What happens to the uterus after curettage. Diagnostic curettage of the uterus. The uterus performs important functions

Curettage is one of the types of surgical intervention in gynecology, in which the mucous membrane of the uterus is removed. Depending on the purpose, it can be therapeutic or diagnostic. Although the procedure is traumatic and can cause complications, sometimes it is necessary. Why and when is it done? In what cases is it carried out? How long does it take? Do they give sick leave, and what to expect after the operation?

A little about curettage of the uterine cavity

The uterus is the main organ of the female reproductive system, in which the intrauterine development of the fetus occurs. Its wall consists of several layers - serous, muscular and mucous membranes. The latter is called the endometrium, it is lined with the inner cavity of the uterus. The endometrium consists of basal and functional layers and changes its thickness depending on the day of the cycle.

Its maximum thickening is observed in the period before menstruation. If conception did not occur in the current month, the uterus begins to contract, rejecting the functional layer of the endometrium. It is this part that is removed during the operation. For this, a curette is used - an instrument shaped like a spoon, so the procedure is often called curettage. If only the endometrium is cleaned with it, we are talking about ordinary cleaning. Separate diagnostic curettage is also accompanied by curettage of the cervix. This removes the endocervix, its inner mucosa.

Cleaning under the control of hysteroscopy is the safest and most effective type of surgical intervention (see video). Hysteroscope - a tube equipped with an optical system, an illuminator and additional devices (forceps, scissors, loops). Thanks to the device, the doctor can see the interior of the uterine cavity, if necessary, magnify the image several times, take a tissue sample.

Why do scraping?

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If the doctor suspects a pathology, a diagnostic curettage is performed to help identify the cause of the existing disorders. In case of diseases, bleeding, miscarriage or missed pregnancy, cleaning is carried out for a therapeutic purpose in order to prevent the development of complications. However, in practice, therapeutic and diagnostic curettage is more often done, in which both diagnostics and therapy of pathologies identified during the procedure are carried out.

Diagnostic purpose

The main purpose of diagnostic curettage is to obtain biomaterial for further research. Usually, separate diagnostic curettage is used for such purposes, since pathologies often extend not only to the uterine cavity, but also to the cervical canal of its cervix. Diagnostic curettage of the uterine cavity is prescribed if a woman has menstrual irregularities, heavy long periods, or the doctor has suspicions about the presence of:

1. Uterine fibroids. Benign neoplasm in the muscular layer of the uterus. It develops due to changes in the properties of cells under the influence of adverse factors - numerous abortions, excess weight, persistent increase in blood pressure, sedentary lifestyle, genetic predisposition.
2. Dysplasia of the cervix. The disease is considered precancerous and is characterized by the replacement of normal cells with atypical ones. The main cause of the pathology is papillomavirus. Separate cleaning is one of the mandatory points of diagnosis and treatment.

Therapeutic purpose

Curettage of the uterine cavity is one of the main surgical techniques for bleeding. Used when other methods have failed. It allows you to stop blood loss and prevent the development of dangerous complications. Cleaning is carried out after a caesarean section, miscarriage or missed abortion to remove the remnants of the fetal egg. The procedure is also used to terminate a pregnancy.

Cleaning the uterus allows you to get rid of polyps - benign formations that resemble mushrooms in shape, which are outgrowths of the epithelium. If they affect the cervix, curettage of the cervical canal is necessary.

Curettage may be necessary for endometrial hyperplasia. The disease is characterized by the growth of its tissues. Provoking factors are trauma during childbirth, abortion, diabetes mellitus, obesity, thyroid pathology and diseases of the reproductive system. In advanced cases, endometrial hyperplasia threatens with infertility, decreased patency of the fallopian tubes due to adhesions, and degeneration into a cancerous tumor.

The operation is indicated for purulent-catarrhal form of endometritis. Pathology is characterized by the presence of an infectious-inflammatory process in the endometrium, which is complicated by the appearance of suppuration. Another indication for surgery is synechia, tissue fusion through bridges. Most often, infections and injuries of the endometrium lead to the development of adhesions.

What is the preparation?

Usually, the procedure for curettage of the uterus is carried out a few days before the onset of menstruation. This is done in order to minimize bleeding and not cause a big disruption in the menstrual cycle. However, in the presence of polyps, the procedure is carried out a couple of days after the end of menstruation, since growths are better visualized on a thin mucous layer.

