home Thyroid How women get cleansed. Why do they clean? How dangerous is the period after the procedure?

How women get cleansed. Why do they clean? How dangerous is the period after the procedure?

Cleaning is carried out mainly in order to obtain material, that is, scraping the uterine mucosa for histological examination. The taken material allows you to install accurate diagnosis. The second purpose of cleansing is to remove pathological formations in the cervix or uterine cavity.

Curettage is prescribed in the following cases:
- if a woman has long-term and very heavy menstruation with the presence of clots, intermenstrual bleeding, for a long time does not occur, as well as other states when the data ultrasound examination do not allow the cause to be determined;
- changes in the uterine mucosa, indicating pathological processes;
- changes in the cervix;
- cleaning is often carried out before a planned gynecological operation.

Preparing for cleaning

If cleaning is not carried out for an emergency indication, but as planned, then the operation is performed before the onset of menstruation. This is necessary so that the process coincides with the physiological period of rejection. If you were prescribed to remove polyps, then the operation is performed after your period.

Before cleaning, a woman must pass general analysis blood tests, tests for HIV, hepatitis B and C, syphilis, undergo an ECG, do a coagulogram, take a vaginal smear for cleanliness. On the day of surgery, you must arrive on an empty stomach. pubic hair must be shaved. You need to bring socks, a long T-shirt, a robe, slippers and sanitary napkin.

Curettage procedure

The woman is invited into the operating room, where she is positioned on a table in the form of a gynecological chair. The anesthesiologist conducts a conversation about the presence allergic reactions on medications and about previous diseases. The operation is performed under general anesthesia, which lasts 15-25 minutes. After administering the drug into a vein, the patient falls asleep.

The doctor uses a special probe to penetrate the uterine cavity and measure the length of the cavity. Then it dilates the cervix. The dilators are alternately inserted into the cervix, which leads to a gradual opening of the canal to a size that allows the curette to pass through. Then the mucous membrane of the cervix is cleaned with a special instrument. The curette is similar to a spoon with a long handle, one edge is sharpened. Sharp side and scraping is performed. The scraping from the canal is placed in a separate jar.

After the process is completed, the dilators are removed from the cervix. The vagina and cervix are treated with antiseptics, and ice is placed on the stomach. Under the influence of cold blood vessels stop bleeding, the uterus contracts. The patient is transported to the ward, where she gradually wakes up. Within a few hours the woman can go home.

Country houses usually have their own independent water supply and heating systems, so the owners must independently be able to maintain the functionality of the infrastructure of their own home.

Instructions

Each house has its own individual heating system and in most cases the design solution takes into account independent drainage of water, but there are exceptions and simply “careless work” of the system installers (for example, pipes can run at or below floor level), in which you must intervene the process of draining water to avoid freezing in the system and, accordingly, failure of the system. To do this, be sure to purchase a compressor and receiver, which you use after the water has naturally drained, so that the system can remove residues.

When purchasing a compressor, take into account the dimensions of the heating system, the diameters of the pipes, depending on which specialists will select a compressor of a certain power and a receiver of the required volume.
Remember that the volume of the receiver should be approximately 3 times the volume of water placed in your system.

Be sure to check with the specialist how many branches your system includes and how many drain valves it has. For greater efficiency, blow through each branch of the system separately, otherwise, due to the increasing cross-section, the speed of air movement in some places may not be enough, or purchase a more powerful receiver right away.

Remember that even if you use a compressor, you may not be able to blow out all the moisture completely! In this case, it makes sense to add antifreeze, which will give you 100% confidence that in the next warm season you will not have to think about repairing the heating/water supply system.

The uterine organs are the most important paired organ reproductive system women. Often, inflammatory processes in the tubes lead to a woman’s inability to conceive a child. One of the methods of treating obstruction is pipe cleaning.

From hydroturbation to laparoscopy

The adhesive process occurs as a result chronic inflammation female genital area. It is often the reason female infertility. In this case, there is complete or partial obstruction of both or one pipe. This prevents the sperm from fertilizing the egg, resulting in the impossibility of pregnancy.

