How is curettage surgery performed? Contraindications to diagnostic curettage of the uterine cavity

Diagnostic curettage of the uterine cavity; many women know what this procedure is. This is what is popularly called cleansing the uterus. This procedure is performed for the purpose of diagnosis, as can be understood from the name, and treatment of certain gynecological diseases. Let's take a closer look at what indications diagnostic and therapeutic curettage of the uterine cavity has, how painful it is, and how the body recovers after it.

Hyperplasia and endometrial polyp

Hyperplasia, in short, is excessive growth of the uterine mucosa. Occurs in women of reproductive age mainly due to an excess of the hormone estrogen. An overabundance can occur when taking certain hormonal medications and as an independent phenomenon.

Endometrial hyperplasia can be diffuse or focal; this is when a polyp forms in the uterus. Symptoms of the disease are intermenstrual bleeding, heavy menstruation, and often infertility. But although hyperplasia in young women very rarely turns into cancer, it needs to be treated. A diagnostic curettage of the uterine cavity is performed for endometrial hyperplasia. As a result, the pathologically overgrown endometrium and focal formations in the uterine cavity, if any, are removed. The material is sent for histological examination. If everything is normal, no atypical cells are found, oral contraceptives are prescribed. The duration of their appointment will depend on the patient’s personal wishes and reproductive plans. The tablets can be taken for a long time without any complications. If you plan to become pregnant, it is usually recommended to take it for three months, and then, while discontinuing the drug, to become pregnant. It is believed that it is easier to get pregnant this way, since ovulation will most likely occur when the drugs are stopped.

Oral contraceptives prevent hyperplasia and benign ovarian tumors.

Doctors pay special attention to patients who have already reached menopause, but for some reason the endometrium continues to grow. This may indicate an oncological process. Without curettage, it is impossible to make a diagnosis and decide on further treatment tactics.

Separate diagnostic curettage of the uterine cavity (RDC), the first word in the name of the procedure means that material is taken not only from the uterine cavity, but also from the cervical canal, first from it - this is a very useful procedure if it is performed to remove a polyp or submucous fibroid . Since these neoplasms can play the role of intrauterine contraceptives and do not allow the fertilized egg to penetrate the endometrium for further development.

By the way, a polyp can not only be hormonally determined, but also be a consequence of an incomplete miscarriage. In this case, according to histology, a diagnosis of “placental polyp” is made. Moreover, sometimes women do not even understand where it came from, this polyp, if there were no pregnancies, there were no delays. It happens that pregnancy is terminated almost immediately after implantation of the fertilized egg into the wall of the uterus. Therefore, there are no symptoms. But such a “gift” in the form of a polyp may remain.

Diagnosis of endometriosis (adenomyosis)

Endometriosis is a disease in which cells from the endometrium, the inner layer of the uterus, spread into the muscular layer of the uterus or beyond the main reproductive organ. If endometrial cells invade the inner layer of the uterus, lesions form. In this case, the disease is called adenomyosis. Women often experience uterine bleeding and pain during, before and after menstruation. Menstruation is always profuse. But the most important thing is that with widespread adenomyosis it is very difficult to get pregnant.

How is the diagnosis made? The doctor can guess it based on the symptoms. In general, adenomyosis is a very common pathology among women of different ages. If an ultrasound confirms its probable presence, plus endometrial pathology, then the woman may be offered an examination. Diagnostic curettage of the uterine cavity is indicated for such problems, but to identify the prevalence of adenomyosis, it would be better to perform this procedure under the control of hysteroscopy - with a visual examination of the uterine cavity using a special device.

It is not possible to completely get rid of adenomyosis during reproductive age. Its symptoms will disappear only with pregnancy. And they will disappear completely - with the onset of menopause or after removal of the uterus. But you can significantly improve your condition and increase your chances of pregnancy if you take hormonal medications prescribed by your doctor according to special regimens. Some of them put a woman into artificial menopause, but this is part of the healing process. After this, the foci of adenomyosis become smaller, and pregnancy may occur.

Uterine fibroids

Diagnostic curettage of the uterine cavity for fibroids is performed in two cases:

if the tumor grows inside the uterus, that is, it is submucous, it can be removed through the vagina;
if there is a suspicion of endometrial pathology;
this procedure is performed before removal of uterine fibroids to ensure that there is no endometrial cancer.