It is necessary to prepare in advance for the planned therapeutic and diagnostic curettage. Within 2 weeks, in agreement with the doctor, you should stop taking medications, using vaginal suppositories.

2-3 days before the procedure, sexual rest is observed. It is unacceptable to drink alcohol, sweet, fatty, fried foods. For 8-10 hours you can not eat. It is recommended to take a shower the morning before the operation.

Necessary tests before curettage

Before the operation it is necessary to carry out the following studies:

1. Blood tests, clinical and biochemical. They are needed to exclude inflammatory and infectious processes and assess the condition of internal organs.
2. Tests for infections - HIV, syphilis, hepatitis B and C. They help to assess the risk to medical workers who will take part in the operation. If the detected disease is from an acute stage, the operation is postponed.
3. Fluorography. It is necessary to determine the state of the respiratory system.
4. Analysis for blood type and Rh factor. It is necessary for the preparation of donor blood in case of bleeding.
5. Vaginal smear. Allows you to determine the degree of purity, the presence of genital infections and inflammation.
6. Ultrasound of the pelvic organs. It is carried out to assess the condition and location of organs.
7. Analysis of urine. The presence of leukocytes and bacteria indicates an inflammatory process.
8. Coagulogram. Evaluation of blood clotting allows you to identify the risks of bleeding.
9. Cytological examination of a smear of the cervix. Determines the presence of altered tissue cells indicating oncology.
10. Electrocardiogram. It is necessary for assessing the state of the heart, choosing the type of anesthesia and its dosage.

How is the scraping procedure going?

With uterine curettage, general anesthesia is more often used, anesthetics are injected into a vein. The patient is located on the gynecological chair. The doctor installs dilators and treats the vagina with disinfectants. The uterus is fixed with forceps, the length of the cavity is measured with a special probe. A dilator is used to open the neck.

conservative method

After the neck is expanded, a hysteroscope is inserted, thanks to which the cavity of the muscular organ and its walls are examined. A curette is inserted into the uterine cavity. With its help, with careful energetic movements, first the cervix is ​​scraped, then the uterine walls (with separate diagnostic curettage). The biomaterial is placed in a container and left for further research.

After cleaning, the hysteroscope is reintroduced to check the result. Tools are removed, the neck is treated with antiseptics. Ice is applied to the woman's stomach and she is moved to the ward. Sometimes they are discharged by the evening, but it happens that you have to stay in the hospital for several days. It depends on the condition of the patient.

vacuum cleaning

Although the vacuum method of removing the endometrium is gentle, it is usually also performed under general anesthesia in a hospital setting. Sometimes the procedure is carried out under ultrasound guidance. The algorithm of actions during the procedure is the same as during normal cleaning. The difference lies in the fact that instead of a curette, an aspiration tube is included in the set of instruments, which sucks up mucosal tissues. The doctor, rotating it, cleans the uterine cavity. This method is called manual.

With the machine method, which is less common, an electric aspirator is inserted into the uterus. With the help of a special technique, negative pressure is created inside the muscular organ, and the membrane tissues are sucked inward. The advantage of vacuum cleaning is to minimize trauma to the uterus and cervix.

Complications after curettage

After curettage, the following complications may develop:

1. perforation of the uterus. Damage to the wall of the organ with the instruments used during the surgical intervention. Requires urgent surgery for suturing or even removal of the uterus in case of infection. Threatening conditions for uterine rupture are subsequent inflammation of the peritoneum and severe bleeding.
2. Bleeding. It occurs due to the careless actions of a doctor who allowed deep injury to the walls of the uterus, or due to the presence of tissue remnants.
3. Hematometer. The accumulation of blood in the uterus due to a violation of the outflow leads to the development of an infectious process that can cause inflammation of the endometrium and peritoneal membranes, the accumulation of pus in the fallopian tubes.
4. Endometritis. Inflammation of the endometrium of the uterus with damage to both the functional and basal layers develops due to infection during surgery if asepsis is not followed. Pathology can also occur if scraping was carried out against the background of an inflammatory process. The cause of the disease may be conditionally pathogenic flora of the vagina.
5. Damage to the cervix. Separate curettage can cause a violation of the integrity of the walls of the body, requiring suturing.
6. Ovarian cyst. The appearance of a pathological cavity in the form of a cyst is a hormonal response to intervention. Usually, ovarian cysts go away on their own after the normalization of the cycle.
7. Soldering process. Its main cause is damage to the basal layer of the endometrium during surgery. Depending on the degree, the pathology affects the uterus, leading to fusion of its walls, and the fallopian tubes. Such changes affect the functionality of the female reproductive system.

