Every surgical operation is a combination of risky and highly undesirable procedures. But unfortunately, sometimes situations arise when several of them are urgently needed. There are quite a few methods of surgical interventions at the moment, and one of them, used quite often, is curettage of the uterine cavity, which is carried out both for diagnostic purposes and as treatment. Most often, such operations are used to confirm the presence of pathologies of a malignant nature.
Curettage of the uterus is a common procedure in which the doctor removes the protective membrane of the uterine mucosa from its surface - the endometrium, using specially designed instruments (curettes) or using a vacuum. The operation is performed not only in the uterus, but also in the cervical canal of the cervix at the entrance to it.
Although curettage is not difficult to perform, it remains a surgical procedure performed through the cervix. Before the procedure, the necessary examination and tests are carried out. The patient may experience pain when dilating the cervix and using a curette, and to avoid this, the operation is performed under anesthesia.
Using the method
Curettage is performed by a doctor using a dilator, probe, curette and hysteroscopy under the supervision of a special camera, which is inserted through the dilated cervix. The doctor's further actions consist of carefully scraping the uterus with a curette to obtain tissue for subsequent histological analysis. The analysis performed is able to determine the structure of the tissue with the ability to distinguish pathological damage from healthy tissue that corresponds to the norm. This technique takes a lot of time and lasts about 35-40 minutes.
Objectives
Curettage can be performed by a doctor for various purposes: diagnostic, in which the final diagnosis of the disease is determined, therapeutic, when the pathological focus is removed by cleaning, and to terminate the current pregnancy.
Diagnostic test
Diagnostics are carried out to obtain and further study samples of tissue from the uterus, mucous membrane of the cervix and to identify the causes of the violation:
- changes in the cervix of unknown nature;
- changes in the endometrium in the uterus;
- menstruation lasting a long time, sometimes with the presence of a blood clot;
- infertility or problems conceiving;
- preparation for operations;
- suspicions of the development of malignant neoplasms;
- bleeding during postmenopausal periods;
- bloody discharge from the vagina that occurs between cycles.
Preparation for the event
Before carrying out the procedure, you must follow several recommendations, for example:
- Avoid eating completely in the evening before the operation and in the morning before it is performed.
- Carrying out the necessary hygiene requirements and showering is mandatory.
- Colon cleansing with an enema.
- Complete shaving of hair in the genital area.
- Conversation with an anesthesiologist about tolerability of anesthesia.
- Examination by a gynecologist using mirrors.
In addition, to carry out cleaning using curettage, it is necessary to provide the results of previously performed tests. This list includes:
- examination for RW;
- examination for the presence of hepatitis C and B;
- general clinical blood test with detailed interpretation;
- examination of a smear taken from the vagina to exclude inflammation;
- assessment of blood clotting.
Medicinal or therapeutic value
Therapeutic curettage is used as an additional measure in the treatment of several diseases, for example:
- Uterine bleeding, in which pain is felt and continuous bleeding from the uterus is observed. More often than not, the reason that caused it is not fully understood. Cleaning is carried out using a curette, which is inserted into the uterus through the dilated cervix to stop bleeding.
- Polyps of the cervix or the lining of the uterus itself. The use of medications to remove polypous growths is ineffective, so in such situations the doctor uses cleansing.
- Endometritis is inflammation occurring in the endometrial layer of the uterus. To obtain the effect of therapeutic drugs during the development of this disease, it is necessary to first curettage the affected endometrium.
- Hyperplastic inflammation of the endometrium or hyperplasia, a disease characterized by thickening of the uterine mucosa resulting from inflammation. Carrying out curettage for this pathology serves as a single procedure both in diagnosis and as a therapeutic technique. As a result of the cleaning, the patient is treated with fixative medications.
- Remains of membranes or embryonic tissue obtained as a result of an ectopic pregnancy, miscarriage, frozen pregnancy or abortion - the use of curettage will relieve such complications.
- Synechia is the formation of adhesions of the uterine walls. Curettage can remove adhesions and is performed using a hysteroscope, which is inserted through the open cervix.