But diagnostic curettage of the uterine cavity and cervical canal is useless if the doctor wants to make a diagnosis between fibroids and sarcoma, and the tumor itself is located in the muscular layer or even grows on the uterus, that is, it is subserous. Even if the histology is good, it is not a fact that it is not sarcoma. At the initial stages of development of a malignant tumor, its cells in the endometrium may be absent.

In general, distinguishing fibroids, a benign tumor, from sarcoma, a very aggressive, malignant tumor, is a difficult task even for an experienced physician. In most cases, the main difference is the very rapid growth of the tumor. When it grows literally a centimeter per month. For sarcoma, the entire uterus is removed, and often the appendages along with it. Uterine sarcoma is a rare finding in young women. It is most often diagnosed in women over 50 years of age.

Removal of uterine fibroids is carried out not only because of the rapid growth of the tumor and its significant size, but also if it interferes with conception. This happens with submucosal, submucosal fibroids. Just to remove it, the woman undergoes a so-called hysteroresectoscopy and immediately diagnostic curettage.

Before the procedure

In the case of a planned intervention, a woman first undergoes blood and urine tests, a smear for flora, must undergo an ECG and visit a therapist with all the results. Such “difficulties” are necessary because the procedure will most likely involve general anesthesia. And there are many contraindications for its implementation. The anesthesiologist must know everything about the health of his patient in order to give her the safest possible anesthesia.

At the same time, the results of smears are important. If they are bad, the procedure may be postponed. The only time the results of smears are not taken into account is during emergency cleaning. It is performed, for example, in case of heavy intermenstrual bleeding in order to stop it. But after the procedure, antibiotics are necessarily prescribed.

Possible complications and consequences

Immediately after the procedure, the woman will have to recover from anesthesia. This can last up to three hours. You should not get up on your feet earlier than two hours after scraping, as you will feel dizzy.

There may be nagging pain in the uterine area. You can remove them with any antispasmodic quite quickly.

Discharge after diagnostic curettage of the uterine cavity continues for several days. And sometimes they can be quite intense, especially if the procedure was more therapeutic, for example, if a woman had a polyp or fibroid removed. As with menstruation, at first the discharge will be bright red, gradually it will become less, its color will be brown, and finally it will end in a light spotting. Sometimes complications occur during diagnostic curettage of the uterine cavity in the form of severe bleeding. Then the woman is prescribed a hemostatic drug: “Vikasol”, “Ditsinon”, “Tranexam”, etc.

And if you do not take antibacterial drugs prescribed by your doctor, endometritis, inflammation of the uterus, leading to the formation of adhesions and infertility, may occur. At the same time, the woman is also prescribed antifungal tablets for the purpose of prevention; they will protect against thrush, which will probably appear otherwise while taking antibiotics.

Another common complication is cervical injury. They may arise due to its mechanical damage as a result of careless use of instruments by the doctor. For example, if the bullet forceps, which are used to pull the cervix downwards before its instrumental dilatation, are torn off. As a result, a woman experiences isthmic-cervical insufficiency and miscarriages in late pregnancy.

Recovery process

Menstruation after diagnostic curettage begins at different times. They depend on what day of the cycle the intervention took place. Usually doctors prescribe the procedure for the last 1-2 days of the cycle so as not to disrupt the cycle. In this case, menstruation should be expected after about 30 days.

If you start taking oral contraceptives, then bleeding will begin within a week after taking the last, 21st tablet from the package. Starting to take contraceptives is 1-5 days after cleansing.

Sometimes there is a delay in menstruation - this may be the consequences of diagnostic curettage of the uterine cavity. If the procedure is performed too carefully, intrauterine synechiae and adhesions may form; this is the result of endometrial trauma. Symptoms: prolonged absence of menstruation or very scanty discharge. Surgical treatment - dissection of adhesions.

Pregnancy can be planned 3 months after the procedure. Typically, this is the period gynecologists advise their patients to wait.

After examination by a gynecologist, the patient may be referred for curettage of the uterine cavity, but what is this? Among themselves, women call this process cleansing. Curettage is a surgical procedure to clean the uterus and cervical canal.

The uterus is the middle section of the reproductive system, a pear-shaped organ that contains a small cavity connected to the cervix. In this way, the organ controls the external environment of the vagina. The main function of the uterus is bearing offspring.

