How is a scraping operation performed? Contraindications to diagnostic curettage of the uterine cavity

Diagnostic curettage of the uterine cavity, what kind of procedure many women know. This is the so-called cleaning of the uterus in the common people. This procedure is performed for the purpose of diagnosing, as the name implies, and treating certain gynecological diseases. Let us consider in more detail what indications the therapeutic and diagnostic 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 an overgrowth of the lining of the uterus. Occurs in women of reproductive age mainly due to an excess of the hormone estrogen. An excess can occur when taking certain hormonal drugs and as an independent phenomenon.

Endometrial hyperplasia can be diffuse and focal, this is when a polyp forms in the uterus. Symptoms of the disease - intermenstrual bleeding, heavy menstruation, often infertility. But although hyperplasia in young women very rarely turns into cancer, it needs to be treated. Diagnostic curettage of the uterine cavity is carried out with endometrial hyperplasia. As a result, the pathologically enlarged 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 term of their admission will depend on the personal wishes and reproductive plans of the patient. Tablets can be taken for a long time without any complications. If there is a pregnancy in the plans, then it is usually recommended to take it for three months, and after, on drug withdrawal, to become pregnant. It is believed that it is easier to get pregnant in this way, since ovulation will most likely be on the withdrawal of drugs.

Oral contraceptives are the prevention of hyperplasia and benign ovarian neoplasms.

Doctors pay special attention to patients who have already gone through 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 (RDV), 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 submucosal fibroid . Since these neoplasms can play the role of intrauterine contraceptives and do not allow a fertilized egg to penetrate into the endometrium for further development.

By the way, a polyp can be not only hormonally determined, but also be the result of an incomplete miscarriage. In this case, according to histology, a diagnosis of "placental polyp" is made. And sometimes women do not even understand where it came from, this polyp, if there were no pregnancies, there were no delays. It happens that the pregnancy is interrupted almost immediately after the implantation of a fertilized egg in 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 the cells of the endometrium, the inner layer of the uterus, spread into the muscular layer of the uterus or even outside the main reproductive organ. If endometrial cells infect the inner layer of the uterus, lesions form. In this case, the disease is called adenomyosis. Women often experience uterine bleeding, pain during, before and after menstruation. Menses are always profuse. But most importantly, with widespread adenomyosis, it is very difficult to get pregnant.

How is the diagnosis made? The doctor can guess it by the symptoms. In general, adenomyosis is a very common pathology among women of different ages. If the ultrasound confirms its probable presence, plus the pathology of the endometrium, then the woman may be offered an examination. Diagnostic curettage of the uterine cavity is indicated for such problems, but to determine 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.

Completely get rid of adenomyosis in reproductive age will not work. Its symptoms will disappear only when pregnancy occurs. And they will completely disappear - with the onset of menopause or after the removal of the uterus. But you can significantly improve your condition and increase the chances of pregnancy if you take hormonal drugs prescribed by your doctor according to special schemes. Some of them introduce a woman into an artificial menopause, but this is part of the healing process. After that, the foci of adenomyosis are smaller, and pregnancy may occur.

uterine fibroids

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

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

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

In general, distinguishing a fibroid, a benign tumor, from a 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 a month. With sarcoma, the entire uterus is removed, and often along with it, the appendages. 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 myoma. Just to remove it, a woman is given a so-called hysteroresectoscopy and immediately diagnostic curettage.

Before the procedure

In the case of a planned intervention, a woman first takes blood tests, urine tests, a swab for flora, must undergo an ECG and visits a therapist with all the results. Such "difficulties" are necessary because during the procedure, most likely, general anesthesia will be performed. And for its implementation, there are many contraindications. The anesthesiologist must know everything about the health of his patient in order to make her the safest possible anesthesia.

At the same time, smear results are important. If they are bad, the procedure may be postponed. The only time when the results of smears are not taken into account is an emergency cleaning. It is performed, for example, with severe intermenstrual bleeding in order to stop it. But after the procedure, antibiotics are required.