Symptoms such as fever, severe pain in the pelvis and back, putrid odor, or sudden cessation or sudden copious discharge should alert. The use of general anesthesia can also negatively affect the well-being of a woman. Sometimes there are headaches and muscle pains, clouding of consciousness, memory impairment and attention disorder, panic attacks.

Recovery period

Usually, the sick leave is issued to the patient for 3 days, if necessary, it is extended. Due to the traumatic nature of the procedure, curettage requires 3-4 months of complete rehabilitation. During this period, strong physical exertion, overheating should not be allowed. Personal hygiene must be observed. The use of intravaginal suppositories and tampons is not allowed. After the operation (sometimes a couple of days before it), the patient is prescribed antibacterial medications that prevent infection. The course is 5-10 days.

To prevent inflammation during the week, it is recommended to take anti-inflammatory drugs. The term for the resumption of intimate life after curettage of the uterus is agreed with the doctor. Usually you can return to it after a week.

In the postoperative period, it is necessary to monitor the diet, excluding the use of fried, fatty, smoked foods, fast food.

Is pregnancy possible after the procedure?

Violations of the cycle after curettage of the uterine cavity are not uncommon. Delayed menstruation up to 4-6 weeks is not considered a pathology. Usually the cycle is restored after 4 months. Theoretically, pregnancy is possible after the arrival of menstruation. Moreover, if curettage was carried out as part of the treatment of infertility, the chances of becoming a mother after a successfully performed operation are higher than before it. Many women after cleansing were able to get pregnant. If the patient is planning a pregnancy after the procedure, it is better to discuss the timing of the planned conception with the attending physician.

Scraping (cleansing) Most women in their lives are faced with a situation where a gynecologist after an examination prescribes curettage. Women often refer to this operation as "cleansing". Not all patients are told in an accessible form what this operation is, and this ignorance breeds unreasonable experiences.

Let's figure it out.

What is scraped (a bit of anatomy)?

scraping occurs

What is scraped (a bit of anatomy)?

The uterus is a pear-shaped muscular organ in which there is a cavity that communicates with the external environment through the cervix, which is located in the vagina. The uterine cavity is the place where the fetus develops during pregnancy. The uterine cavity is lined with a mucous membrane (endometrium). The endometrium differs from other mucous membranes (for example, in the oral cavity or in the stomach) in that it is able to attach a fertilized egg to itself and give rise to the development of pregnancy.

During the entire menstrual cycle, the mucous membrane of the uterine cavity (endometrium) thickens, various changes occur in it, and if pregnancy does not occur, it is rejected in the form of menstruation and begins to grow again in the next cycle.

In scraping time- it is the mucous membrane of the uterus that is removed - the endometrium, but not the entire mucous membrane is removed, but only superficial (functional layer). After curettage, a germ layer of the endometrium remains in the uterine cavity, from which a new mucous membrane will grow.

For example, every autumn a rose bush is cut to the root and in the spring a new rose bush grows from this root. In fact, curettage is like normal menstruation, only done with an instrument. Why this is done - read below.

During this operation scraping is also performed cervical canal(the place where the entrance to the uterus is located). With this, the scraping procedure usually begins - the mucous membrane lining this channel is also scraped off to the germ layer. The resulting scraping is sent for research separately.

Name deciphering.

Scraping- this is the main action during the manipulation, but the manipulation itself can have various names.

WFD- separate diagnostic (sometimes an addition is used: diagnostic and treatment) curettage of the uterine cavity. The essence of this name: will be fulfilled

separate(first curettage of the cervical canal, then the uterine cavity)

a medical examination, which will make it possible to make an accurate diagnosis, is “cured” - since in the process of curettage, the formation (polyp, hyperplasia) for which it was prescribed is usually removed.

scraping- process description.

