Cervix Anatomy Lowermost part of uterus Cylindrical shape Diameter and length are 2.5 cm. Parts Supravaginal Infravaginal Extends from histological internal os to anatomical external os. Nulliparous - Pin hole cervix Parous - Bilateral slit Cervical Biopsy Punch Biopsy Wedge Biopsy Ring Biopsy Whole of squamo-columnar junction area of the cervix is excised with a special knife. The tissue is subjected to serial section to detect cervical intraepithelial neoplasia (CIN) or early invasive carcinoma. Cone Biopsy - Conization Complications Thank you

1. Cervical Biopsy
Dr.Yashika

2. Cervix Anatomy
• Lowermost part of uterus
• Cylindrical shape
• Diameter and length are 2.5 cm.
• Parts Supravaginal
Infravaginal
• Extends from histological
internal os to anatomical
external os.
• Nulliparous - Pin hole cervix
• Parous - Bilateral slit

3. Cervical Biopsy
Removal of a small sample of tissue from the cervix for
examination under microscope; used for the diagnosis and
treatment of cervical cancer and precancerous conditions.
Types:
1. Punch Biopsy
2. Wedge Biopsy
3. Ring Biopsy
4. Cone Biopsy
5. Surface Biopsy

4. Punch Biopsy
• An out patient procedure without
anesthesia.
• Using Cusco’s Bivalve Speculum
biopsy is taken from the
suspected area or a 4-quadrant
using Punch Biopsy forceps.
• It can be also Colposcopic directed or stained with Schiller’s
iodine or Acetic acid.

5. Iodine staining revealing saffron-
colored abnormal area.
Acetowhite lesion after
washing with acetic acid.

7. Wedge Biopsy
• It is done when definite growth is visible.
• An area near the edge is the ideal site.
Steps:
a) Posterior vaginal speculum is introduced.
b) Anterior and the posterior lip of the
cervix is held by Alley’s forceps.
a) With a scalpel, a wedge of tissues is cut from the edge of the
lesion including the healthy tissue for comparative histological
study.

8. Ring Biopsy
• Whole of squamo-columnar junction area of the cervix
is excised with a special knife.
• The tissue is subjected to serial section to detect cervical
intraepithelial neoplasia (CIN) or early invasive
carcinoma.

9. Cone Biopsy - Conization
• Both diagnostic and therapeutic
purpose
• Removal of cone of the cervix which
includes entire squamocolumnar
junction, stroma with glands and
endocervical mucous membrane.
• Methods: Cold knife, CO₂ laser, Laser
diathermy loop

10. Indication:
– Unsatisfactory Colposcopic findings.
– Inconsistent findings : Colposcopic, Cytology and directed
biopsy.
– Positive endocervical curettage for CIN II and III.
– When biopsy cannot rule out invasive cancer from
carcinoma in-situ.
– Biopsy shows microinvasion – to exclude gross invasive
carcinoma.

11. Complications
• Secondary hemorrhage.
• Cervical stenosis leading to haematometra.
• Infertility.
• Diminished cervical mucus.
• Cervical incompetence leading to recurrent miscarriage.

12. Thank
you