Medical cleaning of the uterus. Repeated cleaning of the uterus: when it is needed

Many women receive a referral for curettage of the uterine cavity after a routine gynecological examination. But few doctors explain what the procedure is. Therefore, women begin to be afraid of even the very name of this manipulation. We hasten to dispel unfounded fears and understand in detail what scraping is, how and why it is carried out.

The uterine cavity is lined with endometrium - this is its mucous membrane. During the menstrual cycle, the thickness of the endometrium increases to accommodate the egg. When pregnancy does not occur, unclaimed cells leave the uterus along with menstrual flow.

When cleaning, the doctor removes the top layer of the epithelium of the uterus and cervix. The germ cells from which the new mucosa grows remain intact.

Scraping is the essence of the procedure, the manipulation itself is called differently:

Separate diagnostic curettage. Separate because tissue samples from the cervix and uterus are collected and examined separately.
Diagnostic curettage under hysteroscopy control. This is a more precise procedure, during which the doctor can observe what is happening with the help of a hysteroscope.

Curettage is carried out using a curette or vacuum suction. The instrument is chosen by the doctor depending on the indications for the procedure.

Indications

Gynecological cleaning can be carried out for diagnostic purposes, when it is necessary to obtain tissues for histological examination, or for therapeutic purposes, when a pathological formation is removed.

Curettage is an operative method of treating a mass of pathologies, including:

uterine bleeding of various nature;
endometritis - inflammation of the uterus, adenomyosis;
frozen pregnancy, ectopic pregnancy in the cervix, remnants of the membranes, placenta (placental polyp);
adhesions in the body of the uterus, preventing the onset of pregnancy.

Training

Most often, cleaning is carried out before menstruation - at this time, the cervix is \u200b\u200bpliable to disclosure.

Before the operation, the necessary tests are taken;

coagulogram;
general analysis of urine and blood;
tests for HIV, hepatitis, syphilis;
vaginal swab.

A few days before the cleansing, stop douching, using vaginal preparations, and stop having sexual intercourse.

How do they do

On the appointed day, you should come to the hospital on an empty stomach. Bring with you sanitary napkin, change of underwear, shirt.

The procedure is performed in a small operating room on a table with legs, as in a gynecological chair. The anesthesiologist makes an intravenous injection, after which anesthesia occurs for 15-30 minutes. Modern anesthesia does not cause hallucinations: normal dreamless sleep occurs. Naturally, during the operation, pain will not be felt.

The operation is performed as follows:

a mirror is inserted into the vagina;
the neck is fixed with special forceps;
a special wand measures the internal size of the uterine cavity;
with the help of dilators - a set of metal sticks of different thicknesses - the cervical canal is expanded to the size of a small curette (a tool that looks like a sharpened spoon);
the cervical mucosa is scraped, the material for analysis is collected in a separate container;
if necessary, a hysteroscope is inserted into the uterus - a thin tube with a camera, the walls are examined;
the top layer of the endometrium is removed with a curette, the material is collected for analysis;
a hysteroscope is inserted to examine the result, if not all have been removed, the curette is used again;
remove the forceps from the neck, treat the external pharynx and vagina with an antiseptic, put ice on the stomach;
the patient is transferred to the ward, in which it is necessary to stay for several hours to be completely sure that there are no acute complications.

Video: Conducting therapeutic curettage of the uterine cavity (curettage)

Unlike curettage, with vacuum aspiration, it is possible to remove without injuring the surrounding tissues:

remnants of the fetal egg or placenta;
frozen pregnancy;
hematometer;
stop dysfunctional uterine bleeding.

During the operation, after the cervix is dilated, the tip of the aspirator syringe is inserted into the uterus, which creates a vacuum around the formation and draws it into itself without damaging the mucosa. This is the main difference between vacuum cleaning and scraping with a curette.

Examination and treatment after curettage

Tissues removed from the surface of the uterus and cervix are collected in separate jars and sent for histology. There, the structure of cells is studied and their nature is determined to detect oncology. The result of the analysis will be ready in 10-15 days.

2 weeks after cleaning, the doctor may recommend a follow-up ultrasound, which will show whether everything has been removed. According to its results, a second cleaning can be assigned.

Of the medicines after the procedure, a short course of antibiotics is prescribed to prevent inflammation and painkillers for abdominal pain.