Abortion
To terminate a pregnancy, doctors today prefer to use it as the most gentle method for the female body. If the period is more than 6 weeks, only cleaning is still carried out. Reasons for curettage, in addition to unwanted pregnancy, may include medical indications in the case of pathological development of the fetus, viral infections or severe inflammation of the cervix, manifested by discharge mixed with pus.
Interesting video:
Contraindications
It is strictly not recommended to carry out the curettage procedure in several situations. These include pathological disorders developing in the genital organ, in the uterine cavity or in the cervix during acute and subacute inflammation, infections occurring in the female body at that time, unusual discharge mixed with pus, chronic diseases of the heart, liver and other internal organs during the period exacerbations, possible violation of the integrity of the uterine walls. However, if a situation arises that threatens the patient’s life, existing prohibitions may be violated.
Features of the method
The methods by which the operation is performed are determined based on the nature of the disease. For example, if uterine fibroids are diagnosed, cleaning is performed with extreme caution to avoid damage to the lumpy surface and fibroid nodes characteristic of this disease. During pregnancy, cleaning is carried out carefully so as not to cause damage to the neuromuscular system. In case of inflammation and infectious lesions of the cervix, curettage is recommended to be used only in urgent cases; it is advisable to carry out the necessary treatment before performing it. To do this, after an examination, the doctor prescribes several medications based on the specific situation. With caution and under the supervision of a physician, a similar technique is used in cases of existing damage or rupture of the cervix resulting from previous childbirth. Since during the procedure, instruments are inserted through the cervix, which is previously dilated, secondary injury to the cervix is possible. Materials for analysis obtained by scraping are sent for further histological study. If a malignant process is suspected, scrapings from the uterine cavity and tissue taken from the mucous membrane of the cerebral canal of the cervix are placed separately in several containers.
Risk of possible complications
As a result of using the method, it is possible to develop some complications that may appear immediately or after some time:
- The occurrence of an infection in the genital organs as a result of curettage, which develops against the background of untreated inflammation or insufficient compliance with hygienic requirements, when insufficiently processed instruments are inserted through the open cervix. Antibiotics are used as treatment.
- Perforation of the uterine wall resulting from surgical interventions. One of the most common reasons may be increased looseness of the uterine walls and insufficient dilation of the cervix. For minor lesions, treatment is not required; integrity damage occurs on its own. In severe cases, when the patient feels pain and continuous bleeding for a long time, surgical methods are used when a suture is placed on the damaged surface.
- Disruption of the endometrium as a result of very careful curettage. The prognosis is disappointing; in most such cases, the damaged layer is no longer restored.
- Reproductive function disorders and menstrual cycles are often the result of the formation of synechiae. Antibiotics and hormonal treatment are used for treatment.
- Accumulation of blood in the uterine cavity or hematometer. Recommended treatment includes taking special medications to relieve spasms. In such a condition, urgent consultation with a doctor is necessary.
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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.
Diagnosis and treatment of some gynecological pathologies requires a special procedure such as curettage (cleaning) of the uterine cavity.
Many women perceive this procedure as an abortion. In fact, this is true; when performing an artificial abortion, the procedure of gynecological curettage is also used.
The main difference between cleaning the uterine cavity and an abortion is the purpose for which it is performed. With conventional curettage, the goal is to provide a therapeutic effect or conduct a diagnostic examination.
Curettage itself is a procedure in which the gynecologist removes the top layer of the uterine mucosa. This is done using a vacuum system or a special tool.
The procedure for cleaning the uterus is possible only if the uterine cervix is sufficiently dilated. Enlargement can be achieved by taking certain medications or using special instruments.
In practice, curettage is very common since it allows you to visually evaluate the cleaned cavity in order to determine the presence of unaffected areas.
What preparation is required from the patient?
In order to minimize blood loss during cleansing, it is usually carried out several days before menstruation. This also allows you to significantly speed up the recovery process of the uterus after cleaning.