Possible complications and consequences

Immediately after the procedure, the woman will have to move away from anesthesia. This can take up to three hours. It is not worth getting up on your feet earlier than two hours after scraping, as your head will be spinning.

There may be pulling pains in the uterus. You can remove them with any antispasmodic pretty quickly.

Allocations after diagnostic curettage of the uterine cavity continue 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 they will become less, their color will be brown, and finally everything will end with a light daub. 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, Dicinon, Tranexam, etc.

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

Another common complication is trauma to the cervix. They may occur due to its mechanical damage as a result of careless use of tools by the doctor. For example, if bullet forceps are torn off, with which the cervix is pulled down before its instrumental opening. As a result, isthmic-cervical insufficiency and miscarriages in late pregnancy in a woman.

Recovery process

Menstruation after diagnostic curettage begins at different times. They depend on which day of the cycle the intervention was. 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 pill from the package. Start taking contraceptives - 1-5 days after cleansing.

Sometimes there is a delay in menstruation - these may be the consequences of diagnostic curettage of the uterine cavity. Due to a too carefully performed procedure, intrauterine synechia, adhesions can form, this is the result of an endometrial injury. Symptoms - prolonged absence of menstruation or very poor discharge. Surgical treatment - dissection of adhesions.

Pregnancy can be planned 3 months after the procedure. Usually it is this period that 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 it? Among themselves, women call this process - cleaning. Curettage is a surgical intervention 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 associated with the cervix. In this way, the organ controls the external environment of the vagina. The main function of the uterus is the bearing of offspring.

The inside of the body is covered with a special layer called the endometrium. During menstruation, it is rejected if pregnancy has not occurred. Cleansing the uterus involves a partial removal of the uterine mucosa, almost the same as with menstruation, only with the use of special tools. After the procedure, the endometrium grows back.

What is cervical canal scraping and why is it needed? Cleaning is carried out precisely from scraping 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 cleaning can be carried out in two ways:

Separate diagnostic curettage (RDV). 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, as the doctor removes all the formations, due to which curettage was prescribed.
Separate diagnostic cleaning under the control of hysteroscopy is one of the new methods in gynecology. The usual WFD is carried out without observing that the instruments are removed, and the WFD + GS with the help of direct control of the operation. First, an endoscopic device is inserted into the uterus, then the uterus is scraped and then checked. This technology allows you to check the degree of purification, as well as to find out if there are any other anomalies.

Indications

Gynecological cleaning is needed to obtain biological material, its study, as well as 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 diagnosis does 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 to clean the cervical canal and cervix.

Curettage of the uterine cavity is carried out with strong menstrual bleeding, the inability of a woman to become pregnant for six months, and also with an unclear reason for feeling unwell. Other reasons include abnormalities in the cervix and routine cleaning due to fibroma, while the uterus is preserved.

First of all, indications for scraping are benign formations on the mucous membranes, in other words - polyps. Their feature is the lack of response to treatment with pharmacological drugs. Polypoid growths are removed only with the help of 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 increasing cells.

For women during menopause, uterine hemorrhages are characteristic and cleaning in such cases is carried out only to stop the bleeding. And also cleaning takes place after a miscarriage or abortion occurs.

Training

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 they begin to do it at the same time when the endometrium itself should have begun to be rejected. In the case of removal of polypoid growths, cleaning is carried out after menstruation, in order to know the exact location of the formation.

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 is associated. And as a result, when the mucous membrane of the uterus is removed ahead of time, the work of the ovaries and the hormonal background is disrupted.

Preparation for cleaning the uterus includes the delivery of such tests:

complex analysis of blood coagulation parameters;
general blood analysis;
electrocardiogram;
HIV test;
analysis for hepatitis B and C;
flora smear.

At the appointed time before the procedure, you can not eat and you need to remove pubic hair. Take a bathrobe, pads, slippers with you.