The inside of the organ is covered with a special layer called the endometrium. During menstruation, it is rejected if pregnancy does not occur. Cleaning the uterus involves partial removal of the lining of the uterus, almost the same as during menstruation, only using special tools. After the procedure, the endometrium grows again.

What is cervical canal curettage and why is it needed? Cleaning is carried out precisely from curettage of the cervical canal to the functional layer. A small part of the material is sent for a separate study. This procedure is necessary for severe uterine bleeding, to remove cervical polyps, or if any abnormalities are suspected.

Gynecological cleansing can be carried out in two ways:

Separate diagnostic curettage (RDC). During this procedure, the surface is first removed from the cervical canal, and only then the endometrium is dealt with. After surgery, the patient is considered healthy, since the doctor removes all formations for which curettage was prescribed.
Separate diagnostic cleaning under hysteroscopy control is one of the new techniques in gynecology. Conventional RDV is carried out without observing that instruments are removed, and RDV+GS is carried out with the help of direct control of the operation. First, an endoscopic device is inserted into the uterus, then the uterus is scraped out and then checked. This technology allows you to check the degree of purification, as well as find out whether any anomalies remain.

Indications

Gynecological cleansing is needed to obtain biological material, study it, and also to remove pathological processes that have formed in the cervical canal or endometrium.

Curettage is carried out for the most part precisely to determine the diagnosis. Ultrasound diagnostics do not always accurately differentiate or help establish the name of the disease. Sometimes ultrasound is performed twice: before and after menstruation. All kinds of formations are rejected along with the endometrium; if this does not happen, then this indicates pathological processes. In this case, the woman is sent for cleaning of the cervical canal and cervix.

Curettage of the uterine cavity is performed in cases of heavy menstrual bleeding, a woman’s inability to become pregnant for six months, and also in case of an unclear reason for poor health. Other causes include abnormalities in the cervix and routine cleaning due to fibroids, while the uterus is preserved.

First of all, the indication for curettage is benign formations on the mucous membranes, otherwise known as polyps. Their peculiarity is the lack of response to treatment with pharmacological drugs. Polypoid growths can only be removed through surgery.

In addition, the procedure is prescribed for endometrial hyperplasia - this is an abnormal condition of the uterine mucosa, in which the structure and shape of the endometrium changes by enlarging cells.

Women during menopause are characterized by uterine hemorrhages and cleaning in such cases is carried out only to stop the bleeding. Cleaning also takes place after a miscarriage or abortion occurs.

Preparation

Preparation for curettage of the uterine cavity is an important and responsible task, which is carried out as intended (planned) or in emergency cases. If the procedure was planned, then it begins to be done at the same time when the endometrium itself should have begun to be rejected. In case of removal of polypoid growths, cleaning is carried out after menstruation, so that the exact location of the formation is known.

Gynecological curettage is rarely performed in the middle of the menstrual cycle, as this leads to prolonged bleeding. This process is explained by the fact that the growth of the endometrium and follicles are connected. And as a result, when the uterine mucosa is removed ahead of schedule, the functioning of the ovaries and hormonal levels is disrupted.

Preparation for cleaning the uterus includes the following tests:

complex analysis of blood clotting indicators;
general blood test;
electrocardiogram;
HIV test;
analysis for hepatitis B and C;
smear on flora.

At the appointed time before the procedure, you cannot eat and you need to remove pubic hair. Bring a robe, pads, and slippers with you.

Procedure

Patients are interested in how uterine curettage is done. In the office there is a chair similar to a gynecological one, where gynecological cleaning will take place. Before the procedure, you need to take a survey to find out if there is any allergy to the active ingredients of the drugs. Anesthesia is administered intravenously, and the duration of the entire operation is a maximum of 30 minutes. After curettage, the patient is transported to the ward, where she wakes up.

As instruments for the operation, the doctor uses a speculum, Schroeder forceps, an iron stick, dilators, and a curette. When separate diagnostic cleaning is used under hysteroscopy control, a tube with a camera is inserted after the uterus is dilated.

How is the uterus cleansed? The doctor treats the external genitalia with an antiseptic, then inserts a speculum to open access to the cervix. The next step is to open the cervix using dilators to gain access to the endometrium.

Using a curette, the doctor performs curettage, while he carefully inserts instruments along the inner layer of the uterus, removing it. When curettage using an endoscope, the doctor sees the uterus on a computer monitor, which allows you to remove only the affected areas of the endometrium without affecting healthy ones.