Today, medicine offers four methods of cleansing fallopian tubes: hydroturbation, laparoscopy, fertiloscopy, recanalization. The attending physician will select a method based on individual characteristics organism and the degree of disease. For many years, hydroturbation has been used in our country - this is a method of cleaning the fallopian tubes, in which a woman is washed with a solution through the vagina with a syringe. However, in last years efficiency this method Pipe cleaning is in question, which is why laparoscopy has now become more popular.

Laparoscopy is a modern and less traumatic way to clean the fallopian tubes. Its essence is that the doctor does three small puncture on the peritoneum. Through them, small instruments are used to excise formations leading to the formation adhesive process, and the fallopian tubes are cleared. The fallopian tubes are then sutured. The patient is under general anesthesia during the procedure. On a positive note of this method is that after the operation the patient quickly recovers and returns to active life. This is the most common method of cleaning the fallopian tubes today.

Fertiloscopy is similar to laparoscopy. The main difference between these operations is that during fertiloscopy, instruments are inserted through the vagina. In this way, the doctor cleans the woman’s fallopian tubes.

With partial damage to the fallopian tubes

Recanalization is used for women in whose tubes the inflammatory process has not started. A special feature of recanalization is that a catheter moves through the fallopian tubes, separating the welded sections of the tubes. On average, the procedure takes about half an hour. The woman does not require observation in a hospital and can go home immediately.

It is worth saying that often a woman undergoes cleaning of the fallopian tubes not once, but several times. This is due to the resumption of the inflammatory process in the pipes. To reduce the risk of secondary formation of adhesions after cleaning the fallopian tubes, physical therapy is prescribed.

Cleaning the uterus (curettage or curettage) is a very common surgical intervention. Information preparation before this manipulation will allow the patient to calm down, be confident in its necessity and learn about all the nuances of the intervention. A woman should not be afraid of curettage, since in modern gynecology this procedure is painless, and its complications are extremely rare.

If the patient has been prescribed a cleaning, there is nothing surprising about this. When scraping, you can determine various diseases uterus, remove the pathological process or stop the bleeding that debilitates the woman. There are two types of scraping:

diagnostic;
medicinal.

The main function of the uterus is to bear the fetus. The inner uterine layer is called the endometrium and is a protective mucous membrane. Monthly in the uterus of women reproductive age cyclical changes occur. At the same time, the endometrium grows, preparing for the possible fertilization of the egg and its consolidation. If pregnancy does not occur, the endometrial cells are shed, accompanied by menstruation.

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

When curettage is performed correctly, only the functional uterine layer is removed, which is quickly restored. The basal uterine layer is not affected.

After cleaning, a layer of the endometrium (germ) remains in the uterus, which quickly grows and is restored. Recovery after cleansing occurs within the normal time frame for the monthly cycle.

The tissue obtained from scraping is sent for examination.

What is the purpose of scraping?

Typically, uterine curettage is performed for the following reasons:

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

In what cases is cleaning done for diagnostic purposes, and in what cases is it performed for treatment?

Diagnostic curettage is performed when:

formations on the cervix;
long periods with clots, or bleeding outside the cycle;
infertility of unknown cause;
before operations in the uterine cavity;
suspected oncological processes;
after changes in the mucosa, confirmed by ultrasound and not disappearing after menstruation.

Scraping with therapeutic purpose can be done in situations:

polyps on the uterine mucosa that do not disappear after drug treatment;
hyperplasia (excessive growth of the endometrium) of the endometrium (the only method of treatment);
uterine bleeding (with various reasons, incl. and when unclear);
incomplete termination of pregnancy;
inflammation after an abortion or after spontaneous miscarriages;
dissections during fusion of the uterine walls;
treatment of endometritis.

Contraindications

For anyone surgical intervention exist general contraindications in the form of infectious diseases with high fever, inflammation acute course, severe general ailments.

Curettage is also not performed for some gynecological diseases or conditions:

normal pregnancy;
developmental defects or infectious processes uterus;
deforming tumors;
less than 6 months after termination of pregnancy.

The doctor always decides about the possibility of curettage for a woman.