Procedure

How do curettage of the uterus, patients are interested. In the office there is a chair similar to a gynecological one, where the 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 takes place 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 gynecological mirror, Schroeder forceps, an iron stick, dilators, and a curette. When using a separate diagnostic cleaning under the control of hysteroscopy, the tube with the camera is inserted after the expansion of the uterus.

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 with dilators to gain access to the endometrium.

With the help of a curette, the doctor performs curettage, while he gently inserts the instruments along the inner layer of the uterus, removing it. When scraping 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.

At this time, the woman is prescribed to take antibiotics and vitamins. During the entire recovery period, the doctor monitors the condition of the woman. Before discharge, an ultrasound examination must be performed without fail.

Effects

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 inaccurate movement of the doctor can lead to the formation of scars or fistulas. In addition, such a rough effect on the internal cavity of the uterus increases the risk of developing serious complications:

Injury of the cervix, its anguish.
perforation of the uterus.
Infection of the uterus and cervix with subsequent inflammation.
Damage to the germ 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 is likely to do no harm if the woman prepares for it properly and does not refuse hospitalization after surgery. It is especially important to follow the advice of a doctor to women who have undergone a cleansing for the purpose of terminating 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. There is such a procedure for treatment and diagnostics, 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 there are no consequences and complications. About how rehabilitation takes place after cleaning (curettage) of the uterus, will be described in this material.

Period duration

Strictly speaking, such an intervention is not considered a surgical operation, although in fact it is traumatic, and during it an extensive wound surface is formed. For example, after scraping to remove cysts or with 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. In case of deviation from the norm, it is recommended to immediately consult a doctor. Normally, during this period, there may be:

Pain in the lower abdomen due to the fact that the uterus contracts after scraping;
minor bleeding;
Sensations of pulling, 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 see a doctor. You also need to act if there is severe bleeding and excessively intense pain, or a temperature appears after cleaning the uterus.

During this period, it is necessary to reduce physical activity, which will have a good effect on well-being. You can not bathe in the bathroom, hygiene must be observed with the help of a shower. In this case, it is better not to use chemicals for intimate hygiene, drugs administered vaginally, tampons and douches. Avoid overheating - do not visit saunas, baths, solariums, the beach, do not swim in open water and pools, carefully observe hygiene.

Preparations

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. Taking medications is carried out in order to improve the condition and well-being of the patient, avoid relapses of the disease, and also prevent the development of serious consequences and complications, for example, infection.

Antispasmodics

Antispasmodics after curettage of the uterus should be administered with caution. This is due to the fact that after this procedure, the uterus contracts, pushing out excess endometrium and rejecting its remnants. 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 undesirable to remove it with antispasmodics, because if the uterus does not contract, the healing process may be delayed. In severe conditions, No-shpu and other drugs are prescribed.

Diagnostic curettage

Antibiotics

Antibiotics after curettage of the uterine cavity are always prescribed. 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 condition of the patient, the course may begin on the day of the cleaning or a day or two earlier.

Why are antibiotics prescribed at all? Drinking them is necessary in order to avoid the addition of any concomitant infection. The fact is that with this intervention, not only a wound surface is formed, but local immunity is also greatly reduced. All this in combination significantly increases the likelihood of 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, she is able to recover herself, 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 action 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) is very beneficial. You can drink decoctions and infusions from a boron uterus and a red brush. The upland uterus after scraping 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 about the same thing that antibiotics are needed for - they prevent the development of an inflammatory process on the wound surface. Such drugs as Nurofen, 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 administered by injection. In addition to the direct anti-inflammatory action, they are also good pain relievers.

If a temperature appears after scraping, then this may indicate the beginning of the inflammatory process. Therefore, you must immediately consult a doctor.

intimate life

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

Sport

You can go in for sports as usual about a month after the intervention. At the same time, you can return to light loads, 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 a lot depends on the individual characteristics of the body and the speed of healing.

Example of daily routine

For a quick recovery, it is important to properly balance the modes of work and rest. 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 is associated with physical exertion, then you need to take sick leave for at least a few days after the procedure. If the work is not hard physically, then, usually, you can return to it the very next day. But this must be agreed with the doctor.