Many patients are interested in how long they need to stay in the hospital after curettage. Curettage is a serious intervention that can lead to many serious consequences. Therefore, gynecologists recommend spending at least a week in a hospital setting.

At this time, the woman is prescribed to take antibiotics and vitamins. The doctor monitors the woman’s condition throughout the recovery period. Before discharge, an ultrasound examination must be performed.

Consequences

Currently, gynecological curettage is considered not the best method of therapy, especially if it is performed blindly, without the use of endoscopic equipment. The fact is that any careless movement by the doctor can lead to the formation of scars or fistulas. In addition, such a rough impact on the internal cavity of the uterus increases the risk of developing serious complications:

Trauma to the cervix, its tear.
Perforation of the uterus.
Infection of the uterus and cervix with subsequent inflammation.
Damage to the growth layer of the endometrium, which subsequently disrupts the process of growth of the uterine mucosa and causes infertility.
The risk of bleeding increases.

Gynecological curettage will most likely not cause harm if the woman prepares for it correctly and does not refuse hospitalization after surgery. It is especially important to follow the advice of a doctor for women who have undergone a cleanse to terminate a pregnancy. The fact is that the pregnant body becomes many times more vulnerable to infection and the occurrence of inflammatory diseases.

Collapse

Curettage of the uterus is a traumatic procedure for removing the endometrial layer using a loop or other surgical instruments. This procedure can be therapeutic or diagnostic; the first is usually more extensive. But regardless of the type and purpose of the procedure, the recovery period after such an intervention is quite long, and it must be carried out correctly so that no consequences or complications arise. How rehabilitation proceeds after cleaning (scraping) of the uterus will be discussed in this material.

Duration of the period

Strictly speaking, such an intervention is not considered a surgical operation, although in fact it is traumatic, and during it a large wound surface is formed. For example, after curettage to remove cysts or in case of endometriosis, almost the entire inner surface of the uterus becomes the wound surface, since the endometrium is removed from the entire surface.

Scraping

Recovery after curettage has a number of normal characteristics. If there is a deviation from the norm, it is recommended to immediately consult a doctor. Normally, during this period the following may be present:

Pain in the lower abdomen associated with contraction of the uterus after curettage;
Minor bleeding;
Feelings of nagging, aching pain in the back.

Such symptoms may be present only in the first few days. If it persists after a week, then you need to consult a doctor. You should also do this if there is heavy bleeding and excessively intense pain, or if you have a fever after cleaning the uterus.

During this period, it is necessary to reduce physical activity, which will have a good effect on your well-being. You cannot steam in the bathroom; hygiene must be maintained with the help of a shower. At the same time, it is better not to use chemical products for intimate hygiene, medications administered vaginally, tampons and douches. Avoid overheating - do not visit saunas, steam baths, solariums, the beach, do not swim in open reservoirs and pools, carefully observe hygiene.

Drugs

Treatment after curettage of the uterine cavity involves taking medications. They are not aimed at directly promoting the growth of the endometrium, since this is not necessary - this is a natural process that occurs physiologically. The medications are taken in order to improve the patient’s condition and well-being, avoid relapses of the disease, and also prevent the development of severe consequences and complications, such as infection.

Antispasmodics

Antispasmodics after uterine curettage should be prescribed with caution. This is due to the fact that after this procedure the uterus contracts, pushing out excess endometrium and rejecting its remains. This is a normal physiologically determined process in this situation, but it causes quite severe pain in the lower abdomen, which persists in the first days after the intervention.

It can cause quite severe discomfort to the patient, but it is not advisable to relieve it with antispasmodics, because if the uterus does not contract, the healing process may be delayed. In severe conditions, No-shpa and other drugs are prescribed.

Diagnostic curettage

Antibiotics

Antibiotics are always prescribed after curettage of the uterine cavity. They are taken in a course of five to ten days, one or two tablets per day, depending on the selected drug. Depending on the patient’s condition, the course may begin on the day of cleaning or a day or two earlier.

Why are antibiotics prescribed at all? It is necessary to drink them in order to avoid any concomitant infection. The fact is that with this intervention not only a wound surface is formed, but also local immunity is greatly reduced. All this together significantly increases the likelihood of developing an infection in the uterus. To prevent this, strong broad-spectrum antibiotics are prescribed, such as Tsiprolet, Ceftriaxone, Amoxiclav, etc.