Types of curettage

There are two main types of curettage commonly used:

Separate. With this method, the cervical canal, and then the uterus itself. It makes it easier to carry out correct diagnosis and is often combined with hysteroscopy, when a optical instrument. This method makes the procedure safe and reduces the risk of complications
The usual method of curettage is with surgical instruments. This manipulation is performed blindly and can cause damage to the uterus.
Vacuum cleaning. This is a gentle method that minimizes trauma during intervention. It is used as a method of diagnosis, treatment or during abortion.

When to clean

It is undesirable to cleanse in parallel with the onset of menstruation due to the low information content of such research results.

It is also undesirable to clean the uterus at the beginning or middle of the cycle due to the friability of its mucous membrane and the risk of bleeding.

When cleaning at the beginning of the cycle or in its middle, there is a high probability of hormonal imbalance in the woman’s body. After all, the growth of the uterine mucosa occurs in parallel with the growth of ovarian follicles. If at this moment the uterine mucosa is suddenly removed, the work of the ovaries is disrupted - a contradiction occurs between the uterine and ovarian cycles.

How to prepare for curettage

Cleaning the uterus can be done by emergency indications(for example, with uterine bleeding). In this case, there is simply no time to prepare for this intervention.

If scraping is carried out according to plan, then preparation for it is mandatory.

Before curettage, a woman is usually prescribed tests:

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

For curettage, the woman comes on an empty stomach, having shaved the hair in the perineum. The patient is advised to limit the amount of fluid and take with her pads, slippers, a disposable diaper, and clean cotton clothes (T-shirt, socks, robe).

What awaits a woman during curettage?

Of course, it is important for a woman to know in advance what to prepare for and what awaits her in the process of cleaning the uterus. Let's look at how scraping is done in general.

A woman enters the operating room and sits on a table similar to a gynecological chair.
The anesthesiologist clarifies the patient’s possible allergic reactions and past illnesses.
A woman is given intravenous drugs for anesthesia with short-term action. After that, she falls asleep and wakes up in the ward. The patient will not have to endure any pain. Besides, modern drugs are not accompanied by hallucinations or difficult recovery from anesthesia.

What manipulations does the patient undergo during cleaning?

Before the operation, a speculum is inserted into the woman to expose the cervix.
Using special “bullet” forceps, the gynecologist fixes the cervix to ensure its immobility at the time of intervention.
Using a probe, the specialist penetrates the uterus. Dilators are then used on the cervix until it begins to pass through the curette (curettage instrument). In this case, after scraping, the tissue is placed in a special container.
When using a hysteroscope (a device with a camera at the end), everything is examined uterine walls. Then scraping is performed. After the procedure, the hysteroscope is reinserted to check the result. It is thanks to the hysteroscope that various pathological inclusions in the uterus (myomatous nodes, polyps, etc.) Usually curettage lasts no more than 15-20 minutes.
After the operation, the vagina and cervix are treated with antiseptics. Ice is placed on the woman's stomach to prevent bleeding.

The woman is transferred to a ward, where she remains for several hours. After this (or the next day), the woman is often sent home.

Possible complications

Complications after cleaning are rare. To do this, scraping should be done in medical institution a qualified specialist.

However, cleaning is an operation and may have complications. Rare, but possible complications when scraping, there may be cases:

exacerbations of gynecological inflammation;
adhesions in the tissues of the uterus;
puncture of the uterus with surgical instruments;
neck tear;
damage to the mucous membrane;
leaving polyps, adhesions or nodes in the cavity that were planned to be removed;
hematometers (collections of blood in the uterus)

With careful manipulation, complications can almost always be avoided. Minor tissue damage heals on its own after cleaning. Only massive injuries to the cervix or uterus require surgical intervention. When inflammation or hematomas occur, drug treatment is used.

A serious complication of brushing is removing too much mucous. This condition often leads to infertility due to the inability to attach ovum.

Vacuum cleaning of the uterus

The use of vacuum minimizes complications during interventions in the uterine cavity.

