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mycatsmom 02-24-2010 11:30 AM

transvaginal ultrasound & endometrial biopsy
Hi all,

Went to my dr. yesterday because I've been having spotting between periods for the last month. She said she didn't think it was anything to worry about but wanted to do an endometrial biopsy just in case. I asked her if it'd hurt. She said yes, there's cramping involved. ARE YOU KIDDING ME??? It felt like she doused a chain saw with acid & rammed it up inside me. "Cramping" seems to be code in doctor world for unbearable, searing agony.

She also wants me to have a transvaginal ultrasound. I've never had one & would like to know if it's as gut-wrenchingly, excruciatingly painful as the biopsy. If so, I'm not going through with it. I'd much rather die....though that seems unlikely since she thinks there's "nothing to worry about" anyway.

Thanks in advance for any input.

Bracelet 02-24-2010 12:06 PM

Re: transvaginal ultrasound & endometrial biopsy
The biopsy hurts because they are actually snipping a little tissue, which causes that excrutiating pain. I don't know of many women that have had biopsies down there that said it didn't hurt.

But the transvaginal u/s isn't that bad. I've had it a few times. They basically have you lie in stirrup position (which sucks, I know) and they thread a small catheter through your cervix into the uterus. That part, to me, is a little painful and very uncomfortable. But it's manageable. If I can handle it and I'm the biggest crybaby about everything in the universe, then I'm sure you will be ok. Once they get the catheter in there, they fill your uterus with water so they can expand it and see better whether you have fibroids or polyps. It will show up really well once they get the water in there. Then once they're done, they let the water out and you sit up and it's all good. It feels a little weird when you first stand up because some water might still come out. And make sure you wear a pad for the rest of the day, just in case you expel any more water afterwards.

The biopsy I can see why you freaked, I hate those! I've never had one that didn't hurt! But I've had close to 6 transvaginal ultrasounds and it's really not a big deal in comparison. They're not snipping off any tissue and they're not even sticking you with any needles. The catheter placement is uncomfortable and a little painful but not totally unbearable. I think you will be ok.

mycatsmom 02-24-2010 12:30 PM

Re: transvaginal ultrasound & endometrial biopsy
Hi Bracelet,
Thank you very much for your reply. I had no idea the ultrasound involved ramming something up inside my uterus again. It'll be over my dead body that they'll do anything like that to me again. I'll call right now & cancel the appt.
Thanks again.

StenoLady1 02-24-2010 02:58 PM

Re: transvaginal ultrasound & endometrial biopsy
Yikes, I've had many, many t/v ultrasounds, and no one ever threaded anything into my uterus.

I, too, have had midcycle spotting and ovarian cysts, so my doctor does a t/v ultrasound as part of my yearly exam and pap, and it's absolutely nothing. The pap is more uncomfortable than the ultrasound. All he uses is a large tampon-looking thing, inserts it and moves it from side to side to look at my ovaries, egg and stuff. It's always been the easiest part of the appointment. And kind of cool, as I can watch the screen, too, as he explains what everything is.

rosequartz 02-24-2010 03:10 PM

Re: transvaginal ultrasound & endometrial biopsy
the vaginal ultrasound is nothing!
the worst part is drinking all the water beforehand so your bladder is full!

rosequartz 02-24-2010 03:44 PM

Re: transvaginal ultrasound & endometrial biopsy
it was just a regular vaginal ultrasound (or pelvic ultrasound), not sure of the proper terminology....because of sporadic bleeding which was caused by uterine fibroids. The water was to see with the bladder full...they did the scan on the outside of the stomach (I'm guessing like they would with a pregnant lady?), then I was allowed to empty my bladder and they did the probe thing inside. It was not painful, not in the least....I would not put this off due to fear.....once you have it done, you'll say.....that was nothing! I worried about that??
See I got the ultrasound because I was terrified of the endometric biopsy.....
you survived that.....the ultrasound will be a piece of cake!

Kszan 02-24-2010 06:45 PM

Re: transvaginal ultrasound & endometrial biopsy
Lol, you guys are too funny! Ok, here's the deal, listen up MyCatsMom.....

The transvaginal ultrasound is just when they stick this wand inside your vagina and move it from side to side to view your ovaries and uterus. It does not involve threading anything through anything. They put a condom on a wand type thing that frankly looks like a vibrator, stick it in, and move it around a little. It's no big deal at all! I've had to do this tons of times because I keep having polyps. It's seriously the least painful and easiest thing I've ever had to do at the gyne! I'd rather do that a ton of times than a pap smear!

The thing with threading through the cervix is when you get a saline ultrasound. My gyne does that when she wants to verify what was seen on the regular transvaginal ultrasound. Since the transvaginal only shows a thickening of the lining of the uterus, she always wants to verify (at least in my case) whether there's a polyp causing the thickened appearance of the uterus.