Herbs

How to restore the uterus after curettage? In general, it is able to recover on its own; this is a normal process, similar to the restoration of the endometrium after menstruation, when it is almost completely rejected and renewed. The growth of the mucous layer within the cycle and after curettage occurs under the influence of the hormone estrogen produced by the ovaries. The more it is, the more actively the endometrium grows.

Estrogen preparations can cause hormonal imbalance, but the use of herbs rich in phytoestrogens (plant analogues of estrogen) has a very beneficial effect. You can drink decoctions and infusions from boron uterus and red brush. Borovaya uterus after curettage is especially indicated, as it contains more phytoestrogens than other herbs.

Anti-inflammatory drugs

Anti-inflammatory drugs are not always prescribed, but in most cases they are still indicated. They are needed for approximately the same thing that antibiotics are needed for - to prevent the development of the inflammatory process on the wound surface. Drugs such as Nurofen and Ibuprofen are prescribed, which are taken 2-3 tablets per day for a week, starting from the day of the procedure. For the same period, Diclofenac can be prescribed by injection. In addition to the direct anti-inflammatory effect, they are also good pain relievers.

If a temperature appears after curettage, this may indicate the onset of an inflammatory process. Therefore, it is necessary to immediately consult a doctor.

Intimate life

You can have sex a week after the procedure, but it is better to coordinate this with your doctor. In addition, if the patient experiences pain during sexual intercourse, she should immediately consult a specialist. It is important to carefully maintain hygiene and use barrier methods of contraception to prevent various infections from entering the uterine cavity.

Sport

You can play sports as usual about a month after the intervention. At the same time, you can return to light exercise, such as gymnastics or aerobics, earlier - after about a couple of weeks. The time to start playing sports should be discussed with a specialist, since much depends on the individual characteristics of the body and the speed of healing.

Example of a daily routine

For quick recovery, it is important to properly balance work and rest modes. Ideally, you need to sleep at least 8 hours a day, work no more than 8 hours, and rest at least 8 hours. At the same time, if the work involves physical activity, then you need to take sick leave for at least a few days after the procedure. If the work is not physically difficult, then, usually, you can return to it the next day. But this must be agreed with your doctor.

Diet example

You need to eat natural, healthy foods, avoiding fried, fatty and smoked foods. An example diet could be like this:

Breakfast - yogurt or cottage cheese, egg, whole grain bread, weak coffee;
Second breakfast - fruit;
Lunch – vegetable or low-fat meat soup, side dish of cereals and white low-fat fish, tea;
Afternoon snack – fruit lard, kefir, or yogurt;
Dinner – vegetable side dish and chicken breast, rosehip decoction.

It is advisable to include foods rich in phytoestrogens in the diet - corn, soybeans, yams.

Pregnancy

Pregnancy after curettage is possible, and often even more likely if the pathological endometrium was removed. Usually, menstruation begins around the third week after the procedure, since during this time the mucous layer of the uterus has time to recover. In this case, the menstrual cycle is completely normalized and becomes regular after about 4 months. In general, it is possible to plan conception within six months after the procedure, but before starting attempts, it is better to consult a doctor.

Progress of the intervention

Conclusion

Curettage is a traumatic but necessary procedure. You cannot avoid it if it was prescribed by a doctor, as it can have unpleasant health consequences. Provided that the recovery period is carried out correctly, complications after curettage are extremely unlikely, and this procedure only has a positive effect on health.

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Cleaning the uterus (curettage or curettage) is a very common surgical intervention. Information preparation before this manipulation will allow the patient to calm down, be confident in its necessity and learn about all the nuances of the intervention. A woman should not be afraid of curettage, since in modern gynecology this procedure is painless, and its complications are extremely rare.

If the patient has been prescribed a cleaning, there is nothing surprising about this. With curettage, you can identify various diseases of the uterus, remove a pathological process, or stop bleeding that debilitates a woman. There are two types of scraping:

diagnostic;
medicinal.

The main function of the uterus is to bear the fetus. The inner uterine layer is called the endometrium and is a protective mucous membrane. Every month, cyclical changes occur in the uterus of women of reproductive age. At the same time, the endometrium grows, preparing for the possible fertilization of the egg and its consolidation. If pregnancy does not occur, the endometrial cells are shed, accompanied by menstruation.

Cleaning the uterus for the body looks like artificially induced menstruation. To do this, the uppermost uterine layer is removed using medical instruments or a vacuum system.

