home Analyzes Diagnostic cleansing of the uterus - consequences. Separate diagnostic curettage of the uterine cavity and cervical canal

Diagnostic cleansing of the uterus - consequences. Separate diagnostic curettage of the uterine cavity and cervical canal

Curettage of the uterine cavity - removal of the upper layer of the endometrium with a sharp loop-shaped blade (curette). The procedure is known to patients as “cleansing”. To maintain correct hormonal status, manipulation is prescribed a few days before menstruation. In case of massive bleeding, intervention is carried out immediately, regardless of the phase of the cycle.

This procedure is a minor operation, so it should be as beneficial as possible for the patient. All changes detected during therapeutic and diagnostic curettage are eliminated, and tissue samples are sent for histology to determine the type of cells and changes in them.

Indications

Determining the condition of the endometrium in cases of frequent irregular intermenstrual bleeding, infertility, miscarriage;
Determining the cause of a frozen pregnancy;
Stopping uterine bleeding;
Incomplete removal of the fertilized egg and its membranes during miscarriage or induced abortion;
Obtaining tissue samples for histological examination: diagnosis of malignant tumors of the uterus and cervix;
Inflammation of the uterine mucosa (endometritis), endometriosis;
Elimination of adhesions inside the uterine cavity - synechiae;
Suspicion of the presence of polyps in the uterine cavity or cervix, identified by ultrasound. The examination is carried out on different days of the cycle - if no changes are detected after menstruation, this was folding of the overgrown endometrium. If suspicious formations persist, diagnostic curettage is necessary;
Preparation before removal of uterine fibroids

Types of curettage

Therapeutic and diagnostic – complete removal of the surface layer of the endometrium of the uterine cavity and epithelium from the cervical canal. All detected pathological growths are eliminated. The resulting material is sent for examination;
Separate diagnostic curettage. Similar to the previous one, with one exception: material obtained from the cervix and from the uterine cavity is sent to the laboratory in separate tubes. This allows the doctor to obtain information about changes in each of these departments, therefore it is preferable;
Separate curettage under hysteroscope control. The most advanced and diagnostically valuable type of research. A hysteroscope is an endoscopic device that is inserted into the uterine cavity. For better viewing, it is filled with sterile liquid or gas. Hysteroscopy allows you to monitor the doctor’s work with a curette. At the end of curettage, the device makes sure that the endometrium has been completely removed.

Preparation

The scope of tests before the procedure depends on whether it is planned or used urgently. In case of acute bleeding, the list will include only the maximum necessary parameters:

To carry out a blood transfusion, if necessary, the group and Rh factor are determined;
General blood and urine analysis;
Duration of bleeding and clotting;
Blood glucose level.

A planned operation requires an extensive examination of the patient. In addition, the following are prescribed:

Determination of antibodies to hepatitis C and B, HIV and syphilis;
Biochemical analysis - liver and kidney function, protein levels in the blood, the ratio of different protein fractions to each other are assessed;
Assessing the degree of vaginal cleanliness. If pathological microflora is detected, especially sexually transmitted ones, antimicrobial therapy is prescribed. Otherwise, when the cervical canal is expanded and manipulations inside the uterus, the infection will penetrate inside and cause inflammation there;
Gynecological ultrasound in different phases of the menstrual cycle;
Undergo fluorography, do an ECG and be examined by a therapist.

After conducting all the necessary research, you need to prepare yourself:

Take a shower, remove all hair on the pubis and labia;
Empty your bowels the day before - do a cleansing enema or take a mild laxative;
You can use herbal sedatives: Novopassit, tincture of valerian or motherwort;
Prepare a bag for the hospital: a clean shirt, robe, socks. Be sure to bring pads, as there will be some bleeding after the procedure.

On the day of the intervention, you should not eat or drink; immediately before the procedure, you must empty your bladder.