Recovery

The first hours after the operation there will be a copious discharge of blood with clots. After a few hours, the discharge will become less abundant, in a day they will become spotting, and will be observed for up to about 7-10 days. If they stop earlier and at the same time there is a strong pulling pain in the lower abdomen, be sure to contact the gynecologist - this may be a sign of hematomas. A slight pulling pain, as with menstruation against the background of residual discharge, is not a pathology.

For the first 10-15 days after the operation, you should refrain from:

sexual contacts;
use of tampons;
douching;
visits to the sauna, swimming in a pond, pool, bath;
taking drugs based on acetylsalicylic acid.

After 10-14 days, do not forget to visit a doctor: at this time, a histology will be ready, based on the results of which additional treatment may be prescribed.

Menstruation after cleansing usually comes with a delay of several days. If after 2 months your period has not started, be sure to consult a doctor.

You can plan a pregnancy after scraping after a few weeks, but with conception it is better to wait a couple of months: during this time you will have time to be treated, and the uterus and cervix will fully recover.

Possible complications after curettage

Curettage is tolerated quite easily if you get to a good anesthesiologist and a careful gynecologist. Only in isolated cases complications arise.

perforation of the uterus. The uterus can be pierced with any dilators or probe due to the fact that the cervix does not open or the tissues of the uterus are loose. Small perforations are tightened by themselves, and large ones are sewn up;
Tearing of the cervix. The neck can be flabby, because the forceps sometimes slip off when pulled, injuring the tissues. Small tears heal on their own, large ones are sutured;
Inflammation of the uterus. Inflammation begins if the operation is performed against the background of inflammation, the requirements of antiseptics are violated, antibiotics are not prescribed. For treatment, a course of antibiotics is prescribed.
Hematometer. After curettage, the uterus bleeds. If the cervix suddenly closes (tight cervix), the blood cannot leave the uterus, it forms clots - inflammation and severe pain appear.
Excessive scraping. If a doctor scrapes a thick layer of tissue, the germ cells can be damaged. In this case, the mucosa does not grow. The condition is not corrected and threatens with infertility.

If the procedure is carried out carefully and correctly, complications do not arise.

Make scraping in Moscow

Multidisciplinary medical center "SM-Clinic": Voykovskaya metro station, st. Clara Zetkin 33/28. Cost - 15,000 rubles;
Multidisciplinary medical center "Deltaclinic": metro station Kurskaya, per. Mentor 6 or 2nd Syromyatnichesky lane 11. Price - 10,000 rubles;
Multidisciplinary medical center "Best Clinic": Krasnoselskaya metro station, st. Lower Krasnoselskaya 15/17. Price - 12100 rubles;
Multidisciplinary medical center NEARMEDIC: Polezhaevskaya metro station, Marshal Zhukov pr. 38/1. The cost of the RFE is 5900 rubles.

Scraping is one of the types 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 reproductive system woman in which 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 hysteroscopy control is the safest and most efficient view 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?

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:

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 image life, genetic predisposition.
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 - trauma during childbirth, abortion, diabetes, 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:

Blood tests, clinical and biochemical. They are needed to exclude inflammatory and infectious processes and assess the condition of internal organs.
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.
Fluorography. It is necessary to determine the state of the respiratory system.
Analysis for blood type and Rh factor. It is necessary for the preparation of donor blood in case of bleeding.
Vaginal smear. Allows you to determine the degree of purity, the presence of genital infections and inflammation.
Ultrasound of the pelvic organs. It is carried out to assess the condition and location of organs.
Analysis of urine. The presence of leukocytes and bacteria indicates an inflammatory process.
Coagulogram. Evaluation of blood clotting allows you to identify the risks of bleeding.
Cytological examination of a smear of the cervix. Determines the presence of altered tissue cells indicating oncology.
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:

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.
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.
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.
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.
Damage to the cervix. Separate curettage can cause a violation of the integrity of the walls of the body, requiring suturing.
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.
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 sick leave 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 activity, overheating. 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. Renewal period intimate life after curettage of the uterus is consistent with the doctor. Usually you can return to it after a week.

AT 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. 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.

Often, in order to maintain health and reproductive function, a woman undergoes an operation called diagnostic curettage of the uterus. What is the procedure? How long does the scraping take? In our article we will answer all these questions?