When curettage is performed correctly, only the functional uterine layer is removed, which is quickly restored. The basal uterine layer is not affected.

After cleaning, a layer of the endometrium (germ) remains in the uterus, which quickly grows and is restored. Recovery after cleansing occurs within the normal time frame for the monthly cycle.

The tissue obtained from scraping is sent for examination.

What is the purpose of scraping?

Typically, uterine curettage is performed for the following reasons:

for histological examination and clarification of the presumed diagnosis;
to remove pathologies in the cavity or cervix.

In what cases is cleaning done for diagnostic purposes, and in what cases is it performed for treatment?

Diagnostic curettage is performed when:

formations on the cervix;
long periods with clots, or bleeding outside the cycle;
infertility of unknown cause;
before operations in the uterine cavity;
suspected oncological processes;
after changes in the mucosa, confirmed by ultrasound and not disappearing after menstruation.

Curettage for therapeutic purposes can be performed in situations:

polyps on the uterine mucosa that do not disappear after drug treatment;
hyperplasia (excessive growth of the endometrium) of the endometrium (the only method of treatment);
uterine bleeding (for various reasons, including unknown ones);
incomplete termination of pregnancy;
inflammation after an abortion or after spontaneous miscarriages;
dissections during fusion of the uterine walls;
treatment of endometritis.

Contraindications

For any surgical intervention, there are general contraindications in the form of infectious diseases with high fever, acute inflammation, and severe general ailments.

Curettage is also not performed for some gynecological diseases or conditions:

normal pregnancy;
malformations or infectious processes of the uterus;
deforming tumors;
less than 6 months after termination of pregnancy.

The doctor always decides about the possibility of curettage for a woman.

Types of curettage

There are two main types of curettage commonly used:

Separate. With this method, the cervical canal is first scraped out, and then the uterus itself. It makes it easier to make a correct diagnosis and is often combined with hysteroscopy, where an optical device is inserted into the uterus. This method makes the procedure safe and reduces the risk of complications
The usual method of curettage is with surgical instruments. This manipulation is performed blindly and can cause damage to the uterus.
Vacuum cleaning. This is a gentle method that minimizes trauma during intervention. It is used as a method of diagnosis, treatment or during abortion.

When to clean

It is undesirable to cleanse in parallel with the onset of menstruation due to the low information content of such research results.

It is also undesirable to clean the uterus at the beginning or middle of the cycle due to the friability of its mucous membrane and the risk of bleeding.

When cleaning at the beginning of the cycle or in its middle, there is a high probability of hormonal imbalance in the woman’s body. After all, the growth of the uterine mucosa occurs in parallel with the growth of ovarian follicles. If at this moment the uterine mucosa is suddenly removed, the work of the ovaries is disrupted - a contradiction occurs between the uterine and ovarian cycles.

How to prepare for curettage

Cleaning the uterus can be done for emergency reasons (for example, uterine bleeding). In this case, there is simply no time to prepare for this intervention.

If scraping is carried out according to plan, then preparation for it is mandatory.

Before curettage, a woman is usually prescribed tests:

general blood and urine analysis;
coagulogram (assessment of blood clotting);
for hepatitis, HIV and syphilis;
vaginal smear.

For curettage, the woman comes on an empty stomach, having shaved the hair in the perineum. The patient is advised to limit the amount of fluid and take with her pads, slippers, a disposable diaper, and clean cotton clothes (T-shirt, socks, robe).

What awaits a woman during curettage?

Of course, it is important for a woman to know in advance what to prepare for and what awaits her in the process of cleaning the uterus. Let's look at how scraping is done in general.

A woman enters the operating room and sits on a table similar to a gynecological chair.
The anesthesiologist clarifies the patient’s possible allergic reactions and past illnesses.
The woman is given intravenous drugs for short-term anesthesia. After that, she falls asleep and wakes up in the ward. The patient will not have to endure any pain. In addition, modern drugs are not accompanied by hallucinations or difficult recovery from anesthesia.

What manipulations does the patient undergo during cleaning?

