Curettage of the uterine cavity (curettage) - what are the main goals of the procedure? Separate diagnostic curettage.

Uterine bleeding of unknown origin- such a diagnosis is made,
when it is difficult to understand what pathology is causing intermenstrual uterine bleeding

– a therapeutic and diagnostic procedure used for various pathologies in the cavity and cervix (cervical canal).

Hysteroscopy– a method of optical visualization of the uterine cavity mucosa during surgery.

Histology– laboratory examination of sections of biomaterial under a microscope to identify atypical cells.

Histological response– results of histological examination.

Malignant changes– presence of atypical (malignant) cells in the biomaterial.

Benign changes– changes not associated with atypia.

Consultation with a gynecologist-endocrinologist– necessary for further treatment based on histology results.

Dynamic observation– observation by a gynecologist once every 6 months for a long period.

Separate diagnostic curettage (RDC) at the Medservice clinic

Separate diagnostic curettage in the operating department of the Medservice clinic can be carried out under supervision hysteroscope, which greatly increases the efficiency and effectiveness of the procedure, reducing the likelihood of damage to the mucosa.
The procedure itself does not last long, 15-20 minutes. After the procedure, the patient is admitted to the ward, where she is under the supervision of a surgeon and anesthesiologist for 2-3 hours, then sent home. A hysteroscopy report and medications for antibacterial and anti-inflammatory therapy are issued. The histological examination takes a week to prepare.

A week after Russian Far East An ultrasound scan of the pelvic organs is performed. Based on the results of the histological examination, the doctor decides on the need for further therapeutic treatment.

Preparation for the Russian Far East

Before the procedure separate diagnostic curettage, as with any surgical intervention, a general clinical and laboratory study is carried out, which includes:

Clinical blood test;
Blood chemistry;
Determination of blood group and Rh factor;
Hemostasiogram, coagulogram (test for blood clotting);
Blood test for HIV, syphilis, hepatitis B and C;
Flora smear;
Smear for oncocytology from the walls of the cervical canal.

These tests can be taken at the Medservice clinic.

Cost of separate diagnostic curettage at the Medservice clinic

Type of service	Cost, rub.	What is included
Initial appointment with an obstetrician-gynecologist	2 000	Ultrasound, examination, consultation
Tests on the day of surgery	4 150	Hospital complex, coagulogram, smear
Anesthetic care	3 900	Intravenous anesthesia “Diprivan”. Monitoring vital functions during surgery
Separate diagnostic curettage without / /s	to points 1-3: +5 950/ +13950	Curettage of the cavity and cervix without/with visualization of each stage
Histological examination of material from the uterine cavity	2 000
Histological examination of material from the cervix	2 000	Test for atypical cells

Diagnostic curettage of the uterine cavity (or cleansing of the uterus) is a gynecological procedure during which the doctor uses special instruments to remove the tissue lining the inner surface of the uterine cavity. This tissue is called the endometrium, or the lining of the uterus.

The material obtained as a result of curettage of the uterus is sent for histological examination, which helps to clarify the diagnosis.

Who can undergo uterine curettage?

Indications for uterine curettage can be very different. In fact, curettage can be not only a diagnostic procedure (to clarify the diagnosis), but also a method of treating certain diseases of the uterus.

Diagnostic curettage of the uterine cavity may be prescribed in the following situations:

For uterine bleeding, the cause of which is not clear
During (during menopause)
If endometrial hyperplasia is suspected, and

Therapeutic (therapeutic) curettage of the uterus can be prescribed for the following conditions:

Incomplete miscarriage
Uterine bleeding unresponsive to medication
Bleeding soon after birth if there are portions of the placenta remaining in the uterine cavity

Contraindications to diagnostic curettage of the uterine cavity

Curettage of the uterus cannot be done in the following situations:

With a successfully developing desired pregnancy
For inflammation of the vagina or cervix
If you suspect an abnormal development of the uterus or cervix

How to prepare for diagnostic curettage of the uterine cavity

Before scheduling a uterine curettage, your gynecologist will want to make sure that you have no contraindications to this procedure. If you are sexually active, your doctor may prescribe regular or to eliminate any risk of pregnancy.

It is also necessary to pass before cleaning. In case of inflammatory diseases of the vagina or cervix, curettage can lead to the spread of infection to the uterine cavity (), which is fraught with serious consequences. If a smear on the flora reveals inflammation, then treatment is first prescribed. Only after receiving normal results from a repeat smear can curettage be prescribed.

The day before curettage, you should avoid sexual intercourse, douching and the use of vaginal suppositories (except in cases where the suppositories have been recommended by your doctor).