Technique for conducting separate diagnostic curettage

It is carried out in a small operating room on a gynecological chair. After consultation with an anesthesiologist, the type of anesthesia is selected - local anesthesia or intravenous anesthesia. The doctor conducts a gynecological examination (internal and bimanual) - determines the location and expected size of the uterus. External genitalia are disinfected with antiseptics. The cervix is highlighted with speculum and fixed with forceps. The cervical canal is expanded by inserting special cylinders (Hegar dilators) of increasing diameter one by one. The cervical epithelium is scraped out and material is collected for histology. The depth of the uterine cavity is determined with a probe, and the endometrium is separated with curettes. The resulting tissues are also sent for research. At the end, all surfaces are once again treated with disinfecting solutions, and instruments are removed from the genital tract. The woman is under observation from several hours to several days.

Video from the MedHelp research clinic: what is separate diagnostic curettage, indications, contraindications and research methodology

Recovery

After the intervention, a gentle regimen is prescribed:

2 weeks without physical activity and sex;
The discharge persists for up to two weeks and may cause moderate pain;
Antibiotics are prescribed to prevent infection;
Water procedures - only shower and wash twice a day.

The next menstruation usually comes at the right time of the cycle. You should immediately consult a doctor if your temperature rises, there is no discharge against the background of severe pain in the lower abdomen, or their character has changed: an unpleasant odor or unusual color has appeared.

Everyone knows that gynecological diseases not only cause painful and unpleasant sensations, but also negatively affect a woman’s emotions, her mood and sense of satisfaction. Most often, doctors recommend drug treatment, which may include taking tablets, ointments or suppositories of different spectrums. In some cases, experts may recommend a special procedure - curettage of the uterine cavity. For heavy bleeding, as well as other serious symptoms, it is life-saving for many women. It is also very often used for diagnostic purposes.

However, many representatives of the fair sex do not always know exactly what this manipulation is, otherwise called simply cleaning or curettage of the endometrium of the uterus. Most girls and women are afraid of this procedure like fire, considering it something like an abortion or sterilization. However, this is not at all true.

What exactly is uterine cavity curettage? How long do you have to stay in the hospital after this procedure? Why is it prescribed and how does the rehabilitation process go? These and many other questions can be answered in this article.

Briefly about the organ itself

Everyone knows that the uterus is an important organ that is found only in a woman’s body. It performs a vital reproductive function.

The uterus is located in the pelvic area, between organs such as the intestines and bladder. This is where the embryo (fertilized egg) attaches, after which the fetus develops over the course of nine months. If conception does not occur, then at the end of the monthly menstrual cycle the inner layer of the uterus peels off and leaves the woman’s body. This is how menstrual bleeding occurs.

What is this organ? Externally, the uterus is very similar to a small inverted triangle (the size of which does not exceed seven centimeters). The upper part of the organ is called the bottom, through which the egg enters.

The body is the side walls of the organ in which the cavity is located, where the embryo develops.

The lower part of the uterus is the cervix. This is a thin tube two to three centimeters long that connects the organ cavity and the vagina and in which the cervical canal is located.

The uterus consists of several layers:

The external (or perimeter) is the so-called peritoneum, which protects the organ from external irritants.
The middle (or myometrium) is a layer of smooth muscle, which is a kind of dense wall.
Internal (or endometrium). It is a mucous membrane abundantly supplied with blood vessels. It is this layer that interests doctors when it comes to separate diagnostic curettage of the uterine cavity.

A few words about the endometrium

This mucous membrane is hormonally sensitive, as it undergoes changes in accordance with the phase of the menstrual cycle. For example, immediately after critical days, the thickness of the endometrium can vary within two millimeters, while by the end of the cycle this figure can exceed two centimeters.

Before we figure out what diagnostic curettage of the uterine cavity is, let's find out what the endometrium consists of:

Functional layer. It is the outer layer that is shed with each monthly cycle. The thickness of this layer and its structure are individual, as they depend on the hormonal background of each woman.
The basal layer is the lower layer of the endometrium, which is adjacent to the muscular layer. It practically does not react to hormonal changes in the body associated with critical days, and performs a restorative function of the mucous membrane after childbirth, menstruation and curettage.
The stroma is considered the basis of the endometrium, as it consists of cells and fibers of connective tissue. This layer is a dense mesh.
The uterine glands are tubular glands that secrete a mucous secretion, which ensures the normal functioning of an organ such as the uterus.