Before the operation, a speculum is inserted into the woman to expose the cervix.
Using special “bullet” forceps, the gynecologist fixes the cervix to ensure its immobility at the time of intervention.
Using a probe, the specialist penetrates the uterus. Dilators are then used on the cervix until it begins to pass through the curette (curettage instrument). In this case, after scraping, the tissue is placed in a special container.
When using a hysteroscope (a device with a camera at the end), all uterine walls are examined. Then scraping is performed. After the procedure, the hysteroscope is reinserted to check the result. It is thanks to the hysteroscope that various pathological inclusions in the uterus (myomatous nodes, polyps, etc.) are removed. Usually, curettage lasts no more than 15-20 minutes.
After the operation, the vagina and cervix are treated with antiseptics. Ice is placed on the woman's stomach to prevent bleeding.

The woman is transferred to a ward, where she remains for several hours. After this (or the next day), the woman is often sent home.

Possible complications

Complications after cleaning are rare. To do this, curettage must be performed in a medical facility by a qualified specialist.

However, cleaning is an operation and may have complications. Rare but possible complications during curettage may include:

exacerbations of gynecological inflammation;
adhesions in the tissues of the uterus;
puncture of the uterus with surgical instruments;
neck tear;
damage to the mucosa;
leaving polyps, adhesions or nodes in the cavity that were planned to be removed;
hematometers (collections of blood in the uterus)

With careful manipulation, complications can almost always be avoided. Minor tissue damage heals on its own after cleaning. Only massive injuries to the cervix or uterus require surgical intervention. When inflammation or hematomas occur, drug treatment is used.

A serious complication of brushing is removing too much mucous. This condition often leads to infertility due to the inability of the fertilized egg to attach.

Vacuum cleaning of the uterus

The use of vacuum minimizes complications during interventions in the uterine cavity.

In addition to the diagnosis and treatment of gynecological diseases (hematometra, bleeding), vacuum curettage is very often performed for:

termination of pregnancy;
incomplete abortion;
removal of parts of the fertilized egg or placenta;
frozen pregnancy.

Scraping with the vacuum method is performed with special tips and a vacuum pump. At the same time, due to negative pressure in the uterus, pathological tissues are removed from the uterus.

The vacuum method is a safer and more gentle method of scraping. At the same time, the risk of hormonal disruptions and damage to the uterus or its cervix is minimal.

Complications with a vacuum are extremely rare, but they do happen. In addition to the usual complications of cleaning, air embolism is a complication after vacuum curettage.

Woman's behavior after curettage

After curettage, a woman usually experiences spotting for several days, associated with hormonal changes in the body. Typically, menstruation begins after a month and may differ slightly from normal (be shorter, sparser, etc.)

Abdominal pain is natural after cleansing, and you should not be afraid of it. Usually, for pain in the lower abdomen, it is recommended to use painkillers.

Protect yourself from hypothermia and physical exertion.
Avoid high temperatures (steam rooms, baths, saunas).
Maintain genital hygiene.
Give up sex for a month.

Doctors advise planning a pregnancy after cleansing no earlier than six months after an examination by a gynecologist.

Pregnancy immediately after curettage may result in miscarriage or intrauterine death.

In modern hospital conditions, a woman should absolutely not be afraid of cleaning. Thanks to this useful method, many gynecological pathologies can be identified and treated. Complications during the curettage procedure are extremely rare, and the intervention itself is painless for the patient.

Uterine curettage is a surgical procedure in which the top layer of the uterine lining is removed. The operation is performed with special instruments or vacuum. Often, in order to carry out cleansing, it is necessary to first expand the uterine cavity using instrumental or medicinal methods.

Nowadays, gynecological cleansing is done for both diagnostic and therapeutic purposes. Since general anesthesia is used for the procedure, sometimes hysteroscopy is performed along with it, during which the uterine cavity is examined and, if necessary, curettage of other areas is performed.

Many women are interested in in what cases curettage is performed, how long it lasts and how the recovery period goes. Let's look at these questions in more detail.

Types of curettage and indications for its implementation

There are two types of curettage: diagnostic and therapeutic. Diagnostic cleansing of the uterus is done if certain diseases of the reproductive system are suspected. It is prescribed if the following symptoms are present:

With this type of curettage, samples of the uterine lining are only taken, which are subsequently sent to the laboratory for histological examination. This analysis helps the doctor give the patient the correct diagnosis.

Therapeutic curettage of the uterine cavity is performed in the presence of certain diseases. These include:

Features of preparation, pain relief

Cleansing is often done 4-5 days before your period. This avoids large blood losses and shortens the recovery period.