Diet Example

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

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

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

Pregnancy

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

Intervention progress

Conclusion

Curettage is a traumatic, but necessary procedure. It should not be avoided if it has been prescribed by a doctor, as this can have unpleasant health consequences. Provided that the recovery period is carried out correctly, complications after curettage are extremely unlikely, and this procedure affects health only on the good side.

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Cleaning the uterus (curettage or curettage) is at least a very common surgical intervention. Information preparation before this manipulation will allow the patient to calm down, make sure that it is necessary 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 is scheduled for cleaning, there is nothing surprising in this. When scraping, you can identify various diseases of the uterus, remove the pathological process, or stop the bleeding that exhausts the woman. Scraping is of two types:

diagnostic;
medical.

The main function of the uterus is to bear a fetus. The inner layer of the uterus 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 fixation. If pregnancy does not occur, then endometrial cells are rejected, accompanied by menstruation.

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

With properly performed scraping, 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 recovers. Recovery after cleansing occurs at the usual time for the monthly cycle.

The tissues obtained by scraping are sent for research.

What is the purpose of scraping

Usually, uterine curettage is performed for the following reasons:

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

In what cases does cleaning happen for a diagnostic purpose, and in which it is done for treatment?

Diagnostic curettage is performed when:

formations on the cervix;
prolonged periods with clots, or bleeding outside the cycle;
infertility of unknown cause;
before operations in the uterine cavity;
suspicion of oncological processes;
after changes in the mucosa, confirmed by ultrasound and not disappeared 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 treatment);
uterine bleeding (for various reasons, including those that are not clear);
incomplete abortion;
inflammation after an abortion or after spontaneous miscarriages;
dissections with adhesions 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, 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 scraping a woman.

Types of scraping

Two main types of scraping are commonly used:

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

When to clean

It is undesirable to clean 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 mucosa and the risk of bleeding.

When cleaning at the beginning of the cycle or in its middle, there is a high probability of hormonal failure 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, then the work of the ovaries is disrupted - a contradiction occurs between the uterine and ovarian cycles.

How to prepare for scraping

Cleaning of the uterus can be performed according to emergency indications (for example, with 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 required.

Before scraping, a woman is usually prescribed tests:

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

For scraping, a woman comes on an empty stomach, shaving her hair in the crotch. The patient is advised to limit the amount of liquid and take along pads, slippers, a disposable diaper, clean cotton items (T-shirt, socks, bathrobe).

What awaits a woman when scraping

Of course, it is important for a woman to know in advance what she should prepare for and what awaits her in the process of cleaning the uterus. Consider in general how scraping is performed.

A woman enters the operating room and sits on a table that looks like a gynecological chair.
The anesthesiologist clarifies the patient's possible allergic reactions and previous diseases.
A woman is injected intravenously with drugs for anesthesia with a short-term effect. After that, she falls asleep and wakes up already in the ward. The patient does not have to endure any pain. In addition, modern drugs are not accompanied by hallucinations or severe recovery from anesthesia.

What kind of manipulations is the patient exposed to during cleaning?

Before the operation, a gynecological speculum is inserted into the woman to expose the cervix.
The gynecologist fixes the cervix with special forceps "bullets" to ensure its immobility at the time of the intervention.
With the help of a probe, the specialist enters the uterus. Cervical dilators are then used until the cervix begins to skip the curette (curettage instrument). In this case, the tissues after scraping are 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 done. After the procedure, the hysteroscope is reintroduced 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 the ward, where she stays for several hours. After that (or the next day), the woman is often allowed to go home.

Possible Complications

Complications after cleansing are rare. To do this, curettage must be carried out in a medical institution by a qualified specialist.

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

exacerbations of gynecological inflammation;
adhesions in the tissues of the uterus;
puncture of the uterus with surgical instruments;
neck tear;
mucosal damage;
leaving in the cavity of polyps, adhesions or nodes 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 after cleaning heal themselves. Only massive damage to the cervix or uterus requires surgical intervention. When inflammation or hematometers appear, drug treatment is used.