So, we have understood a little about the structure of the female reproductive organ. Now let's find out what curettage of the uterine cavity is. According to reviews from both doctors and patients, this procedure is considered a fairly common manipulation, so you should not be afraid of it.

Concept and classification of the procedure

In gynecology, there are two types of uterine cavity curettage:

Diagnostic. This type of procedure involves removing (scraping) the inner layer of the endometrium for further examination. In this way, biomaterial is collected to determine the presence of cancer cells.
Separate diagnostic curettage of the uterine cavity. The manipulation is carried out in two stages. First, the inner layer of the cervical canal is removed, and then the upper layer of the uterine cavity. Therefore, very often this procedure is also called curettage of the uterine cavity and cervical canal. Most often, this mini-operation is performed not for diagnostic, but for therapeutic purposes. For example, this method is actively used to remove neoplasms in the form of polyps, pathologically dangerous lesions, or overgrown endometrium. The biomaterial obtained after separate curettage of the uterine cavity is sent for the necessary research.

Recently, when carrying out manipulations, the attending physician uses a device such as a hysteroscope, thanks to which the organ is illuminated from the inside. Moreover, the image of the surface is optically enlarged, thereby improving visibility. This affects the operation, since the specialist can see the situation more accurately and act according to the circumstances.

Why is diagnostic curettage necessary?

This procedure can be used as an independent manipulation or as an auxiliary one (before surgery).

Most often, indications for diagnostic curettage are the following factors:

Endometrial hyperplasia. Most often, anomalies are detected on ultrasound, when thickening of the mucous membrane of the uterine cavity is visible. To identify an objective picture, curettage of the uterine cavity may be prescribed. With endometrial hyperplasia, various neoplasms can be detected. The cleaning procedure will reveal their nature and etiology.
Endometriosis. This condition is characterized by the spread of the mucosal layer beyond the organ.
Polyps.
Various menstrual cycle disorders.
Uterine fibroids.
Cervical dysplasia.

According to patient reviews, the procedure is most often performed when there is bleeding. Curettage of the uterine cavity helps not only to eliminate it, but also to determine the true cause.

Why is separate curettage necessary?

This method is also actively used in gynecology for various types of bleeding. For example, emergency cleansing during heavy bleeding can help prevent severe blood loss. Another reason for prescribing this procedure may be infertility, but only if no obvious hormonal pathologies that provoke such a condition are detected.

Obstetric curettage. What is this?

Are there any contraindications to the procedure?

This is a very important question. Scheduled cleaning is not carried out if the patient suffers from infectious diseases or acute inflammatory processes are detected in the genitals. If emergency curettage is required, the operation is carried out according to vital indications.

Also, cleaning is not carried out if it is necessary to remove a malignant tumor from the uterine cavity.

When is separate curettage performed?

According to reviews from women, most often the operation is performed a couple of days before the start of menstruation. This is necessary so that cleaning at least approximately coincides with the physiological rejection of the mucous membrane. However, there are exceptions. For example, for polyps, the procedure can be scheduled in the first two days after the end of the critical days. This is due to the fact that the neoplasm is well visualized against the background of a thin endometrium.

What can be said about when manipulation cannot be carried out? It's best not to cleanse mid-cycle. Why? The hormones that the ovaries secrete during this period will prevent the mucous membrane from growing again, which can cause heavy bleeding.

During menstruation, they also try not to cleanse. This is explained by the fact that during this period the mucous membrane dies and becomes uninformative as a biomaterial for further research.

Do you need pain relief?

Since cleaning is a painful and quite lengthy procedure, it is carried out under local or general anesthesia.

Most often, as patients say, the second type of pain relief is used. The woman is given anesthesia intravenously (sodium iopental or Propofol is used for this). The anesthesia lasts only twenty to thirty minutes, during which the woman sleeps and does not feel anything. This type of anesthesia is also convenient for doctors, since it is easier for them to perform the operation when the patient is completely motionless.