Just want to focus on the fact that this operation is painful. It does not last long, so it is carried out under short-term intravenous anesthesia. Tissue samples obtained during the procedure must be sent for histological examination. Hence the name of the procedure: "Diagnostic curettage of the uterus." It is necessary in order to identify the real cause of the disease. This is especially important if there is a suspicion of an oncological neoplasm that has arisen in the muscle of the uterus or its inner mucous layer - the endometrium. The results of the research help doctors initially prescribe the right treatment or adjust existing medical procedures.

Indications for diagnostic curettage

There are a number of pathologies that are rightfully considered indications for gynecological cleaning or curettage. Among these, we can safely name the following:

The presence of benign neoplasms in the uterus (polyposis formations);
The presence of malignant tumors on the cervix, on the endometrium and on the body of the uterus itself;
Presence of heavy and irregular menstruation;
The presence of meager monthly discharge;
The presence of uterine bleeding in the intermenstrual period;
Violation of the menstrual cycle;
endometriosis;
Inflammatory processes in the uterus;
Tuberculosis of the pelvic organs;
Infertility;
Strong incessant pain during menstruation;
Regular pulling pains in the lower abdomen and back.

Here it is worth paying attention to the fact that if necessary, for example, if there is a suspicion of oncology of the cervix, then doctors conduct a separate diagnostic curettage of the uterus. At the same time, it first scrapes the inner layer cervix, and then the cavity of the uterus itself. In both cases, all the material obtained during curettage is sent for histological examination. This is necessary in order to take urgent appropriate measures in the presence of oncology, or to exclude the presence of suspicion in the absence of oncology.

How long does the scraping take? The procedure lasts approximately 15-20 minutes.

How to prepare for a diagnostic curettage?

First of all, we draw your attention to the fact that diagnostic curettage of the uterus is not prescribed without a set of preliminary research procedures. This includes the collection of all necessary analyzes:

general blood analysis,
General urine analysis,
Smears from the cervix and vagina,
Blood test for AIDS,
Blood test for Wassermann reaction (syphilis),
Blood for hepatitis B and C.

In addition, the doctor will definitely prescribe an ultrasound examination of the pelvic organs, and, in particular, the uterus. It will not do without a gynecological examination. Actually, these are all preliminary analyzes and studies that take place before diagnostic curettage of the uterus.

At a preliminary consultation before the operation, the doctor will definitely tell you that you should not use vaginal suppositories on the eve of the curettage, that you should not eat breakfast and drink plenty of water on the day of cleaning. In addition, on the day of cleansing, you must do a cleansing enema.

It has already been said above that the procedure is painful, but with the use of modern painkillers and anesthesia, the patient does not feel any discomfort, she just sleeps. The whole procedure takes no more than fifteen minutes, and after its completion, the patient is transported to the ward, where she awakens from anesthesia. Within a few hours after the end of the anesthesia, the patient is allowed to go home. But beforehand, she is given recommendations on what needs to be done in order to avoid postoperative complications. Their strict observance reduces the risk of various postoperative problems at times.

Recovery period rules

One of the main factors of postoperative recovery is strict observance of all the rules of personal hygiene and doctor's prescriptions. A conniving attitude towards one's health during the recovery period can provoke complications and contribute to infection of the pelvic organs. The main rule of the recovery period is not to expose yourself to hypothermia or overheating. Do not swim in open water, do not visit the solarium, sauna, GYM's. In other words, for a few days it is worth limiting physical and thermal stress. And the first two to three days after the procedure, you generally need to adhere to bed rest.

Possible Complications after diagnostic cleaning

In fairness, it should be said that under certain conditions, after a diagnostic curettage of the uterus, some complications may well develop. This largely depends on how the patient spent the recovery period, and on how experienced the doctor performed the procedure. Among the main, most common complications are the following:

An increase in temperature to 37.5 degrees and above;
Constant unrelenting pain in the lower abdomen and back;
Scanty, quickly stopped discharge;
The unpleasant smell of rotten meat, which is acquired by discharge;
Sense of anxiety;
Tears of the cervix.

In the most severe cases, after the procedure, such a terrible diagnosis as infertility can be made. But this rarely happens, especially if you turn to experienced professionals.

If you want to conduct a thorough and comprehensive examination, it would be most correct if you contact our diagnostic and treatment center for help. We have everything you need to quickly restore your health and improve your mood. Our center employs competent professionals, true experts in their field. Under their guidance, you can solve any health problems!

During examinations and treatment of gynecological diseases, many women are prescribed an operation to clean the uterus. This procedure is akin to a small abortion and is carried out on an examination chair. But some women are confused by the very name of the operation, and they want to get to the bottom of it in order to understand what cleaning is in gynecology.