In addition to diagnosis and treatment gynecological diseases(hematoma, bleeding), vacuum curettage is very often performed when:

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

Scraping with the vacuum method is performed with special tips and a vacuum pump. Moreover, due to the negative pressure in the uterus pathological tissue are excreted from the uterus.

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

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

Woman's behavior after curettage

After curettage, a woman usually experiences spotting for several days associated with hormonal changes in organism. Typically, menstruation begins after a month and may differ slightly from normal (be shorter, scantier, etc.)

Abdominal pain is natural after cleansing, and you should not be afraid of it. Usually, for pain in the lower abdomen, it is recommended to use painkillers.

Protect yourself from hypothermia and physical exertion.
Avoid high temperatures(steam rooms, baths, saunas).
Maintain genital hygiene.
Give up sex for a month.

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

Pregnancy immediately after curettage may result in miscarriage or intrauterine death.

IN modern conditions A woman should absolutely not be afraid of hospital cleaning. Thereby useful method many can be identified and treated gynecological pathologies. Complications during the curettage procedure are extremely rare, and the intervention itself is painless for the patient.

Most women in their lives are faced with a situation where the gynecologist, after an examination, prescribes curettage. Women often call this operation among themselves "cleaning". Not all patients are told in an accessible form what this operation is, and this ignorance gives rise to unfounded worries.

Let's figure it out.

What is scraped out (a little anatomy)?

The uterus is a muscular organ shaped like a “pear”, in which there is a cavity communicating with 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 mucous membrane (endometrium). The endometrium differs from other mucous membranes (for example, in oral cavity or in the stomach) in that it is capable of attaching a fertilized egg to itself and giving rise to the development of pregnancy.

Throughout 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.

During curettage, it is the mucous membrane of the uterus - the endometrium - that is removed, but not the entire mucous membrane is removed, but only the superficial one ( functional layer). After curettage, a germinal 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 at the root and in the spring a new rose bush grows from this root. In fact, scraping is similar to normal menstruation, only performed by the instrument. Why this is done - read below.

During this operation, the cervical canal (the place where the entrance to the uterus is located) is also scraped. This is where the curettage procedure usually begins - the mucous membrane that lines this canal also down to the germ layer is scraped off. The resulting scraping is sent for examination separately.

Explanation of names

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

Russian Far East– separate diagnostic (sometimes an addition: therapeutic and diagnostic) curettage of the uterine cavity. The essence of this name: will be fulfilled

separate(first curettage of the cervical canal, then the uterine cavity)
treatment and diagnostic– the resulting scraping will be sent for histological examination, which will allow an accurate diagnosis to be made, “treated” - since in the process of curettage, the formation (polyp, hyperplasia) for which it was prescribed is usually removed.
scraping- process description.

RDV+ GS– separate diagnostic curettage under hysteroscopy control is a modern modification of curettage. Conventional curettage is performed virtually blindly. When using hysteroscopy (“hystero” - uterus; scopia - “look”) - the doctor inserts a device into the uterine cavity, with which he examines all the walls of the uterine cavity, detects the presence of pathological formations, then performs curettage and finally checks his work. Hysteroscopy allows you to evaluate how well the curettage was performed and whether there are any pathological formations left.

Why is curettage performed?

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

Diagnostic purpose of curettage

if a woman's ultrasound shows changes in the mucous membrane, ultrasound does not always allow an accurate diagnosis; most often we see signs indicating the presence pathological process. Sometimes ultrasound is performed several times (before and after menstruation). 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 (an artifact). If the formation that was found remains after menstruation (that is, rejection of the mucous membrane), then it is a true pathological formation, it has not been rejected along with the endometrium, curettage should be performed.
If a woman has abundant long periods with clots, intermenstrual bloody issues, long time Pregnancy and other, rarer conditions do not occur, and according to ultrasound and other research methods it is not possible to establish the cause
If there are suspicious changes on the cervix, a diagnostic curettage of the cervical canal is performed
Before planned gynecological surgery or a procedure for uterine fibroids, in which the uterus will be preserved.