Since diagnostic curettage of the uterine cavity is performed under general anesthesia, it is recommended to refrain from eating 12 hours before the procedure. The anesthesiologist in charge of anesthesia will instruct you on how to behave before surgery to reduce the risks associated with anesthesia.

What happens during diagnostic curettage of the uterine cavity?

During curettage, you will lie in a gynecological chair with your legs spread apart and fixed, as during a regular gynecological examination. The doctor will then insert a speculum into the vagina, which will make it easier to access the cervix. In order to gradually expand the cervical canal, the gynecologist will alternately insert dilators of different diameters into it. Once the cervical canal is open, the doctor will insert a special curettage instrument, similar to a spoon, into the uterus and carefully begin to scrape the lining of the uterus, collecting the resulting material for further examination under a microscope.

If separate diagnostic curettage (RDC) is necessary to clarify the diagnosis, then before curettage of the uterine cavity, the doctor also scrapes the mucous membrane of the cervical canal.

As a rule, the entire procedure takes about 30-40 minutes.

Will it hurt?

Since uterine curettage is a painful procedure, it is almost always performed under general intravenous anesthesia. You will not feel anything during the procedure and will not wake up until the procedure is completed.

What happens after diagnostic curettage of the uterine cavity?

Immediately after the procedure, you will be transferred to a room where you can recover from the anesthesia. In the first few hours after cleansing, you may experience drowsiness, weakness and dizziness.

Bloody vaginal discharge can be quite profuse in the first few hours after curettage. Gradually, the discharge will become more scarce. Spotting after curettage of the uterus may persist for a week.

Pain in the lower abdomen after curettage of the uterus is also normal. As a rule, they resemble pain shortly before the start of menstruation.

Possible consequences and complications of uterine curettage

Complications after uterine curettage are rare. Some of the most common complications after cleaning include:

Severe uterine bleeding
Damage to the cervix
Penetration of infection into the uterus with the development of endometritis
Perforation of the uterus

Contact your doctor as soon as possible if you experience the following symptoms shortly after having your uterus curetted:

Heavy bleeding that requires you to change your pad every hour or more often
Increase in body temperature to 38.5C or higher
Severe abdominal pain for more than a day after curettage
Vaginal discharge with an unpleasant odor

When will menstruation begin after uterine curettage?

The next period after cleaning may be delayed by 1-2 weeks. Often, menstruation occurs only 4-5 weeks after curettage, and in some cases the delay can be several months. Contact your doctor if your period does not come 3 months or more after cleansing.

When can you get pregnant after uterine curettage?

You can get pregnant already in the first months after curettage of the uterus, however, gynecologists recommend postponing pregnancy planning for several months so that the uterine mucosa (endometrium) has time to recover.

Separate diagnostic curettage uterine cavity and cervical canal - a minor gynecological operation consisting of a total scraping of the mucous membrane lining the cervix and body of the uterus. Separate diagnostic curettage (SDC) is a type of biopsy performed to assess the condition of the endometrial scraping through histological examination. This procedure can also be performed for therapeutic purposes (for example, if there are suspected remains of parts of the fertilized egg, uterine bleeding).

Separate diagnostic curettage of the uterine cavity and cervical canal is performed to diagnose the causes of menstrual irregularities, endometriosis, endometrial hyperplasia, uterine fibroids, polyps of the cervical canal and uterine polyps, dysplasia and cervical cancer, endometrial tuberculosis, infertility, etc. When the rhythm is maintained. menstruation, curettage of the uterine cavity and cervical canal is carried out 2-3 days before the start of the next menstruation, in the case of acyclic uterine bleeding - during bleeding.

A contraindication for diagnostic curettage of the uterine cavity and cervical canal is the presence of general infectious diseases, pathologies of the kidneys, liver, heart in the stage of decompensation, infectious and inflammatory processes in the genital organs, as well as specific vulvovaginitis (trichomoniasis, gonorrhea, chlamydia, etc.).

Preoperative examination before the RDV includes general clinical tests, a coagulogram, blood tests for hepatitis B and, syphilis and HIV, blood group and Rh factor, smears for flora and oncocytology, ultrasound with a transvaginal sensor.

Curettage of the uterine cavity and cervical canal takes about 20 minutes and is performed under short-term intravenous anesthesia. The vagina is opened using speculum, exposing the cervix, then treated with iodonate solution. The cervix is fixed using bullet or two-pronged forceps. A probe inserted through the cervical canal into the uterine cavity determines the length and position of the uterine body relative to the cervix. First, the mucous membrane of the cervical canal is scraped. Then, using dilators, they begin to expand the cervical canal. A curette inserted into the uterine cavity is used to scrape the mucous membrane of the anterior and posterior walls of the uterine cavity, its fundus and tubal angles. After making sure that the endometrium has been completely scraped and there is no bleeding, the instruments are removed, the cervix and vagina are again treated with iodonate solution. RDV can be performed using a hysteroscope.