WFD+ GS– separate diagnostic curettage under control hysteroscopy- This is a modern modification of scraping. Conventional scraping is performed virtually blindly. When using hysteroscopy (“hystero” - the uterus; scopia - “look”) - the doctor inserts a device into the uterine cavity, with which he examines all the walls of the uterine cavity, the presence of pathological formations is detected, after that he makes a curettage and at the end checks his work. Hysteroscopy allows you to assess how well the curettage is performed, and whether there are any pathological formations.

Why are scrapings carried out - testimonies?

Scraping carried out for two purposes: get material(scraping of the mucous membrane) for histological examination - this allows you to make a final diagnosis; the second goal is remove pathological formation in the uterine cavity or cervical canal.

Diagnostic purpose:

if a woman has an ultrasound scan mucosal changes- Ultrasound does not always allow an accurate diagnosis, most often we see signs indicating the presence of a pathological process. Sometimes ultrasound is performed several times (before menstruation and after). This is necessary in order to be sure that the pathological formation actually exists, and is not just a variant of the structure of the mucous membrane only in this cycle (artifact). If the formation that was found remains after menstruation (that is, rejection of the mucous membrane) - then this is a true pathological formation, it has not been rejected along with the endometrium, curettage should be performed.

If a woman has profuse, prolonged menstruation with clots, intermenstrual spotting, pregnancy does not occur for a long time and other, rarer conditions, and according to ultrasound and other research methods, it is impossible to establish the cause

about uterine fibroids, in which the uterus will be preserved.

Therapeutic goal:

polyps mucous membrane (polypoid growths of the mucous membrane of the uterus) - there is no other type of treatment, they do not disappear with medication or on their own (there will be a separate article on the site)

rong>Synechia

- fusion of the walls of the uterine cavity - is performed using a hysteroscope and special manipulators. Fusions are dissected under visual control

What is the preparation for scraping?

If curettage is not carried out according to emergency indications(as, for example, with uterine bleeding), and in a planned manner, the operation is performed before menstruation, a few days before it starts. This is necessary so that the scraping process itself is practically coincided with the physiological period of rejection of the uterine mucosa(endometrium).

If scraping is carried out in the middle of a cycle or at the beginning - this can lead to prolonged bleeding in the postoperative period. This is due to the fact that the uterine mucosa grows in sync with the growth of follicles in the ovaries - if the uterine cavity mucosa is removed much earlier than the onset of menstruation, the hormonal background created by the ovaries "come into conflict" with the absence of a mucous membrane and will not allow it to fully grow. This condition is normalized only after synchronization between the ovaries and the mucous membrane again occurs.

It would be logical to suggest scraping during menstruation so that the natural rejection of the mucous membrane coincides with the instrumental one. However, they do not do this, because the resulting scraping will not be informative, as the torn mucosa has undergone necrotic changes.

Before curettage, the patient must undergo the following tests (basic set):

General blood analysis

you are invited to a small operating room, where you sit on a table with legs, like a gynecological chair. The anesthesiologist will ask you about the diseases you have experienced and the presence of allergic reactions to medications (prepare for these questions in advance). Later, that is, the whole operation, you may dream of pleasant hallucinations - now they are no longer used, although the art of the anesthesiologist in conducting anesthesia is of great importance) .to expose the cervix. With special forceps (“bullets” at the ends of this instrument there is a clove) it catches the cervix and fixes it. This is necessary so that the uterus is immobile during the procedure - without fixation, it is easily displaced, as it is suspended on ligaments. ia of the cervix. Expanders are a set of iron sticks of various thicknesses (ascending from thinnest to thickest). These sticks are alternately inserted into the cervical canal - which leads to a gradual expansion of the canal to a size that freely passes the curette - the instrument used for curettage. It is a tool that looks like a spoon with a long handle, one edge of which is sharpened. A sharp edge is scraped. Scraping obtained from the cervical canal is placed in a separate jar. is given after the expansion of the cervical canal, a hysteroscope (a thin tube with a camera at the end) is inserted into the uterine cavity. The uterine cavity, all walls are examined. After this, the uterine mucosa is scraped. If a woman had a curette in the process of curettage. After the curettage is over, the hysteroscope is reintroduced and the result is checked. If something is left, the curette is reintroduced and scraped out until everything is achieved. rong> special instruments are introduced into the uterine cavity and these formations are removed under visual control. ng> forceps are removed from the cervix, the cervix and vagina are treated with an antiseptic solution, ice is placed on the stomach so that under the influence of cold the uterus shrinks and the small blood vessels of the uterine cavity stop bleeding. The patient is transferred to the ward, where she wakes up. Day hospital, and the hospital - discharge is carried out the next day). nyh and unpleasant sensations for a woman

It takes about 15-20 minutes, on the same day a woman can go home.