Very rarely, local anesthesia can be used, when the tissues around the cervix and the organ itself are impregnated with a certain anesthetic. At the time of the operation, the woman is conscious and experiences discomfort.

How is the procedure performed?

Many women worry about curettage, and this is not surprising, because cleaning is a kind of mini-operation. However, you shouldn't worry too much. The procedure is common and uncomplicated.

All manipulations are carried out on a special table equipped with leg holders (like in a gynecological chair). What does a doctor do?

At the very beginning, using palpation, he examines the uterus, its position and size. Then he moves on to the internal inspection. To do this, the specialist treats the external genitalia with a solution of iodine and alcohol, after which he expands the vaginal walls using gynecological speculum. Then the cervix is fixed with special bullet forceps.

Then a metal probe with a rounded end is inserted inside, thanks to which the uterus is examined in more detail. In order to carry out curettage, it is necessary to expand the cervical canal. To do this, the gynecologist uses small metal cylinders called Hegar dilators. The passage must be enlarged so that surgical spoons (curettes) can be inserted.

After this, they begin cleaning. The curette is inserted very carefully, then it is pressed against the wall of the mucous membrane of the cervical canal and the epithelium is scraped out. This action must be performed several times until all the walls are completely cleaned. The resulting material is placed in a special container, pre-filled with a ten percent formaldehyde solution.

After this, the gynecologist proceeds to curettage of the uterus. It is necessary to clean the mucous membrane with careful but energetic movements, starting from the front wall. As cleaning progresses, smaller curettes are used until all mucous is removed. The biomaterial is also placed in a container with a formaldehyde solution.

Then comes the final stage - the vagina and cervix are treated with a special anesthetic. To stop bleeding, ice is placed on the woman's stomach. You can keep it cold for half an hour.

The patient is then transferred to a ward, where she recovers from anesthesia and rests for another six hours. Many women are interested in the question of how long the procedure takes and how long to stay in the hospital. Curettage of the uterine cavity cannot be called a complex operation, therefore, if it was successful and without complications, and if the patient feels satisfactory, then she is discharged on the same day that the procedure was performed. A woman’s sick leave can be closed the next day.

As you can see, this is a fairly simple operation - curettage of the uterine cavity. How long a woman will stay in the hospital depends on how well the manipulation went and how well the patient herself feels. According to reviews from many women, within a few hours after cleaning they were able to get home on their own. The next day, in accordance with their wishes, they were able to begin performing their professional duties. Some women still preferred to rest longer after the procedure, as they felt slight dizziness and loss of strength.

What is required from the woman herself

Despite the fact that cleaning is a simple and common procedure, it is a mini-operation and requires the necessary preparation not only on the part of the gynecologist, but also on the part of the patient herself. What should a woman do to ensure that the manipulation goes well? Of course, your doctor will tell you in more detail about preparing for the procedure, but it would be useful to familiarize yourself with the information presented below.

According to reviews of many specialists, additional examinations should be carried out before performing the operation. For example, take the necessary blood tests (this includes a general analysis, biochemistry, analysis for HIV, hepatitis, coagulogram). A urine test and a bacteriological smear from the vagina will also be required.

A woman should also warn her doctor about what medications she takes on a regular basis and tell her about her concomitant chronic diseases.

Three days before the procedure, it is best for the patient to refuse sex, stop douching and use vaginal suppositories. It is recommended to perform the operation on an empty stomach (most often, doctors ask women not to drink or eat for twelve hours). Before the procedure, it is best to perform a cleansing enema and take a shower. It would be a good idea to remove hair around the labia.

How to behave after the procedure

This is also an important issue. Since women do not always take cleansing seriously, they may behave incorrectly after it is done. However, it is very important to follow the doctor’s recommendations, and then the postoperative period will pass without complications.

So, after cleansing, a woman may experience painful, aching sensations that can be localized not only in the pelvic area, but also radiate to the lower back. To reduce pain, you can apply a cold heating pad to the lower abdomen.