Therapeutic purpose of curettage

Mucosal polyps (polyp-like growths of the uterine mucosa) - 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)
The hyperplastic process of the endometrium (hyperplasia) - excessive thickening of the uterine mucosa - is treated and diagnosed only by curettage, subsequently drug therapy or instrumental methods(there will be a separate article on the site)
Uterine bleeding – the cause may not be known. Curettage is performed to stop bleeding.
Endometritis is an inflammation of the uterine mucosa. For complete treatment, the mucous membrane is first scraped off.
Remains of membranes and embryonic tissues - treatment of complications after abortion
Synechia - fusion of the walls of the uterine cavity - is performed using a hysteroscope and special manipulators. Under visual control, adhesions are dissected

How to prepare for curettage?

If curettage is not performed for emergency indications (as, for example, with uterine bleeding), and as planned, the operation is performed before menstruation, a few days before its onset. This is necessary so that the curettage process itself practically coincides in terms of the physiological period of rejection of the uterine mucosa (endometrium). If you plan to undergo hysteroscopy with removal of a polyp, the operation, on the contrary, is performed immediately after menstruation so that the endometrium is thin and the location of the polyp can be accurately seen.

If curettage is carried out in the middle of the cycle or at the beginning, this can lead to prolonged bleeding in the postoperative period. This is due to the fact that the uterine lining grows synchronously with the growth of follicles in the ovaries - if the uterine lining is removed significantly ahead of schedule the onset of menstruation, hormonal background, created by the ovaries, “will come into conflict” with the absence of the mucous membrane and will not allow it to fully grow. This condition is normalized only after synchronization between the ovaries and the mucous membrane occurs again.

It would be logical to propose curettage 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, since the rejected mucous membrane has undergone necrotic changes.

Tests before curettage (basic set):

General blood analysis
Coagulogram (assessment of the blood coagulation system)
Tests for hepatitis B and C, RW (syphilis) and HIV
Vaginal smear (there should be no signs of inflammation)

On the day of curettage, you need to come on an empty stomach, the hair in the perineum should be removed. You bring a robe, long T-shirt, socks, slippers and pads.

How does curettage occur?

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 your previous illnesses and any allergic reactions to medications (prepare for these questions in advance).

The operation takes place under intravenous anesthesia - this is a type general anesthesia, but only it is short-term, on average 15-25 minutes.

After the drug is injected into a vein, you immediately fall asleep and wake up in the ward, that is, you sleep throughout the operation and do not experience any discomfort, but on the contrary, you may have sweet dreams. Previously used for anesthesia heavy drugs, which caused very unpleasant hallucinations - now they are no longer used, although the skill of the anesthesiologist in administering anesthesia is of great importance.

The operation itself is performed as follows. The doctor inserts a speculum into the vagina to expose the cervix. Using special forceps (“bullet pins” there is a tooth at the ends of this instrument) it catches the cervix and fixes it. This is necessary to ensure that the uterus remains motionless during the procedure - without fixation, it easily moves, as it is suspended by ligaments.

Using a special probe (iron rod), the doctor enters the cervical canal and penetrates the uterine cavity, measuring the length of the cavity. After this, the stage of cervical dilatation begins. Extenders are a set of iron sticks, various thicknesses(in ascending order from thinnest to thickest). These sticks are alternately inserted into the canal of the cervix, which leads to a gradual expansion of the canal to a size that freely passes the curette, the instrument used to perform curettage.

When the cervical canal is dilated, the mucous membrane of the cervical canal is scraped. This is done with the smallest curette. A curette is an instrument similar to a spoon with a long handle, one edge of which is sharpened. A sharp edge is used to scrape. The scraping obtained from the cervical canal is placed in a separate jar.

If curettage is accompanied by hysteroscopy, then after dilation of the cervical canal, a hysteroscope (a thin tube with a camera at the end) is inserted into the uterine cavity. The uterine cavity and all walls are examined. After this, the lining of the uterus is scraped. If a woman had polyps– they are removed with a curette during the curettage process. After the curettage is completed, the hysteroscope is reinserted and the result is checked. If something remains, reinsert the curette and scrape it out until the result is achieved.

