Tests & Procedures
Physical Exam and History
During a physical exam, your physician will check general signs of health, including checking for signs of uterus discomfort, pelvic masses or other symptoms that that are not usual for you. A history of your health habits, past illnesses and treatments will also be taken.
Pelvic Exam
A pelvic exam involves an initial look at the vulva, vagina and cervix. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for lesions or discharge. A Pap test or Pap smear of the cervix is usually done during a pelvic exam. At this time other procedures, such as colposcopy, cervical biopsies or an endometrial biopsy may be performed. These will be discussed with you by your provider and consent will be obtained. The doctor or nurse may then insert one or two lubricated, gloved fingers of one hand into the vagina and the other hand is placed over the lower abdomen to feel the size, shape and position of the uterus and ovaries. The doctor or nurse may also insert a lubricated, gloved finger into the rectum to feel for masses and check for any blood in your stool.
Testing for Uterine Cancer
Tests that examine the endometrium are used to detect and diagnose uterine cancer. Because uterine cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and examined under a microscope to look for cancer cells. Two common procedures for sampling endometrial tissue are (1) endometrial biopsy and (2) dilatation & curettage.
Endometrial Biopsy
A biopsy of the endometrium (the uterine lining) involves the removal of tissue from the inner lining of the uterus by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently aspirate (remove with suction) a small amount of tissue from the endometrium. A pathologist will then view the tissue under a microscope to look for abnormalities.
Dilatation & Curettage (D&C)
Curettage is a surgical procedure to remove samples of tissue from the inner lining of the uterus. The cervix is dilated and a curette (a metal loop on the end of a long, thin handle) is inserted into the uterus to remove tissue. Tissue samples may be taken for biopsy. This procedure is also known as a D&C. Dilation is a widening of the cervix to allow instruments into the uterus. This procedure may require anesthesia as it may be more uncomfortable than the endometrial biopsy which can be performed in your doctor’s office without anesthesia.
Ultrasound
Your physician may occasionally order/perform a transvaginal ultrasound in order to evaluate your uterus for masses such as fibroids (benign smooth muscle growths), polyps, and ovarian masses. This will also allow your physician to see if the lining of the uterus is thickened, which is common in women with endometrial cancer.
If tests determine that you have uterine cancer and if your physician determines that hysterectomy is the best treatment option, you may be interested in a new, minimally-invasive procedure, da Vinci® Hysterectomy.
> Find out more about da Vinci Hysterectomy