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What is a pipelle biopsy and is it painful? What are the long term side effects of a post menopausal radical hysterectomy?

Mar 2013
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What is a pipelle biopsy and is it painful.
What are the long term side effects of a post menopausal radical hysterectomy.
Thank you XXXXXXX
Posted Sat, 4 May 2013 in General Health
Answered by Dr. Aarti Abraham 33 minutes later
Thanks for the query

An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus (endometrium ). The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find problems in the endometrium.

There are several ways to do an endometrial biopsy.

1. A soft, strawlike device (pipette) to suction a small sample of lining from the uterus. This method is fast and is not very painful.
2. A sharp-edged tool called a curette. Your doctor will scrape a small sample and collect it with a syringe or suction. This is called a dilation and curettage (D and C). This is done with general or regional anesthesia.
3. An electronic suction device (Vabra aspiration). This method can be uncomfortable.

The Pipelle is the least painful method of taking an endometrial biopsy.

Regarding radical hysterectomy

A radical hysterectomy removes the entire uterus, including the cervix and an area of normal vaginal tissue through a low abdominal incision. This area of normal tissue also includes a portion of the upper vagina, and may result in vaginal shortening after the operation. A modified radical hysterectomy is similar to a radical hysterectomy but less invasive. A simple hysterectomy removes a smaller rim of normal tissue, and spares most of the length of the vagina. With both types of surgery, the ovaries and Fallopian tubes can be removed as well, and this is known as a bilateral salpingo-oophorectomy. The decision to perform a bilateral salpingo-oophorectomy depends on your age and whether the ovaries are still functioning.

Some patients will have cancer that has spread outside the cervix into the lymph nodes in the pelvis. Before performing a hysterectomy, the doctor will sometimes perform a pelvic lymph node dissection. Pelvic lymph node dissection involves the removal of lymph nodes to determine the presence or absence of cancerous cells. If the lymph nodes contain cancer, usually the surgeon will not proceed with a radical hysterectomy. Instead, another form of treatment, usually radiation therapy and chemotherapy, is generally recommended.

Any form of hysterectomy is major surgery with associated surgical risks. Hemorrhage, blood clots, surgical wound complications or allergic reaction to anesthesia are surgical risks that should be discussed with your doctor. In-hospital death occurs after radical hysterectomy in less than 1% of cases.
Normal and expected temporary effects of surgery for the treatment of cervical cancer may include pain, nausea, fatigue and anxiety. Urinary tract infection after the surgery is also common.

Additional temporary side effects may include difficulty urinating or having a bowel movement. Since the bladder may be pushed and pulled due to all of the dissection around it, a temporary catheter (tube in the bladder to drain the urine) is usually required to give the bladder time to heal. With a simple hysterectomy, disturbance to the bladder is minimal making urinary complications rare. However, approximately one-third of women undergoing a radical hysterectomy may experience temporary bladder difficulties which may last a few weeks after surgery. Although most women return to normal bladder functioning, a very small percentage may require more permanent self-catheterization. Depending on the type of hysterectomy, your age and general health, recovery from short-term side effects may take 6 to 8 weeks.
In addition to rare bladder dysfunction, injury to the rectum and lower leg lymphedema are also potential long-term side effects of a hysterectomy. In a few cases, injury to the rectum or tubes that drain the kidneys (ureters) or bladder can occur. This may be in the form of a “fistula” or abnormal connection to the vagina. This is a chronic problem that may require surgery to repair the opening. Lower leg lymphedema (swelling) as a result of lymph node dissection may also occur in some cases. Elastic stockings or support hose as well as preventing infection and injury to the leg, can help minimize lymphedema.
Long-term sexual complications due to the removal of the uppermost part of the vagina are reportedly minor. In a few cases, patients indicate some loss of sensation and lubrication, as well as intercourse difficulty due to vaginal shortening. The emotional impact of the surgery may also affect libido in some patients.

The physical loss of reproductive organs has significant long-term physical and emotional side effects and should be discussed with your doctor before surgery. Some patients may want to investigate having their eggs harvested for possible surrogacy before surgery. Once the uterus is removed, women no longer menstruate and can no longer have children. Furthermore, if the ovaries are removed in a woman of child-bearing age, menopause will be induced. Some of the side effects of early menopause include hot flashes, irritability, vaginal dryness, sweats and nervousness. Hormone replacement therapy may be used to help control some of the side effects associated with menopause. The impact of losing reproductive organs is far reaching, affecting future plans as well as emotional well-being.

You have not mentioned the details of the indication for surgery or biopsy. It would help more if these details are known.

Take care, and feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: What is a pipelle biopsy and is it painful? What are the long term side effects of a post menopausal radical hysterectomy? 11 hours later
Thank you so much for your reply.I have infact undergone a radical hysterectomy based on erroneous results.I am trying to determine the long term effects of the operation.Research indicates that it can lead to a shorter life span,a thickening of the arterial wall and osteoporosis.I would greatly appreciate your feedback on this material and on any other material you consider relevant.Also with the suction method of a Pipelle biopsy is a swab used.?

Kind regards XXXXXXX
Answered by Dr. Aarti Abraham 10 hours later
Well, the side effects you mention ARE included in the aftermaths of a radical hysterectomy.
Pipelle biopsy does not include a swab, but a Pap smear might have been taken alongwith, or some pelvic infection might have been tested for,.
Above answer was peer-reviewed by
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