Some formations in the uterine cavity cannot be removed with a curette (some polyps, synechiae, small myomatous nodes growing into the uterine cavity), then through hysteroscope Special instruments are introduced into the uterine cavity and, under visual control, these formations are removed.

After the process is completed curettage Forceps are removed from the cervix, the cervix and vagina are treated with an antiseptic solution, ice is placed on the abdomen so that under the influence of cold the uterus contracts and the small blood vessels of the uterine cavity stop bleeding. The patient is transferred to the ward, where she wakes up.

The patient spends several hours in the ward (usually sleeping, with ice on her stomach) and then gets up, gets dressed and can go home (if this is not day hospital, and the hospital - discharge is carried out the next day).

Thus, curettage proceeds without any painful or unpleasant sensations for the woman, takes about 15-20 minutes, the woman can go home the same day.

Complications of curettage

In general, curettage in the careful hands of a doctor is a fairly safe operation and is rarely accompanied by complications, although they do occur.

Complications of curettage:

Perforation of the uterus– the uterus can be perforated using any of the instruments used, but most often it is perforated with a probe or dilators. Two reasons: the cervix is very difficult to dilate, and excess pressure on the dilator or tube causes it to pierce the uterus; Another reason is that 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 heal themselves (observation and complex therapeutic measures), other perforations are sutured - surgery is performed.
Cervical tear– the cervix most often tears when the bullet forceps fly off. Some cervixes are very “flabby” and bullet forceps do not hold well on them - at the moment of tension, the forceps fly off and tear the cervix. Treatment: Small tears heal on their own; if the tear is large, stitches are applied.
Inflammation of the uterus– this happens if curettage was performed against the background of inflammation, the requirements of septic and antiseptic conditions were violated, and a prophylactic course of antibiotics was not prescribed. Treatment: antibacterial 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 (spasm relief)
Damage to the mucous membrane(excessive curettage) - if you scrape very hard and aggressively, you can damage the germ layer of the mucous membrane, which will lead to the fact that the new mucous membrane will no longer grow. A very bad complication - practically untreatable.

Generally, complications can be avoided if this operation is performed carefully and correctly. Complications of curettage include situations when, after this operation, the entire 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 the pathological formation in the uterine cavity.

What's next?

After curettage, you may have spotting and spotting for several days (from 3 to 10). If the bleeding immediately stops and abdominal pain appears, this is not very good, since there is a high probability that a spasm of the cervical canal has occurred and a hematometer. Need it right away contact your doctor and let him know about it. He will invite you for an ultrasound and if the spasm is confirmed, they will quickly help you.

To prevent hematomas in the first days after curettage, you can take No-Spa 1 tablet 2-3 times a day.

In the postoperative period you should be prescribed short course of antibiotics– this is necessary to prevent inflammatory complications.

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

In conclusion, I would like to note that curettage is one of the most frequent and most necessary minor operations in gynecology. It is indispensable in the treatment and diagnosis of some gynecological diseases. Now this operation is very comfortable and can probably be called one of the most comfortable interventions available in gynecology, since you do not experience pain or discomfort. Of course, if you get to a careful gynecologist and anesthesiologist.

Content

The period after curettage of the uterine cavity requires a special approach on the part of the doctor and responsible implementation of all recommendations on the part of the patient. Reproductive and physical abilities female body not unlimited, therefore important task The gynecologist who performed the cleansing of the uterus is considered to have a full, careful observation and provision of a protective regime.

In the period after cleansing the uterus, experts identify three main areas of work for complete rehabilitation:

Prevention of infections.
Restoration of the endometrium and menstrual cycle.
Restoring physical and mental health.

To achieve the goals, gynecologists give recommendations in terms of intake antibacterial drugs, oral contraceptives, limiting physical activity, maintaining sexual rest and performing general strengthening measures.

How you feel after cleaning

Get into the usual rhythm of life, resume sports and physical exercise Not everyone succeeds quickly. Recovery time largely depends on the individual characteristics of the body.

After curettage, moderate abdominal pain, mild anesthesia-related dizziness, and moderate bleeding are usually noted.