Curettage is a surgical operation, so it naturally requires that the patient undergo a series of examinations before it. The list of mandatory tests includes:
- Analysis of the blood coagulation system.
- Bacteriological vaginal smear.
- Cervical smear for oncocytology.
- Biochemical blood test.
- Rh factor and blood group.
- Test for HIV, hepatitis C and B, and syphilis.
The doctor must study the patient’s medical history and find out what medications she is taking. 14 days before surgery, it is recommended to stop taking all pharmacological agents in order to limit their effect on the blood coagulation system.
In addition, 2–3 days before curettage, a woman is recommended to follow the following recommendations:
- Refusal
- Use only warm water and no other cosmetics for intimate hygiene.
- Stopping sexual intercourse.
- Stop using suppositories and tablets that are inserted into the vagina.
8 – 12 hours before the operation itself, it is better to refuse food. This is necessary in order to safely administer anesthesia.
How does the operation itself work?
Curettage is considered a surgical intervention, and therefore is carried out on a gynecological chair in an operating room. The objective of the operation is to completely remove the top layer of the uterine mucosa. It is this layer that is always rejected during menstruation.
The table describes the main stages of curettage:
| Operation stages | Description |
| Extension | This procedure is quite painful, so it is usually performed under anesthesia. Only in cases where curettage is necessary immediately after childbirth and the cervix is sufficiently dilated, anesthesia may not be used. Anesthesia is an intravenous injection of special medications. Next, a dilator is inserted into the vagina. It straightens the vaginal walls. In order to achieve the required expansion, the doctor inserts a special probe with a rounded end. |
| Carrying out hysteroscopy. | After achieving the required dilation, the inside of the uterus is examined using a special video camera. This step may be skipped, depending on the indications. |
| Direct curettage. | An instrument called a curette is used to remove the mucous layer. It looks like a spoon with a long handle. With very careful and smooth movements, the gynecologist removes the top layer. The resulting samples are collected in a test tube for further histological examination. |
The duration of curettage is about 40 minutes. In some cases, it may be necessary to scrape not only the uterine cavity, but also the cervical canal. This operation is called separate diagnostic curettage.
With separate curettage, the resulting materials are collected in separate tubes and also sent for histological analysis.
Why is histology of the obtained materials carried out?
Histological analysis of materials obtained as a result of curettage plays a very important role. It can be used to identify abnormalities in tissue structure.
Known in 10 – 14 days. They can accurately determine the presence of precancerous changes or cancer cells in the material being examined.
In what cases is curettage considered diagnostic?
Diagnostic curettage is prescribed to determine the possible causes of various alarming symptoms of many gynecological pathologies.
The following problems in patients may be the reason for prescribing diagnostic cleaning:
- Heavy, heavy, painful and prolonged menstruation.
- Bloody discharge between periods.
- Bloody discharge after menopause.
- Infertility.
- Problematic conception.
- Suspicion of a cancerous tumor.
In these cases, curettage is necessary to collect biomaterial for further histological analysis.
When is curettage curative?
Curettage can also be a therapeutic procedure. This means that curettage is necessary in order to achieve a therapeutic effect, along with the use of other methods of therapy.
Therapeutic curettage may be necessary for the following diseases:
- Uterine fibroids.
- Polyposis of the uterine cervix.
- Polyps in the uterine cavity.
- Endometritis.
- Endometrial hyperplasia.
- Frozen pregnancy.
- Postpartum curettage.
- Miscarriage.
- Abortion.
Features of the recovery period
Recovery after curettage surgery is quite quick. The bleeding stops within a few hours, due to the fact that the walls of the uterus begin to contract strongly.
In a normal course, complete restoration of the uterus occurs as quickly as after normal menstruation.
During the recovery period, a woman may experience the following unpleasant symptoms:
- Increased weakness and drowsiness are a consequence of the effects of anesthesia.
- Discharge of blood clots from the vagina is observed for several hours after surgery. This is absolutely normal.
