confused about my biopsy, please help

i had my endometrial biopsy done 4 days ago, and i have to say that if felt like more than just a pinch to me!!!! i have a high tolerance for pain, and it was excruciating. im not sure why i had to do it now, my endometrium stripe was prominent, but since i've been on lupron it is normal. he said we still have to find out why it is so thick. what exactly can the biopsy diagnose, besides the obvious. im 34 with no abnormal bleeding, just very heavy periods and alot of pain all the time. i have lap. for multiple adhesions and i have a simple uni-locular cysts on the ovary. it is only 2cm. not getting bigger, but has been there for about 5 months, not going away either. i had an mri and it just showed the thick stripe, the cyst, and free fluid in the cul-de-sac. if i did have endometrios wouln't they know from the surgery and the mri? and what about adenomyosis? i did have an ivp test done in oct. which showed an impression on the dome of the bladder, they thought it was an enlarged uterus, which now we know it is not. im just very confused and cant wait for an answer!!!! my doctor and i have decided to do an ablation after i am done with lupron in september. i think this is going to be for the best. i want to try everything before they take my uterus. if anyone has any insight it will be greatly appreciated. thanks alot

Hi Mary, My situation was a bit different than yours, but hopefully this will help a little.

My doc wanted to do endometrial biopsy before my hysterectomy because I had symptoms similar to yours (heavy bleeding, thickened lining). His thought was "Very unlikely to be cancer, but better to sure when there is even a remote chance" I think he is especailly careful about cancer since he almost lost his wife to breast cancer a few years ago.

I thought, well, if they are taking my uterus anyway, what difference does it make? But he said that the surgeries are very different - if there is cancer they will take everything, including some lymph nodes. If not they would try and leave ovaries and cervix.

As it turned out, could not do the biopsy or a hysteroscopy under general anthesthia because my uterus was twisted 180 degrees by large external fibroid - so went into the surgery "hoping for the best". The pathology report did turn up clean.

Hopefully someone else out there will have other experiences. Also, be sure to ask you doctor any questions. If you don't feel like you are getting answers that satisfy you consider getting another opinion. There are lots of doctors out there who are very good about addressing all your concerns.

Best Wishes.

Debbie

The endometrial biopsy will detect any hyperplasia (overgrowth of the endometrial lining): you can have simple hyperplasia, simple hyperplasia w/aytpia, complex hyperplasia, and complex hyperplasia w/atypia. The heavy bleeding and thicked endometrial lining are signs of hyperplasia.

The pathology from the endometrial biopsy will tell all. Please discuss the results and treatment options with your GYN when the pathology report comes in.

The endometrial biopsy will not diagnose endometriosis or adenomyosis, just the state of your endometrial lining.

Hope this helps.

Sorry your biopsy hurt so much Mary. I had one this past Thursday and it was a breeze compared to my other four I've had done over the years. The difference was that I took (4) 200mg of Motrin...I know it's a lot; but that's the prescription strength and my doctor told me to take it an hour before my appointment. What a difference it made! I had to even ask him if he really did it because I didn't feel a thing..honest! Other times, yea, it was excruciating. So in case you ever have to have it done again; check with your doctor and get clearance to take it beforehand. It made such a difference and I hardly bled at all afterwards.

I'm scheduled for a D&C and hopefully, the NovaSure procedure next month. I can hardly wait! My doctor says as long as my uterine cavity looks normal inside, he can do the NovaSure, but won't know until he's doing the D&C.

All my best to you and hope you get some answers to your questions and feel better soon.