I'm as much of an expert on this as Estria because I've been through this three thousand times. I can tell you without any reservations that if all you're getting done is a plain old transvaginal ultrasound, it's easy as can be. If you end up having to do the saline ultrasound, yes it's slightly more uncomfortable, however, I would rather personally do it again and know for sure there's a polyp than to not know.

I totally get that you don't want to do anything else that might be painful. But I'm telling you that the ultrasound is the best diagnostic tool available in a gyne's office to find out what's going on. And speaking as someone who has had polyps removed FOUR times, I can tell you that it was better to know for sure what was going on rather than to sit there and wonder what was going on. It's way worse not knowing.

mycatsmom 02-24-2010 08:01 PM

Re: transvaginal ultrasound & endometrial biopsy
Thank you all for your input. Personally, I don't ever intend to go anywhere NEAR a gynecologist, or any of their lab people, as long as I live. Maybe I'll just avoid all doctors. You know, once bitten twice shy....well, I've been bitten a few too many times. Any trust I may have once had in the medical industry is long gone. But good luck to the rest of you. Really, I wish you a LOT of luck.

rosequartz 02-24-2010 08:53 PM

Re: transvaginal ultrasound & endometrial biopsy
[QUOTE=mycatsmom;4192348]Thank you all for your input. Personally, I don't ever intend to go anywhere NEAR a gynecologist, or any of their lab people, as long as I live. Maybe I'll just avoid all doctors. You know, once bitten twice shy....well, I've been bitten a few too many times. Any trust I may have once had in the medical industry is long gone. But good luck to the rest of you. Really, I wish you a LOT of luck.[/QUOTE}

find a different one if you don't like your current doctor. get a referral from a friend or something....please please please go for this ultrasound. I promise you it's sooo easy! Don't take chances on your health please...this is so simple and I'm the biggest chicken out there.

Kszan 02-24-2010 09:14 PM

Re: transvaginal ultrasound & endometrial biopsy
You asked if a biopsy is supposed to be painful: Absolutely.
You asked if a transvaginal ultrasound is painful: No

There's no reason for you not to do it. I do think you should find a new doctor. It's weird that she would do a biopsy before an ultrasound. To me that doesn't make any sense. Why do a biopsy when you haven't even looked to see what's happening with an ultrasound?

I had a lot of spotting between periods which ended up being the polyps. Look at the posts about removal of polyps, I'm sure I've posted my story in most of them. If it's a polyp, it's a simple procedure to get it snipped off, all done under anesthesia. I was really afraid before the first time I had it done. It was not a big deal. Second time I was still a little scared but it wasn't that bad. The third time I was like ok whatever. Fourth time I was like ok, let's get this overwith because I'm over it. I'm not a doctor but I do know what my experience has been and I'm telling you the first tell-tale sign I had of the polyps was spotting between periods. Then it was overly heavy periods and more painful cramps. So, now when my periods get overly heavy, I go in for an ultrasound and find a polyp and get it removed. My gyne told me that it's rare for women to have them grow back after they have been removed. I just happen to be one of the lucky ones who keeps getting them.

I realize you're scared because of previous experience, but you need to take my word for it. The ultrasound is nothing. It's nothing worse than you putting in a tampon except it's just bigger. That's it. No needles, no snipping anything no incisions of any kind. I'm sure you've used tampons in the past, you know what that feels like. It's no worse than that. For you to not go just because you're scared is really silly. There's nothing to be afraid of! I wish you would have come here first before the biopsy so people here could have told you to expect the biopsy to hurt. Your doctor was wrong to tell you it wouldn't. You need to find a new doctor and get this checked out.

Polyps are rarely if ever cancerous in pre-menopausal women. But they are truly annoying and they need to be removed anyway. You're better off finding out if that's what you've got and get it taken care of sooner rather than later. Do you want to put up with spotting from now til eternity? It's going to put a damper on your life if you do. All because you didn't want to get a simple ultrasound done. Don't be like that. There's absolutely no reason for you not to get it. I can't think of any reason why it would be painful because they are no needles involved and no removal of tissue at all.