The removed mucosa of the cervical canal and uterus is placed in various containers and sent for histological examination. After curettage of the uterine cavity and cervical canal, the patient is in the clinic under observation for 2-3 hours.

If curettage of the uterine cavity and cervical canal is carried out poorly, tears of the cervix, instrumental perforation of the uterine wall may occur, excessive curettage of the endometrium may occur, and postoperative inflammation may develop. In order to prevent inflammatory processes after RDV, antibiotics can be prescribed.

After 7-10 days, the patient is again scheduled to appear at the clinic for an examination, ultrasound and treatment, taking into account the results of histology. Separate curettage of the uterine cavity and cervical canal is a highly informative diagnostic method, which is especially important in the initial forms of oncological processes.

Endometrial scraping often causes anxiety in patients, because they do not always fully understand how it is carried out, why it is needed and what it is fraught with. In addition, like any operation, cleaning is performed under anesthesia and poses some risk. Also, its outcome without complications largely depends on the qualifications and professionalism of the gynecologist who will carry out the cleaning. In this article we tried to talk in detail about the features of curettage.

What it is

As a rule, curettage is carried out before the onset of menstruation, when the cervix opens easily. The operation is performed on an empty stomach. The patient is given intravenous general anesthesia, which lasts up to half an hour; it does not provoke the appearance of dreams and hallucinations.

Cleaning procedure:

A speculum is inserted into the vagina.
The neck is secured with forceps.
The internal size of the uterus is measured with a special instrument.
Using expanders (metal sticks of varying thickness), the cervical canal is expanded to the size of a curette (a spoon-shaped instrument).
Cleaning occurs, and material for analysis is collected in a specially designed container.
It is possible to insert a hysteroscope into the uterus to examine the walls; if incomplete removal occurs, then the curette is used again.
The tongs are unfastened, processing occurs and ice is placed.
The patient is assigned to a ward, where she must lie for some time to ensure that there are no acute negative consequences.

Recovery period

The first time after curettage, there will be a significant release of blood clots, which will gradually decrease to spotting. This will go on a week and a half. If the discharge stops much earlier with the appearance of a strong tugging in the lower abdomen, you need to urgently contact a gynecologist.

After the operation, you must follow a certain regimen for a couple of weeks, in which the following is contraindicated:

perform sexual acts;
application
douching;
swim in the pool, open reservoirs, visit saunas;
take medications based on acetylsalicylic acid;
drinking alcohol.

After curettage, menstruation will begin with some delay; when they are absent after two months, you must definitely contact a gynecologist.

Did you know? In a calm state, the average depth of the vagina is about 10 cm; during sexual intercourse it can increase almost three times. It has also been established that each vagina has its own characteristic odor, which, moreover, can change during the day. A disease of a bacterial nature, for example, is indicated by a “fishy” smell.

Possible complications

When anesthesia is performed by an experienced anesthesiologist and curettage by a professional gynecologist, cleaning is tolerated quite easily, complications are extremely rare. But still, endometrial curettage is not safe, because it can lead not only to complications during surgery or immediately after it, but also to negative consequences much later. The main ones are:

uterine perforation(it is possible to pierce an organ with dilators or a probe due to poor dilation of the neck or loose tissue; minor perforations heal on their own, large ones are sutured);
cervical tear(this happens due to laxity of the neck, which leads to the slipping of the forceps when tension is applied and damage to the tissues of the organ; depending on the degree of damage, the tears heal on their own or are sutured);
inflammation of the uterus(an inflammatory process is possible if: cleaning is carried out when there is already existing inflammation, the level of antiseptic measures is insufficient, a course of antibiotics is not prescribed after cleaning);
hematometer(during the postoperative period, the uterus bleeds, but if the cervix is tight, it may close and will not be able to pass normally, which contributes to the formation of clots, inflammatory processes with pain);
curettage more than normal(if a layer thicker than necessary is scraped out, damage to the germ cells is possible, which can cause the inability to correct the condition and growth of new mucosa, its renewal - and, as a result, infertility).

With careful and competent cleaning there are no complications.

Important!Half a month after cleaning, you should definitely be examined by a doctor again.

Is pregnancy possible after the procedure?

After scraping a woman can become pregnant within a few weeks. But it is recommended to wait a few months to give the body, including the uterus, the opportunity to recover and get stronger. When it is not possible to get pregnant for six months or more, consultation and examination by specialists is required. Impaired ability to become pregnant is rarely detected after cleansing.