Restoration of the uterus after curettage, both therapeutic and diagnostic, lasts one menstrual cycle, the whole body - from 2 to 6 months.

General health after curettage:

Body temperature up to 37.2-37.3 is considered normal in the first 2-3 days.

Moderate abdominal pain lasts up to 7 days.

Slight dizziness is acceptable.

Discharge after cleaning procedure:

The first few days there is discharge from the genital tract in the form of fresh blood, as during menstruation.
A week after curettage, the discharge takes on a sanguineous character: it becomes mucous and has Brown color due to the admixture of altered blood.
Restoration is completed with secretions having yellow, which gradually take on a classic appearance: scanty, mucous discharge, which, when dry, takes on a yellowish tint.
The duration of discharge is normal recovery period is 10-12 days.

Next after curettage Your period should start after 25-45 days.

Normally, the first day of menstruation should occur after a period of time, equal to length cycle before cleaning (provided it is regular).

What to pay attention to and when to seek help medical workers if a woman has undergone curettage:

Long-term (more than 20 days) bloody discharge.
Scanty or heavy menstruation, spotting not associated with menstruation long term after scraping. These symptoms may indicate the development of cervical endometriosis or hormonal imbalance.
Unpleasant smell of discharge.
The discharge looks like “meat slop”.
Increased discharge with light physical activity.
Pain in the lower abdomen that lasts more than a week after curettage.
An abrupt cessation of discharge after uterine curettage, which may indicate the accumulation of clots in the cavity of the organ (hematometer).
Heavy bleeding.
Increased body temperature.
Loss of consciousness.

The above symptoms may indicate the development of endometritis.

The severity of some purulent-inflammatory diseases of the internal genital organs after curettage may not match clinical picture and laboratory parameters.

That is why it is extremely important to be under the supervision of a doctor if there are even minimal signs of infectious complications.

How dangerous is the period after the procedure?

The uterine cavity after cleaning is an extensive wound surface. The lion's share of recommendations after curettage will be aimed at preventing microorganisms from entering the cavity of the operated organ. Gynecologists are aimed at preventing the development of inflammation reproductive organs and its chronicity.

Experts identify two groups of risk factors for the development of infectious complications after uterine curettage:

Main group. IN this category includes women with a history of endometritis, chronic recurrent chlamydia, urea and mycoplasmosis, candidiasis, human papillomavirus infection, and persistent vaginal dysbiosis. In such patients, the likelihood of developing purulent-inflammatory diseases in the gynecological area during curettage is most likely. Patients are subject to the closest attention from doctors. This also includes emergency cases performing curettage.

Additional group. Patients who had uterine cleansing due to bleeding (endometrial hyperplasia), miscarriage, curettage of placenta or ovum remnants have a lower risk of infectious complications compared to the main group.

Women who have undergone diagnostic curettage have the lowest risk of complications infectious nature. Typically, this type of study is carried out in case of infertility of unknown origin, in preparation for IVF, suspected polyps and subserous fibroids, menstrual irregularities.

Factors that indirectly influence the period after curettage:

Obesity.
Diabetes.
Anemia.
Hypothyroidism.

The above diseases have an indirect effect on the course of the recovery period of curettage, but their presence significantly reduces physical strength, the body's resistance to infections and slows down the healing processes of the wound surface in the uterus after curettage.

Most a common complication infectious nature after curettage endometritis is considered to be inflammation of the inner layer of the uterus.

The causative factor of the disease is the opportunistic vaginal flora (staphylococci, streptococci, coli), as well as representatives of pathogenic flora, if the patient before the operation had untreated sexually transmitted infections - chlamydia, ureaplasmosis, mycoplasmosis, gardnerellosis and others. That is why, in the period after therapeutic curettage Gynecologists recommend taking antibacterial drugs without fail, regardless of the infectious history. After the lapse of diagnostic cleaning You can limit yourself to taking sulfonamides.

According to statistics, the incidence of endometritis after uterine cleansing is 20%.

Purulent-inflammatory diseases of the genital area do not always appear after curettage due to non-compliance with the doctor’s recommendations. Nosocomial infection is still relevant today. A woman should choose modern clinics with extensive obstetrics and gynecology experience.