- Pain in the lumbar region and lower abdomen. Pain may occur for several days after surgery. For unbearable pain, you can take Ibuprofen.
- A yellowish to brown tint can be observed within 10 days. This is also normal. On the contrary, their rapid disappearance may be an alarming sign and indicate the accumulation of clots in the uterus.
Within 14 days after gynecological curettage, the following recommendations must be followed to speed up the recovery process:
- Douching should not be done.
- You cannot use tampons that are inserted into the vagina.
- It is forbidden
- You cannot visit the sauna, bathhouse, or even take a bath. Shower only is recommended.
- You cannot engage in physical activity.
- You should not take medications containing acetylsalicylic acid.
Compliance with these measures guarantees a woman a quick recovery process.
Probably, many women have found themselves in situations where, after conducting an examination and examination, the gynecologist says that it is necessary to perform curettage for one reason or another. Popularly, this procedure is often called cleansing the uterus, which quite accurately reflects its essence.
But not every doctor considers it necessary to explain to patients what exactly this operation is and how it is performed, and therefore many women begin to panic as soon as they see the appointment in the chart - curettage of the uterine cavity.
But in most cases, worries are simply not justified.
The female uterus is a pear-shaped muscular organ where the development of the unborn child occurs from a fertilized egg. The inner surface of the uterus has a protective layer in the form of a special mucous membrane, which is called the endometrium.
Every month, certain changes occur in the uterine cavity, which are cyclical in nature. At the beginning of each menstrual cycle, the uterine cavity begins to prepare for the reception of a fertilized egg and the further development of the baby; if this does not happen and pregnancy does not occur, at the end of the cycle the prepared layers are rejected and the woman begins menstruation.
Carrying out curettage involves removing the functional layer of the uterine mucosa, which is a protective shell, after which the damaged endometrium is quickly restored. When cleansing is carried out correctly, the growth layer of the endometrium is not affected and due to this, rapid recovery occurs.
Curettage of the uterine cavity can be carried out in two types:
- Separate, when at the first stage the cervical canal is cleansed, after which the doctor begins to clean the uterus itself. The scraping obtained during the procedure is sent to the laboratory for testing to determine the disease or make a more accurate diagnosis. Today, separate curettage is carried out simultaneously with hysteroscopy, when a special optical device is placed into the uterine cavity, allowing full control of the cleaning process. This approach to the procedure allows you to make it safer and more convenient, as well as eliminate some possible consequences.
- When carrying out cleaning in the usual way, the operation is carried out blindly, which often leads to complications, since the uterus can be injured, which is excluded when performing hysteroscopy.
As a rule, cleaning the uterus is prescribed 1-2 days before the start of menstruation, since in this case the restoration of the damaged endometrium occurs faster and easier.
Indications for surgery
Curettage is carried out exclusively as prescribed by a doctor for the purpose of diagnosing or eliminating certain diseases.
The indications in this case are:
- Endometrial disorders, changes in its structure detected by ultrasound. Curettage for endometrial hyperplasia and other disorders is usually carried out for diagnostic purposes. Endometrial hyperplasia is said to occur in cases where its thickness deviates significantly from the norm upward. In addition, ultrasound can detect various local formations. In these cases, cleaning the uterus is necessary to make an accurate diagnosis and remove the disorder.
- Polyps on the surface of the uterus. As a rule, during a normal operation, polyps removed along with the endometrial layer do not appear again.
- Menstrual irregularities.
- Long and very heavy menstruation.
- Intermenstrual bleeding.
- Not the onset of a planned pregnancy without obvious reasons.
- The presence of bleeding during menopause.
- Pathological processes of the cervix, especially in cases where the doctor suspects that they are malignant.
- Spontaneous. Curettage after a miscarriage is often a necessary measure, since this is the only way to remove all remnants of the placenta from the uterus if this does not happen naturally.
- Stopping the development of pregnancy. Unfortunately, not every pregnancy ends in childbirth. In some cases, under the influence of various factors, the development of the fetus stops and it dies. Curettage during a frozen pregnancy is necessary to remove the dead fetus and prevent inflammatory processes.