Complications of curettage

Generally scraping in the careful hands of a doctor enough safe operation and is rarely accompanied by complications, although they do occur.

Complications of curettage:

Perforation of the uterus- You can perforate the uterus with any of the instruments used, but most often it is perforated with a probe or dilators. Two reasons: the cervix is ​​very difficult to expand and excessive pressure on the dilator or probe causes it to pierce the uterus; another reason - the uterus itself can be greatly changed, which makes its walls very loose - because of this, sometimes the slightest pressure on the wall is enough to pierce it. Treatment: small perforations are tightened by themselves (observation and a complex of therapeutic measures are carried out), other perforations are sutured - an operation is performed.

“flabby” and bullet forceps do not hold well on them - at the moment of tension, the forceps fly off and tear the cervix.

Inflammation of the uterus- this happens if curettage was performed against the background of inflammation, the requirements of septic and antiseptics were violated, and a prophylactic course of antibiotics was not prescribed. Treatment: antibiotic therapy. Hematometer- accumulation of blood in the uterine cavity. If, after curettage, a spasm of the cervix occurs, blood, which normally should flow from the uterine cavity for several days, accumulates in it and can become infected and cause pain. Treatment: drug therapy, bougienage of the cervical canal (removal of spasm) Mucosal injury(excessive scraping) - if the scraping is done very strongly and aggressively, the germ layer of the mucous membrane can be damaged, which will lead to the fact that the new mucous membrane will no longer grow. A very bad complication - practically untreatable.
In general, all these Complications can be avoided if this operation is performed carefully and correctly.. The complications of curettage include situations when, after this operation, all the pathological formation (polyp, for example) or part of it remains in place. More often this happens when curettage is not accompanied by hysteroscopy, that is, it is impossible to evaluate the result at the end of the operation. In this case, curettage is repeated, since it is impossible to leave a pathological formation in the uterine cavity.

After scraping within a few days (from 3 to 10) you may have spotting spotting. If the spotting stopped immediately and abdominal pain appeared, this is not very good, since there is a high probability that spasm of the cervical canal, and formed hematometer. Need to immediately contact your doctor and tell him about it. He will invite you for an ultrasound and if the spasm is confirmed, they will quickly help you.

As hematometer prevention in the first days after scraping, you can take 1 tablet 2-3 times a day.

In the postoperative period, you must appoint small course of antibiotics- this is necessary for the prevention of inflammatory complications.

Histological examination results are usually ready 10 days after surgery, do not forget to pick them up and discuss with your doctor.

IN imprisonment I would like to point out that scraping is one of the most frequent and most necessary small operations in gynecology. In the treatment and diagnosis of certain gynecological diseases can't do without it. This operation is now being rescheduled. very comfortable and perhaps it can be called one of the the most comfortable interventions, which are in gynecology, since you do not experience pain and discomfort. Of course, if you are in careful gynecologist and anesthesiologist ...

Video. scraping

“Is curettage necessary after a miscarriage? What is bleeding after scraping? Is it difficult to get pregnant after scraping? Why are there pains after scraping? - these questions are most often asked by women in medical forums. Before carrying out curettage, women should ask the doctor in detail about all the features of this procedure and its possible consequences. It should be noted that when the procedure is performed by an experienced and qualified obstetrician-gynecologist, complications are extremely rare. But although a lot depends on the doctor, the diligent fulfillment by the patient of all the prescriptions and recommendations of the doctor, as well as a responsible and careful attitude to her own health, plays a huge role.

What is scraping

A woman's uterus is a muscular organ that looks like a pear. In it, after fertilization of the egg, the unborn child begins to grow and develop. Inside, the uterus is protected by a special mucous membrane called the endometrium. During the cycle of menstruation, this mucous membrane undergoes modifications. When fertilization does not occur, it is rejected, menstruation begins. When scraping, the doctor removes only the upper (functional) layer of the protective mucous membrane. Further, the endometrium is restored from its germ layer.

