Many women will never have endocervical curettage (ECC), but it might be indicated if cervical cancer is suspected. Normally this cancer becomes suspect if a woman has an abnormal PAP smear indicating that cancerous cells are potentially present, or if the woman has more than one PAP smear in a row that shows findings of unusual cells. Basically, this procedure takes a larger sample of cells from the mucus membrane inside the cervix wall to test more specifically for cervical cancer.
Endocervical curettage is usually done at the same time that women undergo a colposcopy. This is a way of visualizing the cervix and potentially taking tissue samples if there appears to be sections of abnormal tissue. When doctors feel curettage is indicated, they insert a small scooplike or spoonlike instrument (curette) into the cervix in order to perform this test. It scrapes off a small amount of tissue in the cervix that is then sent to a pathology lab to be tested. Colposcopy can also involve taking tissue samples from outside the cervix if needed.
Biopsy or scraping of cervical tissue is not completely without discomfort. What is helpful to know is that discomfort is not severe for most people, and endocervical curettage and exterior tissue biopsy tend to be very brief. While it is occurring it can feel a bit like a menstrual cramp and some women do feel a little sore or have minor cramps after they’ve had an ECC. This feeling usually passes within a day or two and may not require any type of special care.
Doctors may advise some women to take a pain reliever like acetaminophen before the procedure to reduce any discomfort, and they may further reduce discomfort if they use a local anesthetic prior to performing insertion of the curette and removal of tissue samples with it. Although an anesthetic may reduce pain, it does nothing to end one of the most symptoms that might occur after endocervical curettage, which is some spotting or bleeding that usually ceases within a few days.
Endocervical curettage is only one potential test that can be performed if cervical cancer is confirmed or likely. Doctors may need to take biopsies from other areas to determine cancer spread. They may also use a variety of visualizing techniques like magnetic resonance imaging (MRI) x-rays or CAT (computerized axial tomography) scans to look for presence of abnormal masses in different parts of the body. These tests may be performed because it is important to make certain that any cancerous cells in the body are addressed and removed if/when possible.