Features of the procedure

When a woman is prescribed a cleaning of the uterine cavity, this refers to the removal of the upper layer of the mucous membrane - the endometrium. It is he who plays a big role both in the health of a woman and in the ability to bear a child.

The endometrium is directly related to menstruation. During the cycle, its layer is building up and compacting - this is how conditions are created for attaching the future fetus. If a woman does not conceive, then the mucous membrane is rejected (the uterus is being cleansed) - this is menstruation.

The operation to clean the uterus is also referred to by another term - curettage.

In other words, with special tools, the gynecologist carefully removes the endometrial layer from all the inner walls. In addition, cleaning of the cervix is also prescribed, as well as washing the tubes in women.

Cleaning in women in gynecology is carried out to interrupt unwanted pregnancy. The same procedure is necessary step after childbirth - uterine curettage allows you to clean the cavity from the remnants of the placenta. It is especially important to clean the uterus after a caesarean section.

But there are other situations when a curettage operation is performed. And these moments are called diagnostic and therapeutic. Next, we will find out why they clean the uterus.

How much does a uterine cleaning cost? The price of the operation depends on the purpose of its implementation. So, diagnostic separate curettage will cost about 3000 - 5000 rubles, therapeutic - much more expensive. Analyzes, consultations of doctors, anesthesia are paid separately.

Indications for scraping

In order for a woman to be referred for a procedure, appropriate indications for this are needed. The doctor determines what type of cleaning will be carried out.

What is the cleaning of the uterus for?

abortive curettage and postpartum. They are carried out in order to clean the internal cavity of the womb;
through the uterus they penetrate into the tubes in order to clean them in case of obstruction;
gynecological cleaning is a medical procedure for removing pathological neoplasms from the uterine cavity (or cervix);
diagnostic cleaning of the uterus is prescribed in order to obtain histological material for research in order to make the correct diagnosis in case of female problems that have arisen.

To carry out medical and diagnostic procedures, good reasons are needed, because this is not an ordinary and rather painful operation, which, if performed ineptly, can have undesirable consequences.

When do the cleaning of the uterus:

it can be complications after abortion and childbirth, as well as miscarriages and missed pregnancies;
polyps on the neck and in the uterus, myomatous nodes;
in situations where it is necessary to clean the fallopian tubes in women;
pathological processes in the endometrium and hyperplasia;
profuse and incessant bleeding;
suspicion of malignancy.

In such cases, curettage of the uterus is done, but in some situations the operation may be canceled. A contraindication will be sexual and infectious diseases that can move to a painful and unprotected endometrium. The only exception is uterine continuous bleeding, especially if it occurs during menopause.

Not always used in gynecology tubal cleaning operational method, since often the cause of obstruction is infectious diseases that can be dealt with in a different way. Therefore, it is recommended to first clean the fallopian tubes in women. folk remedies(flax seeds, milk thistle, cinquefoil, upland uterus).

scraping operation

Women's cleansing usually takes place under intravenous anesthesia, so that the patient will sleep during the operation without seeing what is being done to her. But first, gynecological speculum dilators will be inserted into the vagina. The uterus will be fixed with special forceps so that it remains motionless.

When the patient enters the narcological sleep, the neck is expanded to the size necessary to penetrate the curette, the instrument used for scraping. In a well-equipped clinic, this procedure is not carried out blindly - a hysteroscope is used, which allows the doctor to see the internal cavity.

At the end of the procedure, the curette and hysteroscope are removed, the areas that have been scraped are treated with antiseptic agents, and then the forceps and dilators are removed. The woman is sent to the ward with an ice pack placed on her stomach to stop the wound from bleeding.

How is the uterus cleaned during bleeding? In this case, a more gentle method is used - vacuum cleaning. It is carried out under local anesthesia without visual observation. To determine the depth of the cavity, a special probe is used, and the cleansing itself is performed by a rotating catheter that collects the scraped material in a special container.

Preparing for the operation

The scraping procedure is prescribed at a certain point in the female cycle - 2-3 days before the start of the expected menstruation, when the endometrium has already prepared for rejection, and tissue necroticity has not yet been observed.