Poor quality cleaning can result from the penetration of endometrial cells into the cervical tissue, which leads to endometriosis.

Sexual activity is excluded for 3 weeks after cleansing. The goal is to prevent infectious complications and bleeding. In addition to bacteria, semen contains prostaglandins that relax the uterus.
It is recommended to use a condom for 6 months after curettage to prevent pregnancy.
You should not take a bath or visit the pool for a month.
It is not recommended to use tampons to absorb blood after curettage. This may trigger the development inflammatory processes in the uterine cavity.
After curettage, physical activity should be limited as much as possible.

Recommendations for taking antibiotics and other medications during curettage:

Antibacterial medications must be taken strictly at regular intervals.
Minimum duration of treatment antimicrobial agents: 3 days for Azithromycin and 5 days for other drugs.
The dosage of the drug should correspond to the patient’s weight.
Drinking alcohol while taking antibiotics is not recommended.
To remove pain syndrome you should take Ibuklin or Diclofenac.
To prevent the formation of adhesions, enzyme preparations (Wobenzym, Longidaza) are usually prescribed.

Restoring menstrual function is important part rehabilitation period after curettage. The cyclical work of the female body is very sensitive to various fluctuations and outside interference. “Artificial” getting rid of the endometrium sends incorrect signals to the main regulators of the menstrual cycle - the hypothalamus and pituitary gland. The ovaries, as performers, will also respond to this type impact.

The drugs must be taken for 2 to 6 months, depending on the diagnosis that served as the reason for cleaning the uterus.

Oral contraceptives after the uterine cleansing procedure:

The first tablet is taken on the day of curettage. The selection of the drug is carried out only by a gynecologist and based on the results of a blood test for hormones.

After curettage, it is recommended to resume physical activity no earlier than after 2 months. Visiting the gym should be delayed, and heavy lifting (more than 3 kg) and running should be avoided. Any physical activity is stressful for the body, which undoubtedly reduces immune activity and will interfere with healing.

One of important recommendations The gynecologist after curettage is to perform physiotherapeutic measures. To the most effective methods physiotherapy in gynecology includes:

EHF therapy. Therapeutic effect is achieved through irradiation with electromagnetic waves in the EHF range, which increases nonspecific resistance body, increasing resistance. It is recommended to use EHF therapy after cleansing to prevent endometritis.
Ultrasound therapy. The method is recommended for preventing the formation of adhesions in the uterus and pelvis resulting from curettage.
Phototherapy. Infrared rays have an anti-inflammatory effect.

After curettage manipulation, many experts recommend using sorption therapy as a preventative measure, the essence of which is the introduction into the uterine cavity of a special solution that has sorbent and antiseptic properties. Usually a mixture of Enterosgel and Dioxidin is used. The composite solution is injected into the uterus using a thin catheter. Due to its thick consistency the mixture does not flow out, therefore there are no special restrictive recommendations for physical activity not required. Used to monitor healing aspiration biopsy. The aspirate is examined under a microscope and the condition of the resulting cells is assessed.

After the uterine cleansing procedure, doctors monitor the healing process using aspiration biopsy. It is carried out on days 23-25 of the cycle, 2 months after all types of curettage.

Artificial termination of pregnancy by curettage medical indications – a strong stress factor that negatively affects the adaptive and compensatory capabilities of the body.

An equally important task facing the gynecologist is to ensure comprehensive rehabilitation using means aimed at restoring psychovegetative disorders.

As a rule, after curettage, the patient is recommended the following therapeutic measures and medications:

Acupuncture.
Psychotherapy.
Herbal soothing infusions for 2 weeks after cleansing (Phytosedan, soothing teas with lemon balm, sedative infusions).
Antidepressants (Coaxil, Gelarium, Azafen) for 10-20 days.

The problem of purulent-inflammatory diseases in gynecological practice after curettage it continues to be one of the leading ones. Complete, adequate prescriptions and compliance with them by the patient during the recovery period guarantee complete absence consequences and complications in terms of reproductive function.