A serious complication of cleaning is too much removal of the mucosa. This condition often leads to infertility due to the inability to fix the ovum.

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 (hematometer, bleeding), vacuum curettage is very often performed when:

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

Scraping with a vacuum method is carried out with special tips and a vacuum pump. At the same time, due to the negative pressure in the uterus, pathological tissues are brought out of the uterus.

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

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

Behavior of a woman after scraping

After scraping, a woman usually has spotting discharge for several days, associated with hormonal changes in the body. Usually, menstruation begins after a month and may be slightly different from normal (be shorter, leaner, etc.)

Pain in the abdomen is natural after cleansing, and you should not be afraid of this. Usually, painkillers are recommended for pain in the lower abdomen.

Avoid hypothermia and physical exertion.
Avoid high temperatures (steam rooms, baths, saunas).
Observe the hygiene of the genitals.
Give up sex for a month.

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

Pregnancy immediately after curettage may result in miscarriage of the fetus or its intrauterine death.

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

Curettage of the uterine cavity is understood as a surgical procedure in which the upper layer of the uterine lining is removed. The operation is carried out with special instruments or vacuum. Often, in order to cleanse, you must first expand the uterine cavity with an instrumental or medication method.

Currently, gynecological cleaning is done both for 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 its other sections is performed.

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

Types of scraping and indications for its implementation

There are two types of curettage: diagnostic and therapeutic. Diagnostic cleaning of the uterus is done if some diseases of the reproductive system are suspected. It is prescribed in the presence of the following symptoms:

With this type of curettage, only samples of the uterine lining are taken, which are then sent to the laboratory for histological examination. Such an analysis helps the doctor to make the correct diagnosis for the patient.

Therapeutic curettage of the uterine cavity is carried out in the presence of certain diseases. They belong to:

Features of preparation, anesthesia

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 intervention, some tests must be passed before it is carried out. These include a complete blood count, clotting time, vaginal swab, HIV, hepatitis, and syphilis.

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

Preparation for scraping the day before it includes:

refusal of sexual intercourse;
conducting intimate hygiene without the use of special means;
complete refusal of drugs;
refusal to eat 12 hours before surgery;
conducting an enema;
consultation of an anesthesiologist and a doctor who will carry out curettage of the uterus.

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 done under general anesthesia.

Anesthesia is carried out only by an anesthesiologist. With increased excitability of the patient, several hours before surgery, sedatives are administered intravenously.

Since the operation does not last long, and there is practically no chance of getting the contents of the stomach into the respiratory tract, anesthesia is done while maintaining natural breathing. The patient breathes on his own. She is wearing an oxygen mask. Such 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, 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 for today is anesthesia with propofol. The drug has a mild effect, causes light sleep and has virtually no side effects.

Methodology, postoperative period

A speculum is inserted into the vagina to locate the cervix. Then the neck is fixed with special forceps. This is done to keep the uterus still throughout the 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 with different thicknesses are used. The doctor alternately inserts each of them into the cervical canal. Such expansion is continued until the diameter of the canal reaches the size into which the curette, a tool for scraping, can freely pass.

Then the upper layer of the lining of the uterus is scraped off. Use the smallest curette. It looks like a spoon with a long handle and one sharp edge. This is the part that cleans up. A sample of the mucous membrane is placed in a special container and sent to the laboratory for histological analysis. With 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 done under local anesthesia. Such curettage is often performed after a miscarriage.

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

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

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

To prevent the development of hematomas, in the first days after the operation, no-shpu should be taken.

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

Hygiene must be especially carefully observed if scraping was carried out 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 banal inflammation.

Curettage of the uterine cavity is a surgical procedure in which the top layer of the uterine lining is removed. For anesthesia, only general anesthesia is used. Cleaning is often carried out after a miscarriage, as well as in some diseases of the reproductive system. This is a fairly simple surgical intervention, however, in order to avoid complications, the postoperative period should be under the strict supervision of a physician.