Cleaning preparation steps:

first, a woman undergoes an examination - she takes tests (and first of all for the detection of infections), a coaculogram, bacteriological smears;
14 days before the procedure, it is required to stop taking all nutritional supplements, if they are present in the patient's diet. If a woman is forced to take medical preparations in connection with other diseases, then this moment must be corrected together with the doctor who will carry out the cleaning;
3 days before curettage, all sexual intercourse is excluded, vaginal suppositories, sprays and tablets are not used. With intimate hygiene, you can not use any means - wash only with water;
so that anesthesia does not give side effects, the last meal and drink should be 8-10 hours before surgery.

If a woman withstands all the conditions, then curettage (therapeutic or diagnostic) will pass qualitatively and without complications.

After operation

Cleansing the uterus is akin to the natural rejection of the mucosa during menstruation. Therefore, after the procedure, a woman will have the same symptoms as during menstruation - pain in the lower abdomen, contraction of the uterus, spotting.

How long does the daub last after cleaning? The main layer of the epidermis, which was supposed to come out during menstruation, has already been removed by scraping. Therefore, after the operation, residual discharge with blood clots will be observed.

This lasts for several hours and is considered normal. But for 7-10 days, a woman may still experience a slight daub.

Within 2 weeks after cleansing, it is advisable to give the body peace, excluding sex and exercise. Do not yet use tampons and douching. Baths, saunas and baths are also excluded. From medicines aspirin, which affects blood clotting, is contraindicated.

If a situation arises in life when it is necessary to undergo a cleaning procedure, then you should trust a highly qualified specialist. The more equipped the gynecological clinic is with modern medical equipment, the greater the chance that the operation will go without complications. At the same time, you should not choose where it is cheaper - you need to rely on professionalism.

Probably, many women have found themselves in situations where, after examining and examining, the gynecologist says that it is necessary to do a curettage for one reason or another. In the people, such a procedure is often called cleaning the uterus, which quite accurately reflects its essence.

But not every doctor considers it necessary to explain to patients what exactly this operation is and how it is performed, and therefore many women begin to panic as soon as they see the appointment in the map - curettage of the uterine cavity.

But experiences in most cases are simply not justified.

The female uterus is a pear-shaped muscular organ where the development of the unborn child occurs from the fertilized egg. The inner surface of the uterus has a protective layer in the form of a special mucous membrane, which is called the endometrium.

Every month, certain changes occur in the uterine cavity, which are cyclical in nature. At the beginning of each menstrual cycle, the uterine cavity begins to prepare for the reception of a fertilized egg and the further development of the baby, if this does not happen and pregnancy does not occur, at the end of the cycle, the prepared layers are rejected and the woman begins menstruation.

Curettage involves the removal of the functional layer of the uterine mucosa, which is a protective shell, after which the damaged endometrium is quickly restored. With proper cleaning, the growth layer of the endometrium is not affected and due to this, a quick recovery occurs.

Curettage of the uterine cavity can be carried out in two forms:

Separate, when at the first stage the cervical canal is cleansed, after which the doctor proceeds to clean the uterus itself. The scraping that is obtained during the procedure is sent to the laboratory for histological examination in order to determine the disease or make a more accurate diagnosis. Today, separate curettage is carried out simultaneously with hysteroscopy, when a special optical device is placed in the uterine cavity, which allows you to fully control the cleaning process. This approach to the procedure allows you to make it safer and more convenient, as well as eliminate some possible consequences.
When cleaning in the usual way, the operation is carried out blindly, which often leads to complications, since the uterus can be injured in this case, which is excluded during hysteroscopy.

As a rule, cleaning the uterus is prescribed 1-2 days before the onset of menstruation, since in this case the restoration of the damaged endometrium is faster and easier.

Indications for surgery

Scraping is carried out exclusively as prescribed by a doctor for the purpose of diagnosing or eliminating certain diseases.

The indications in this case are:

Violations of the endometrium, changes in its structure, detected by ultrasound. Curettage with endometrial hyperplasia and its other disorders is usually carried out for the purpose of diagnosis. Endometrial hyperplasia is said to be in cases where its thickness deviates significantly from the norm upwards. In addition, ultrasound can detect various local formations. In these cases, cleaning the uterus is necessary to make an accurate diagnosis and remove the disorder.
Polyps on the surface of the uterus. As a rule, during the normal operation, the polyps removed along with the endometrial layer do not reappear.
Menstrual disorders.
Prolonged and very profuse menstruation.
Intermenstrual bleeding.
Not the onset of a planned pregnancy without obvious reasons.
The presence of bleeding during menopause.
Pathological processes of the cervix, especially in cases where the doctor suspects that they are malignant.
Spontaneous. Curettage after a miscarriage is often a necessary measure, since this is the only way to remove all the remnants of the placenta from the uterus, if this did not happen naturally.
Stopping the development of pregnancy. Unfortunately, not every pregnancy ends in childbirth. In some cases, under the influence of various factors, the development of the fetus stops and it dies. Curettage during a frozen pregnancy is necessary to remove the dead fetus and prevent inflammatory processes.
The remains of the placenta or ovum after natural childbirth.
Cleaning the uterus after an abortion.
The presence of intrauterine adhesions (sinechia).