There is a separate and regular curettage. Separate - involves first cleaning the cervical canal, and then the uterus itself. The resulting scraping is sent for histological examination to establish a more accurate diagnosis.

A more modern analogue of the usual separate diagnostic curettage is hysteroscopy. This procedure is more convenient and safer, since the device that is inserted into the uterine cavity during the procedure allows you to see how the cleaning process is going on.

And the usual procedure is done blindly, which can lead to some violations and complications, for example, the uterus can be injured. Hysteroscopy makes it possible to fully control both the process itself and its results.

Usually the procedure is carried out a couple of days before the onset of menstruation. In this case, the uterus recovers faster.

Curettage, as a rule, is prescribed and carried out according to diagnostic and therapeutic indications.

The main indications for the procedure are:

• endometrial changes detected by ultrasound. When various local formations or thickening of the endometrium are detected. When the thickness of the endometrium has deviations from the norm upwards, they speak of mucosal hyperplasia. To establish an accurate diagnosis, the doctor prescribes this procedure. Such a neoplasm as an endometrial polyp is also an indication for its implementation. In most cases, the polyp does not grow back;
• menstrual cycle disorders. Abundant, prolonged periods, non-occurrence of pregnancy for no apparent reason, the presence of intermenstrual bleeding, bleeding during menopause;
• identified pathologies of the cervix. If during the examination the gynecologist revealed anomalies of the cervix in a woman, especially if they are suspected to be malignant, this procedure is usually prescribed;
• miscarriage. It is prescribed by a gynecologist to remove parts of the placenta remaining in the uterus;
• frozen pregnancy. Unfortunately, not all pregnancies proceed normally. It happens that a woman has to endure curettage as a result of a missed pregnancy.

Indications may also be synechia (intrauterine adhesions), endometriosis, not removed remnants of the fetal egg after a medical abortion or childbirth.

Before the procedure, you need to pass some tests:

• General blood analysis
• Vaginal swab
• Analysis for HIV, syphilis, hepatitis
• Coagulogram

Postoperative complications

After curettage infrequently, but the following complications occur:

• rupture of the cervix. Often the cause of this complication is the dismounting of the bullet tongs. Small tears heal on their own, larger ones require suturing.
• perforation of the uterus. During the operation, the uterus can be pierced by the tools used in the "cleaning". Large perforations require suturing;
• hematometer. Spasm of the cervix leads to the accumulation of blood inside the uterus, as a result of which there is a threat of infection;
• inflammation of the uterus. The causes of this complication include violation of antiseptic requirements and lack of antibiotic treatment. A symptom of the appearance of inflammation of the uterus may be a high temperature;
• damage to the germ layer of the endometrium. This complication is difficult to treat. There is a threat that the endometrium may never recover;
• the pathological formation, due to which the cleaning was prescribed, was not completely removed or not removed at all. This means that repeated scraping will be required. Sometimes neoplasms (for example, a polyp) appear again, then repeated cleaning cannot be avoided either.

When the operation is performed correctly and accurately by an experienced specialist, these complications practically do not occur.

Menstruation after scraping

The first menstruation appears after 4-5 weeks, but a lot depends on the individual monthly cycle and the health of the woman. A delay in menstruation can occur if the girl had a medical abortion. After an abortion, the body needs time to restore reproductive function. Scanty or too heavy periods, especially if they are accompanied by fever and pain in the lower abdomen, are a reason to visit a gynecologist.

The monthly cycle for 2-3 months should be fully adjusted. If the recovery period is delayed, the woman should visit a doctor.

When a patient has had a curettage as a result of a missed pregnancy, miscarriage, to remove polyps, menstruation can be long and profuse. But their absence in due time may indicate the presence of a serious pathology. Therefore, it is not worth delaying in contacting a doctor in this case.

Bleeding after scraping

Often, blood after scraping is observed for several days - like regular periods. But when the bleeding lasts longer, it can indicate the occurrence of serious complications. The blood may come out in clots, or it may be spotty. If the bleeding is too long and profuse, this indicates that complications have arisen. It is also not normal if the bleeding stops very quickly, but severe pain and high fever appear. If you experience these symptoms, be sure to consult a doctor. It should be noted that the temperature after scraping is not higher than 37.5 C is considered quite acceptable.