Mel52 02-24-2010 09:47 PM

Re: transvaginal ultrasound & endometrial biopsy
transvaginal ultrasounds are not painful at all. The worse part, like someone wrote, is having the legs up in those dang stirrups. The technician keeps you covered and looks at the screen the whole time. No biggie at all.
Ultrasounds with a full bladder can be annoying because you have to feel like you have to go so badly and you have to wait. If you have something going on, like I did, A dermoid cyst, it was uncomfortable.

estria 02-25-2010 05:11 AM

Re: transvaginal ultrasound & endometrial biopsy

Yes I remember going through my biopsy and it was not pleasant. My doctor had to use a clamp to keep the cervix open and this is what hurt the most. Felt like an extremely sharp needle being inserted into my skin. The tighter the cervix (ie. if you have not had children) the more painful the biopsy. Before I went for mine, I read up on the procedure and took 2 ibuprofen one hour before so as to negate the cramping. Doctors should suggest this to patients but they don't. I had absolutely no cramping after the procedure whatsoever ... just spotting for a few days. Of course my poor cervix felt like someone had stretched it out of shape and this took a few hours to feel normal again. All that said, the biopsy is very important so as to rule out the possibility of endometrial hyperplasia or even uterine cancer.

As for the ultrasound, are you having an external ultrasound or an internal one ? The external one is just having some jelly put on your pelvis and a wand slid across it. For the internal one, the wand is placed in the vagina .. it is a small wand and when I had mine, it was painless. For the external, you have to drink 32 ounces of water an hour before the procedure and not go to the bathroom. For the internal, you have to empty your bladder beforehand (ie. the opposite). The ultrasounds are nothing compared to the biopsy so I don't think you need to worry.

The ultrasound will look at the thickness of your endometrial lining to see if perhaps a very thick lining is causing your spotting. If you have a choice, try to go for the US around the time of your period (if external) or a few days after the start of your period (after most of the bleeding is done if internal). This will reduce the risk of them seeing ovarian cysts on the US. Ovarian follicles (or cysts) are completely normal things that come and go with your cycle. During your menses is when you are the least likely to see them as this is when your body withdraws hormones in order to clean out your uterus (ie. your period).

Just go for the ultrasound. Yeah the spotting is probably not life threatening but you still want to find out why it is happening. Thickened uterine linings over a long period of time can turn into endometrial hyperplasia and then possibly cancer. Simply cleaning out a thickened lining (either by taking progesterone or with a D & C) can prevent all of that. If this is what you have, you could possibly be preventing a future serious problem from occuring.

Hope this helps ... oh and after the ultrasound, be sure to clean out your bellybutton from the vaseline (if an external one).



ar1642 02-25-2010 07:01 PM

Re: transvaginal ultrasound & endometrial biopsy
I've had two transvaginal ultrasounds and they have not been painful at all. Awkward and uncomfortable, but not painful.

mycatsmom 02-25-2010 08:15 PM

Re: transvaginal ultrasound & endometrial biopsy
[QUOTE=ar1642;4193096]I've had two transvaginal ultrasounds and they have not been painful at all. Awkward and uncomfortable, but not painful.[/QUOTE]

ar1642, I've also heard pap smears described as "uncomfortable". To me they are "excruciating". Anyway, it's a pointless discussion now since I've already canceled the appointment. But thanks to all those who took the time to write.

Kszan 02-25-2010 10:08 PM

Re: transvaginal ultrasound & endometrial biopsy
I don't know who told you that a pap is merely uncomfortable but I'm telling you I've never had a pap smear that didn't hurt. It caused pain. Maybe some women have a higher threshold for pain but not me. I can't handle pain, not at all. But somehow I managed to live through a tonsillectomy at 32 yrs old, a kidney stone attack at 33 and a gall bladder removal at 34, not to mention 4 separate polypectomy/D&C's. All of these surgeries happened since 2006. And I lived to tell about it.

The ultrasound does not hurt. Not at all. I think you're overreacting to cancel that appointment. If you were getting a biopsy or a pap smear I'd be totally honest and say that yes it hurts, you should expect some pain. But an ultrasound?? I'm telling you there's no pain involved. What are you so afraid of? Why are you so afraid of something that feels no different than you sticking in a tampon? I'm telling you you're totally overreacting. If it was painful I would tell you flat out because I'm not in the business of lying to people about stuff like that.

I got a tattoo a year ago. Me, the person who is so terrified of needles that I get a full blown panic attack while waiting to get in IV put in. But I went and got a tattoo because I wanted to prove to myself that I could do it. Did it hurt? Hell Yeah it totally did! Anyone who says it doesn't hurt is totally lying to you! By the same token, I'm telling you right now that there are certain procedures that hurt and certain ones that don't. And the ultrasound does not hurt.

I don't understand this. I can't understand why someone would rather live with having daily spotting ongoing for who knows how long having who knows what going on in the uterus causing it, rather than to go in for a simple test that doesn't even hurt to figure out what's wrong. That makes no sense to me. Sometimes in life we have to submit ourselves to tests that we don't necessarily want but that will help diagnose our problems. Without the proper diagnostic tests, no treatment can be given. I can't believe you would rather not know what's wrong than to go get this simple test done. It makes no sense to me.

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