In addition, the procedure is carried out before many elective operations, for example, before the removal of fibroids in cases where the uterus itself will be preserved.

Complications after surgery

After the curettage, some complications may occur, but they are rare. These include:

Damage to the cervix, its anguish. Sometimes this consequence is observed after scraping with and the cause of its appearance in most cases is the dismounting of bullet forceps. If the tear is small, no measures are taken, such damage is delayed by itself. A large tear will require one or more stitches.
Hematometer. After the operation, spasm of the cervix often occurs, which can lead to infection and the onset of the inflammatory process.
perforation of the uterus. Sometimes during the procedure, with the negligence of the doctor or the inappropriate behavior of the patient (with local anesthesia), the uterus can be pierced by the instruments used. Larger lesions will require additional surgery to close the perforation.
Inflammation of the uterine cavity. The cause of the appearance of inflammatory processes is usually various violations of the requirements of antiseptics, as well as the non-prescription of antibiotics to a woman after surgery. The onset of the inflammatory process is indicated by the appearance of a high temperature after childbirth or a curettage.
Causing damage to the germ layer of the endometrium during cleaning. Such a consequence is very difficult to eliminate, it is difficult to treat. Often, it is this damage that causes further problems with the onset of pregnancy, since the damaged endometrium cannot be restored.
Improper procedure, when the reason for the appointment of the operation, for example, any pathological formation in the uterine cavity, was not completely removed or was partially removed. In such a situation, the woman will need to repeat the operation.

To avoid complications, it is necessary to trust the operation only to a qualified doctor who will do everything not only correctly, but also carefully.

Recovery after a scraping

Within a few days after the operation, a spotting discharge may be observed. Their duration can be different and on average ranges from 3 to 9-10 days.

If there is no discharge, but at the same time, pain appeared in the abdomen, this may indicate that due to a spasm of the cervix, a hematometer has formed. In this case, you must immediately consult a doctor. You can confirm the presence of a spasm with an ultrasound.

To avoid the appearance of hematometers after surgery in the first days after it, you can take No-shpu or its Russian analogue, 1 tablet 2 or 3 times a day.

After the operation, the doctor must prescribe antibiotics, which is necessary as a prevention of the occurrence of possible inflammatory processes. It is not worth neglecting such an appointment after cleaning the uterus.

10 days after the scraping, you need to visit a doctor to get the results of the histological examination of the scraping and discuss their details with your doctor.

It is important to remember that pregnancy after a normally performed procedure can occur within 2-3 weeks, so do not mistakenly believe that curettage will become a temporary means of protection.

Complications during childbirth in this case usually do not occur. If within 6-9 months after such an operation the planned pregnancy does not occur, you need to consult a doctor and undergo an examination.

Violation of the ability to conceive after cleaning the uterus appears in rare cases, but such cases have been noted in medical practice.

The recovery period usually lasts about 14-15 days and some restrictions should be observed during this time, for example:

You should refrain from sexual intercourse.
Douching is not allowed.
Do not use vaginal tampons to absorb secretions.
Do not administer suppositories without a doctor's prescription.
You should refrain from any physical activity, especially from lifting weights and working in an incline.
It is important to observe personal hygiene.
Hypothermia should be avoided.
You should refuse to visit baths, saunas, solariums, swimming pools and gyms for 3-4 weeks after cleaning.
You should not take baths during this period, especially hot ones, as well as swim in the sea or in another body of water.

Compliance with all prescriptions in the recovery period allows you to avoid complications. But you should not be afraid of such an operation, since modern equipment and the qualifications of many doctors allow you to get excellent results from such a procedure without harm to health.

Until a few decades ago, curettage often led to problems with conception or complications in childbirth in the future. Today, such operations often help to eliminate the problems of female infertility and allow a woman to experience the joy of motherhood.

Useful video about the scraping procedure

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