Since curettage is a surgical procedure, you need to undergo some tests before it is performed. These include a complete blood count, blood clotting time, vaginal smear, testing for HIV, hepatitis and syphilis.

Preparation for surgery includes some other activities. 14-15 days before the procedure you need to stop taking any medications. If complete refusal is impossible, you should consult a doctor who will assess all the risks of using a particular drug. After all, there are drugs that can reduce blood clotting, increasing the likelihood of bleeding during surgery.

Preparation for curettage the day before it includes:

refusal of sexual intercourse;
carrying out intimate hygiene without the use of special means;
complete refusal of medications;
refusal to eat 12 hours before surgery;
performing an enema;
consultation with an anesthesiologist and a doctor who will perform uterine curettage.

How long the operation will last depends on the size of the pathological area. Often its duration does not exceed 20 minutes. The surgery is performed under general anesthesia.

Anesthesia is performed only by an anesthesiologist. If the patient is hyperexcitable, sedatives are administered intravenously several hours before surgery.

Since the operation does not last long, and there is virtually no chance of stomach contents entering the respiratory tract, anesthesia is performed while maintaining natural breathing. The patient breathes on her own. At the same time, she is put on an oxygen mask. This type of anesthesia is called intravenous.

Intravenous anesthesia has a strong sedative effect, causing sound sleep and relieving pain. In Russia, general anesthesia is performed using ketamine, sodium thiopental, and propofol. Ketamine is used less and less because it is an old drug that can cause hallucinations. Such anesthesia will cause significant discomfort to the patient. The best choice today is anesthesia with propofol. The drug has a mild effect, causes easy sleep and has virtually no side effects.

Methodology, postoperative period

To detect the cervix, a speculum is inserted into the vagina. Then the neck is fixed using special forceps. This is done to keep the uterus still during the entire procedure.

Using a special probe, the doctor passes through the cervical canal, enters the uterine cavity and measures its length. After determining this parameter, the uterine cavity is expanded. For this purpose, special expanders of different thicknesses are used. The doctor inserts each of them one by one into the cervical canal. This expansion is continued until the diameter of the canal reaches a size into which a curette, a curettage instrument, can freely pass.

Then the upper layer of the lining of the uterus is scraped. Use the smallest curette. In appearance, it resembles a spoon with a long handle and one sharp edge. This is the part where the cleansing is carried out. A sample of the mucous membrane is placed in a special container and sent to the laboratory for histological analysis. If there is severe bleeding during surgery, a clamp is applied to the bleeding vessel.

In addition to instrumental scraping, vacuum cleaning is carried out. In this case, the mucous membrane of the uterus is sucked in with a special syringe. Vacuum cleansing is less traumatic and can sometimes be performed under local anesthesia. Such curettage is often performed after a miscarriage.

After surgery, the woman remains in the hospital. How much time she should spend in the hospital depends on the complexity of the operation and is determined by the attending physician. Usually the woman goes home after 1-3 days.

During the recovery period, you need to closely monitor body temperature and vaginal discharge. Spotting and spotting is considered normal. How long they last depends on the characteristics of the woman’s body. Discharge for no more than 10 days is considered normal.

If there is no discharge, but there is pain in the lower abdomen, you should immediately inform your doctor. Similar signs indicate a hematometra - the accumulation of blood in the uterine cavity when it is blocked. The cause of this condition is a spasm of the cervical canal.

To prevent the development of hematomas, in the first days after surgery you need to take no-shpu.

The doctor also prescribes antibiotics. They are needed to prevent infection and inflammation. The labia and vagina should be washed with antiseptics once a day during the entire recovery period.

There are cases when uterine bleeding occurs after curettage. In this case, copious amounts of blood are released from the vagina. It poses a threat to life and requires immediate stop. If the bleeding is not severe, oxytocin injections are given. Severe bleeding may require surgical control.

It is especially necessary to observe hygiene if curettage was performed due to a miscarriage. It is as a result of such cleaning that inflammatory processes often develop. There are cases when, after a miscarriage, a woman becomes infertile, and the reason for this is simple inflammation.

Uterine curettage is a surgical procedure during which the top layer of the uterine lining is removed. For pain relief, general anesthesia is used exclusively. Cleaning is often carried out after a miscarriage, as well as for certain diseases of the reproductive system. This is a fairly simple surgical intervention, but in order to avoid complications, the postoperative period should be under the strict supervision of a doctor.