- Remains of the placenta or fertilized egg after natural birth.
- Cleaning the uterus after an abortion.
- The presence of intrauterine adhesions (synechias).
In addition, the procedure is performed before many planned operations, for example, before removal of fibroids in cases where the uterus itself will be preserved.
Complications after surgery
After curettage, some complications may occur, but they are rare. These include:
- Damage to the cervix, its tear. Sometimes this consequence is observed after curettage and the cause of its appearance in most cases is the dislodgement of bullet forceps. If the tear is small, no measures are taken; such damage heals on its own. A large tear will require one or more stitches.
- Hematometra. After surgery, spasm of the cervix often occurs, which can lead to infection and the onset of an inflammatory process.
- Perforation of the uterus. Sometimes during the procedure, due to the carelessness of the doctor or the inappropriate behavior of the patient (under local anesthesia), the uterus can be pierced by the instruments used. Larger injuries will require additional surgery to close the perforation.
- Inflammation of the uterine cavity. The cause of inflammatory processes is usually various violations of antiseptic requirements, as well as non-prescription of antibiotics to a woman after surgery. The onset of the inflammatory process is indicated by the appearance of a high temperature after childbirth or curettage.
- Causing damage to the growth layer of the endometrium during cleaning. This consequence is very difficult to eliminate and is difficult to treat. Often it is this kind of damage that causes further problems with pregnancy, since the damaged endometrium cannot recover.
- Improper conduct of the procedure, when the reason for the operation, for example, some pathological formation in the uterine cavity, was not completely removed or was partially removed. In such a situation, the woman will need to have the operation repeated.
To avoid complications, you must trust the operation only to a qualified doctor who will do everything not only correctly, but also carefully.
Recovery after curettage
For several days after the operation, spotting may be observed. Their duration may vary and on average ranges from 3 to 9–10 days.
If there is no discharge, but pain appears in the abdomen, this may indicate that due to spasm of the cervix, hematometra has formed. In this case, you must immediately consult a doctor. The presence of spasm can be confirmed using ultrasound.
To avoid the appearance of hematomas after surgery in the first days after it, you can take No-shpa or its Russian analogue, 1 tablet 2 or 3 times a day.
After the operation, the doctor must prescribe antibiotics, which is necessary to prevent the occurrence of possible inflammatory processes. You should not neglect this appointment after cleaning the uterus.
10 days after the scraping, you need to visit a doctor to get the results of a histological examination of the scraping and discuss their details with your doctor.
It is important to remember that pregnancy after a normally performed procedure can occur within 2-3 weeks, so you should not mistakenly assume that curettage will be a temporary means of contraception.
In this case, complications usually do not occur during childbirth. If the planned pregnancy does not occur within 6–9 months after such an operation, you need to consult a doctor and undergo an examination.
Impaired ability to conceive after cleansing the uterus appears in rare cases, but such cases have been noted in medical practice.
The recovery period usually lasts about 14–15 days and during this time some restrictions should be observed, for example:
- You should abstain from sexual intercourse.
- Douching is not allowed.
- Vaginal tampons should not be used to absorb discharge.
- You cannot administer suppositories without a doctor’s prescription.
- You should refrain from any physical activity, especially heavy lifting and bending work.
- It is important to maintain personal hygiene.
- Hypothermia should be avoided.
- You should avoid visiting baths, saunas, solariums, swimming pools and gyms for 3-4 weeks after cleaning.
- During this period, you should not take baths, especially hot ones, or swim in the sea or other body of water.
Compliance with all instructions during the recovery period allows you to avoid complications. But you should not be afraid of such an operation, since modern equipment and the qualifications of many doctors make it possible to obtain excellent results from such a procedure without harm to health.
Just a few decades ago, curettage often led to problems with conception or complications during childbirth in the future. Today, such operations often help eliminate problems of female infertility and allow a woman to experience the joy of motherhood.
Useful video about the scraping procedure
Replies
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.