Does a woman worry about discharge after curettage of the uterine cavity? Certainly. According to reviews from many patients, the discharge is profuse, with large bloody clots, as during normal menstruation. This phenomenon is considered normal when cleaning the uterus, and you should be prepared for it. Therefore, a woman needs to stock up on pads. Remember, using tampons during the postoperative period is strictly prohibited!

How long will a woman be bothered by discharge after curettage of the uterine cavity? Heavy bleeding is possible in the first days after the procedure. Then the strong discharge will smoothly turn into spotting. They can be released for another week, or even ten days after the procedure.

What to do if a woman does not have such discharge? Curettage of the uterine cavity is a kind of operation. It should be accompanied by bloody discharge. If they are not there, or they end very quickly, and the patient is worried about the high temperature, then such symptoms may indicate blood stagnation or an inflammatory process. In this case, you need to consult a doctor. Perhaps he will decide to stimulate the uterus by prescribing a course of oxytocin.

Is it possible to wash after scraping? Of course, but you can't take a bath. Hygienic procedures should be carried out twice a day and after each bowel movement.

Don't forget about rest! It's best to spend a day or two in bed. Avoid sitting in a sitting position to avoid putting pressure on the uterus.

Briefly about medications

Naturally, pharmacological medications will be prescribed to you by your attending physician. He will describe in detail the dosage and regimen. Below are general recommendations regarding which medications are most often prescribed.

First, painkillers. These include “Diclofenac”, “Renalgan”, “Baralgin”. The drugs not only eliminate pain, but also slightly reduce bleeding. Most often, doctors recommend taking pills after meals. For the first couple of days, take one pill orally three times a day. Then take one tablet before bed for another two days.

“No-shpu” is taken as an antispasmodic. It enhances uterine contractions and accelerates the removal of bloody discharge remaining in the organ cavity. Take one tablet two or three times a day for three days.

To prevent the occurrence of postoperative infection, antibacterial therapy is prescribed. Most often, doctors prescribe Cedex or Cefixime tablets. Antibiotics can be taken four hundred milligrams once a day. The course of treatment is at least five days.

Sometimes the attending physician may consider it appropriate to prescribe suppositories that contain iodine. These may be drugs such as Betadine or Iodoxide. Suppositories are used to prevent inflammation and infections in the uterus. The specialist may prescribe one suppository per day for a week. It is best to insert a suppository into the vagina at night.

Antifungal drugs prescribed to prevent thrush are also often recommended for patients after curettage. “Fluconazole” or “Futsis” can be taken orally in a one-time dosage of 150 milligrams.

Healing process

As mentioned above, curettage is a mini-operation, so where the endometrial layer was removed there is an open bleeding wound. To avoid infection or complications, you must follow simple rules.

First of all, after cleaning the uterus, women should not have sex for a month, lift weights over three kilograms, sunbathe in the sun, take baths, swim in a pool or river, visit saunas, and so on.

If there is an elevated temperature, severe pain, no bleeding, or worsening general condition, a woman should definitely consult a doctor.

When can I expect my next period? According to reviews from patients and doctors, critical days will occur four to five weeks after the operation. Your cycle will become regular three months after the procedure.

Pregnancy is possible within a few weeks after cleansing. However, experts recommend planning conception after two to three months.

A couple of days after curettage, you need to visit your doctor for an ultrasound examination and monitoring your well-being, and ten to twelve days later you will be able to find out the result of a laboratory analysis of the endometrium.

Briefly about complications

They occur extremely rarely, but undesirable manifestations can still occur, and you need to be aware of them. Complications after curettage include:

stagnation of blood in the uterus, provoking an inflammatory process;
tear or damage to the walls of the uterus with instruments (the doctor sews up the resulting wound);
damage to the inner layer of the endometrium, which can cause infertility.

Such undesirable postoperative consequences are extremely rare and most often do not pose a threat to the life or health of the patient.

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.

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

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

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

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

Gynecological cleansing can be carried out in two ways:

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

Indications

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

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

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

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

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

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

Preparation

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

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

Preparation for cleaning the uterus includes the following tests:

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

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

Procedure

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

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

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

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

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

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

Consequences

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

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

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