Cystic or simple hyperplasia progresses to cancer in less than 5 percent of patients. Most authors recommend a follow-up endometrial biopsy after three to 12 months, regardless of the management strategy. Atypical complex hyperplasia is a premalignant lesion that progresses to cancer in 30 to 45 percent of women. The Catheter Won't Go Up into the Uterus Easily in Perimenopausal Patients . The internal cervical os may be very tight in perimenopausal and menopausal patients.
Osmotic dilators cause gentle, slow opening of the cervix.
The osmotic dilator is removed in the afternoon, and then the endometrial biopsy can be easily performed. Patients Report Cramping Associated with the Procedure . Intraoperative and postoperative cramping frequently accompany instrumentation of the uterine cavity. Spraying the cervix with a topical anesthetic, such as 20 percent benzocaine, can also help with discomfort. The Procedure Should Not Be Performed in Pregnant Patients .