Many women will never have endocervical curettage (ECC), but it may be indicated if cervical cancer is suspected. Typically, this cancer becomes suspicious if a woman has an abnormal PAP smear indicating that cancer cells are potentially present, or if the woman has more than one PAP smear in a row showing unusual cell findings. Basically, this procedure takes a larger sample of cells from the mucous membrane within the wall of the cervix to test more specifically for cervical cancer.
Endocervical curettage is usually done at the same time women have colposcopy. This is a way to visualize the cervix and potentially take tissue samples if there appear to be sections of abnormal tissue. When doctors feel that endocervical curettage is indicated, they insert a small spoon-shaped instrument (curette) into the cervix to perform this test. A small amount of tissue is scraped from the cervix which is then sent to a pathology lab for analysis. Colposcopy may also involve taking tissue samples from outside the cervix if needed.
The biopsy or scraping of cervical tissue is not completely free of discomfort. What is helpful to know is that the discomfort is not serious for most people, and the endocervical curettage and outer tissue biopsy tend to be very brief. While it's happening, it can feel a bit like a menstrual cramp, and some women have a little cramping or pain after having an ECC. This feeling usually passes within a day or two and may not require any special attention.
Doctors may advise some women to take a pain reliever such as acetaminophen before the procedure to reduce any discomfort, and they may further reduce discomfort by using a local anesthetic prior to curette insertion and tissue sampling. Although anesthesia can reduce pain, it does nothing to end one of the most common symptoms that can occur after endocervical curettage, which is some spotting or bleeding that usually goes away within a few days.
Endocervical curettage is only one potential test that may occur if cervical cancer is confirmed or likely. Doctors may need to take biopsies from other areas to determine the spread of the cancer. They may also use a variety of visualization techniques, such as magnetic resonance imaging (MRI) or CT scans (computerized axial tomography) to look for the presence of abnormal masses in different parts of the body. These tests may be done because it is important to make sure that any cancer cells in the body are treated and killed if possible.