Discharge after scraping

After scraping, a woman may experience discharge of this nature:

• brown discharge indicates that the blood begins to clot, and they will soon stop;
• severe bleeding, accompanied by pain and high fever. These secretions have an unpleasant odor. This indicates that complications have arisen;
• yellow highlights. The presence of such secretions means that an infection has entered the body and antibiotic treatment may be needed.

Normally, white mucous discharge is restored when bloody discharge ends and there are no complications.

Pain after scraping

When the anesthesia wears off, women complain that their stomach hurts after scraping. The pain is similar to menstrual pain in nature. Such pain can last from two to three hours to several days. No special pain treatment is required. For pain in the postoperative period, the doctor may prescribe pain medication to the woman.

Pregnancy and childbirth after scraping

A woman is able to become pregnant after scraping after 2-3 weeks. Childbirth in this case, as a rule, pass without complications. In the case when it is not possible to become pregnant after this procedure within 6-9 months, you need to consult a doctor. It should be noted that the ability to conceive a baby after curettage is violated only in rare cases.

If a woman plans to become pregnant, she should consult her gynecologist about this. He will correctly assess the situation, and select the most favorable time for conceiving a baby.

Sex after scraping

After scraping for 2 weeks, it is not recommended to have sex. The uterus will be open for some time. The endometrium remains injured. Therefore, during vaginal sex, an infection can be introduced into the uterine cavity, which can lead to serious consequences.

At first, sex can be painful. If the pain lasts no more than 2 months, you should not worry, otherwise you should consult a doctor.

Treatment after scraping

A large number of women after scraping feel pain in the lower abdomen during menstruation. This is a fairly common situation, so antispasmodics, for example, no-shpa, can be prescribed by a doctor to reduce pain and prevent the accumulation of blood clots in the uterus. It is taken one tablet three times a day.

Quite often, doctors prescribe antibiotics to prevent various infections from entering the body and speed up recovery. To prevent severe uterine bleeding that may occur after the procedure, the gynecologist may prescribe a course of oxytocin injections to the patient. Two weeks after the operation, you need to visit the doctor for a re-examination.

Within 14 days after curettage, sex, douching, the use of vaginal tampons, and heavy physical exertion are contraindicated.

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 myoma 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.

Women sometimes face the need to perform a curettage procedure, some tolerate it normally, others experience complications. But in each case, discharge appears after curettage of the uterine cavity, the nature of which is an important diagnostic sign.

Introduction: what is scraping?

Curettage is a surgical operation. It is performed under general anesthesia if there are no contraindications. Such an intervention is carried out to clean the uterine cavity from unwanted or, but sometimes doctors prescribe a procedure for diagnostic purposes.

Regardless of the task, a woman has a bleeding wound for several days, because the essence of the operation is the instrumental scraping of living cells. The only difference is the amount of tissue removed.

Therefore, the discharge after curettage of a missed pregnancy is similar to fluids that naturally leave as a result of intervention for other reasons. However, there are several nuances by which doctors determine the success of the operation and the absence of complications.

In the final phase of the menstrual cycle, the functional layer is rejected, and many women will not notice the difference in monthly discharge and those after curettage. The uterus will bleed for some time, but many of the fair sex are interested in: how many days will the discharge after scraping last?

In this situation, the complexity of the operation, the hormonal background, blood clotting, and many other factors play a role. However, in clinical practice, there are still certain criteria for the normality of such discharges:

1. Lasts an average of 5-6 days, but no more than 10.
2. The intensity of bleeding gradually decreases and the discharge acquires a smearing character.
3. There is pain in the pelvic area.

Each woman has an individual menstrual cycle, depending on the functioning of the ovaries and pituitary gland. If the operation was performed on the eve of menstruation, then the bleeding usually stops after 6 days. By the way, this little trick will allow a woman to avoid double torment.

One of the signs of successful healing is after scraping. This color indicates the beginning of blood clotting. However, if they continue after a 10-day period, then you should consult a gynecologist.

What other symptoms should alert a woman?

Pathological discharge after curettage

Well, if the operation went smoothly, and there were no difficulties. However, in some cases, the discharge becomes pathological:

1. They smell bad.
2. Too liquid and rich.

Liquid exudate is usually released from such wounds - ichor. If it comes out of the vagina in large quantities, this indicates difficult healing. Particular attention should be paid to the color of the liquid: yellow discharge appears only in case of a bacterial infection. And this is very serious! Doctors usually prescribe a 5-day course of antibiotics after surgery to stop the infection.

