Some cramping may occur as a pipel is passed into through
the cervical os and into the uterus.
Have some motrin handy, check with MD about administering dose.
There will be spotting afterwards, so have a clean pad ready
to give to the patient.

The pipel may disturb the lining of the uterus, so
it would be good to make sure a pre-menopausal
woman is not pregnant prior to the procedure.

We usually do this on post menopausal bleeding patients.
It can be reassuring that the biopsy does not contain cancer.

Sometimes the doctor asks for a "Single Tooth Tenaclum".
This helps stabilize the cervix when the pipel is being passed.
If the os needs dilated, you may be asked to provide a thin dilator
that will help strech the opening to get the pipel through.
It is not too tramatic because they will stop and say they
have to do it in the OR if it is too hard to pass in the office.

Take a peek at the instrument photo.
The single tooth tenaculum (don't EVER say "pincher")
is on the lower right and the dilators are in the lower middle photos.
If they are used, then the dirty bin drawer is ususally employed.
Keeping instruments out of sight most of the time helps patients stay relaxed.

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