormalities or when the squamocolumnar junction is not fully visible during colposcopy.
• Investigating Symptoms: To identify the cause of unexplained vaginal bleeding, particularly post-coital bleeding or irregular menstrual bleeding, when other tests are inconclusive.
• Confirming Findings: To provide additional diagnostic information following an abnormal Pap test or colposcopic examination, helping to guide further treatment decisions.

Risks and Recovery from Endocervical Curettage

While generally considered a safe procedure, understanding the endocervical curettage risks and recovery process is important. Most individuals experience mild side effects, such as cramping similar to menstrual cramps, and light vaginal spotting or bleeding for a few days after the procedure. Over-the-counter pain relievers can help manage any discomfort. It is common to have a dark discharge, which is usually a result of the antiseptic solution used during the procedure.

Rarely, more significant complications can occur, including:

• Infection: Symptoms like fever, foul-smelling discharge, or severe abdominal pain warrant immediate medical attention.
• Excessive Bleeding: While light spotting is normal, heavy bleeding (soaking more than one pad per hour) is not and should be reported to a doctor.
• Cervical Stenosis: In very rare cases, scarring from the procedure can narrow the cervical opening, though this is uncommon.

During the recovery period, which typically lasts for about one to two weeks, patients are usually advised to avoid certain activities to prevent infection and promote healing. This often includes refraining from using tampons, douching, and sexual intercourse. Following all post-procedure instructions provided by the healthcare provider is crucial for a smooth recovery and to minimize potential complications. Any persistent or worsening symptoms should be promptly discussed with a medical professional.