So, curettage of the uterine cavity is not a procedure with significant hazard. But this is still a surgical operation, the success of which depends on the qualifications of the surgeon and anesthesiologist, as well as on the physiological characteristics of the woman herself and many other nuances. Therefore, the issue of carrying out this operation must be approached with full responsibility.

Separate diagnostic curettage (abbreviated as RDV) of the uterus is one of the operational types of tests performed in the field of gynecology.

Separate diagnostic uterine curettage is a diagnostic procedure during which the doctor has the opportunity to take a sample of the endometrium to send it for laboratory tests. During the procedure, the doctor scrapes the inner surface of the epithelium of the uterine cavity and cervical canal.

Such intervention is mainly carried out at the very beginning of the menstrual cycle. Thus, doctors minimize the risk of bleeding. The purpose of this procedure is to collect biological material or rid the patient of the tumor process (in the initial stages). The obtained mucosal samples are used to clarify the diagnosis using histological examination.

Indications for RDV

This procedure is justified by obtaining data to confirm the presence of fibroids, dysplasia, endometrial hyperplasia, and cervical cancer. Menstrual irregularities are a reason for performing RDV of the uterus.

Separate diagnostic curettage can be carried out not only for diagnostic purposes, but also for therapeutic purposes. If during the RDV the doctor discovered polyps, fibroids, or cysts, these tumors can be removed using separate diagnostic curettage. The RDV of the uterus allows the doctor to carefully examine the condition of the uterine cavity, but also to determine with maximum accuracy the presence of diseases or pathologies of the uterus.

This procedure makes it possible to detect diseases or the presence of tumors at an early stage. This allows you to make an accurate diagnosis and begin timely treatment.

Thanks to in-depth analysis of samples obtained from the surface of the mucous membrane of the uterus and cervical canal, the presence of atypical cells can be detected in a timely manner. They may indicate the development of a number of ailments - hyperplasia of endometrial tissue, or their dysplasia, as well as the presence of fibroids, polyps, Asherman's syndrome (adhesions), active division of cancer cells, etc.

Is preparation necessary for the RDV procedure?

To begin with, specialists refer their patient to undergo a number of tests:

assessment of the level of blood clotting (by compiling a hemostasiogram and coagulogram);
Testing for STDs, including HIV;
Cardiogram, etc.

If any acute inflammatory processes, heart diseases, or the presence of infections (viral, infectious, bacterial, etc.) are detected, the operation is postponed until the identified ailments are completely eliminated. The same rule applies to patients who have heart, kidney or liver diseases.

The sequence of medical procedures for RDV

To begin with, specialists determine the type of anesthesia that is suitable for a particular patient. It can be general or local, it all depends on the evidence obtained during the preliminary examination. In the first case, the drug is administered intravenously. Well, when choosing a local type of anesthesia, the cervix is “needed”.

Then doctors begin to solve the following problems:

immediate preparation for surgery. To prevent infection, the vulva and cervix are treated using an aqueous solution of alcohol. Alternatively, in some cases, iodine (also diluted in a certain percentage) can be used;
To improve access to the equipment used, mechanical expansion of the cervical canal is used;
Using probes, the condition of the uterine mucosa is checked;
Collection of biological material. To solve this problem, a special device is used - a curette. And to avoid damage to the female organ being examined, doctors mainly use a hysteroscope. This device allows you to fully control the RDV procedure;
The resulting endometrium is placed in special sterile vessels and undergoes pre-treatment, after which it is sent to the laboratory for further examination.

All of the above procedures take a maximum of 20 minutes. As after any intervention in the female reproductive system, in order to avoid problems in the functioning of the internal genital organs, specialists select individual therapy for each patient. We are talking about taking general strengthening and antibacterial drugs.

After the Russian Far East

To avoid complications, the patient after RDV of the uterus remains in the hospital for some time (maximum several hours). Her condition is monitored by an anesthesiologist who administered general or local anesthesia, as well as an obstetrician-gynecologist, with whose participation biological material was collected.

If no changes are detected during this period, the patient is sent home. However, after a maximum of 7 days, she needs to return to the clinic. Doctors check the healing processes of the mucous membrane by examining the uterine cavity and cervical canal using transvaginal ultrasound. Depending on the results of this examination, special therapeutic treatment is selected.

Can complications occur after RDV?

It all depends on how qualified the doctor was in taking samples of biological materials. In addition, the tools and equipment used by specialists have a significant influence on the outcome of the procedure.

When visiting a little-known clinic with an imperfect technical base, you risk the following complications:

mechanical damage and tears to the walls of the uterus;
Formation of hematomas on this internal genital organ;
Development of inflammation of the mucous membrane;
The appearance of hematometra, that is, accumulations of blood, etc.

To avoid these dangers, you should seek the help of highly qualified specialists at our medical center!