In addition, pathological discharge often smells bad. The fact is that bacteria in the course of their life activity synthesize volatile compounds, which cause an unpleasant, and sometimes even a pungent odor.

In general, a woman should carefully monitor her condition and go to the hospital if she has the following symptoms:

• the temperature has risen to 38 °C;
• there are no discharges;
• severe pain in the abdomen;
• excessive amount of outgoing sputum;
• change in color, density and smell of secretions;
• general deterioration of well-being (weakness, dizziness, etc.).

Of course, any operation is stressful for the body. Therefore, the temperature will inevitably rise to at least 37 ° C, and for a couple of days the patient's condition will not be the best. With a pronounced pain syndrome, it is allowed to take an analgesic, for example, No-shpu.

However, gradually the body should come to noma on its own. And if this does not happen, then the doctor may suspect complications and prescribe an additional examination.

Possible Complications

The presence of pathological discharge is an indirect sign of complications. They provide grounds for in-depth verification using ultrasound. In addition, biological material is often taken to study for a bacterial infection. Such diagnostic measures are necessary to accurately determine the nature of the pathology, because treatment will also depend on this.

And the sooner a woman seeks help, the better. What complications can the patient expect after the operation?

1. Uterine bleeding.
2. Hematometer.
3. Endometritis.

Uterine bleeding occurs due to poor blood clotting. At the same time, a woman has to change sanitary pads almost 2 pieces in 1 hour.

The result can be anemia, which often provokes insufficient oxygen saturation - hypoxia. And this is already fraught with premature tissue death. In a particularly serious condition, doctors even administer Oxytocin to the patient to stop uterine bleeding.

The main symptom of hematometra is a spasm of the cervix, which prevents the free evacuation of fluid. This usually happens right after surgery.

As a result, the uterine cavity fills with blood, and bacteria begin to develop in it. Hematometra is accompanied by pain in the lower abdomen, and to solve the problem, one thing is required - to clear the way for blood.

This can be done either with medicines or surgical instruments. But in any case, there is a risk of spasm recurrence and bacterial infection, therefore, after the pathology is eliminated, a course of antibiotics is prescribed in combination with antispasmodics.

Endometritis is a fairly common complication after curettage. It manifests itself in the form of inflammation of the uterine mucosa due to the activity of pathogenic microorganisms. The infection enters the body in different ways, and often from the vagina. Infection is also possible due to medical negligence (insufficiently processed instrument, dirty gloves, etc.).

Vivid signs of endometritis are rightfully considered yellow discharge and an unpleasant odor from the vagina. Along the way, the patient has a fever and pain in the abdomen. Pathology is treated with antibiotics.

Women are usually afraid to have an abortion because there is a risk of losing the ability to conceive. Of course, no one is immune from such an outcome, but in medical practice there are not many facts that indicate the development of infertility precisely because of curettage. If initially the uterus functioned normally and the operation was successful, in the vast majority of cases the tissues will recover and the woman will be able to have children.

Question answer

Before scraping, the fair sex is very worried. The concern is understandable, because surgery sometimes provokes serious complications. That is why women have a lot of questions to the gynecologist. And it is not in vain that patients are interested in: forewarned is forearmed. Below are the most frequently asked questions in the doctor's office and short answers.

What should be the discharge after scraping?

Bleeding is considered normal, as with menstruation. Gradually, their intensity decreases, and the color becomes brownish. If the liquid has acquired a yellow tint, smelled badly, or has become like an ichor, then this indicates a pathology.

How long is the discharge after scraping?

The average duration of sputum discharge is 5-6 days. If the discharge stopped after 1-2 days or did not stop after 10 days, you need to go to the hospital.

Does the temperature rise after scraping?

As a rule, body temperature fluctuates between 37-37.5 ° C - this is normal. But an increase above 38 ° C indicates an infection.

What causes pain after scraping?

Surgery is the removal of living tissue. In this case, the nerve endings are damaged and inevitably there is pain in the lower abdomen. However, such a syndrome can be of varying intensity. Severe pain often indicates uterine bleeding, hematometer or endometritis. And if analgesics do not help, then you need to see a doctor.