Uterine scraping is a traumatic procedure for removing the endometrial layer with a loop or other surgical instruments. There is such a procedure, therapeutic and diagnostic, the first is usually more extensive. But regardless of the type and purpose of the operation, the recovery period after such an intervention is long enough, and it should be carried out correctly so that no consequences and complications arise. How the rehabilitation after cleaning (curettage) of the uterus takes place will be described in this article.
Strictly speaking, such an intervention is not considered a surgical operation, although in reality it is traumatic, and in the course of it an extensive wound surface is formed. For example, after scraping to remove cysts or with endometriosis, almost the entire inner surface of the uterus becomes a wound surface, since the endometrium is removed from the entire surface.
For this reason, a sufficiently long recovery period is recommended after this procedure. It is, depending on the amount of intervention and the individual characteristics of the organism, from three to four weeks.
Restoration after scraping has a number of normal characteristics. In case of deviation from the norm, it is recommended to immediately consult a doctor. Normally, during this period may be present:
- Pain in the lower abdomen, due to the fact that there is a contraction of the uterus after curettage,
- Minor bleeding,
- Feeling of a nagging, aching backache.
Such symptoms may be present only in the first few days. If it persists after a week, then you need to consult a doctor. You also need to do if there is heavy bleeding and excessively intense pain, or there is a temperature after cleaning the uterus.
During this period, it is necessary to reduce physical activity, which will have a good effect on well-being. You can not bathe in the bathroom, hygiene must be observed with the help of the shower. It is better not to use chemicals for intimate hygiene, drugs, administered vaginally, tampons and douches. Avoid overheating - do not visit saunas, baths, solariums, the beach, do not swim in open ponds and pools, carefully observe hygiene.
Treatment after curettage of the uterine cavity involves medication. They are not aimed at directly contributing to the growth of the endometrium, since this is not necessary - it is a natural process that occurs physiologically. Taking drugs is carried out in order to improve the patient's condition and well-being, to avoid the recurrence of the disease, and also to prevent the development of serious consequences and complications, for example, the accession of infection.
Antispasmodics after curettage of the uterus should be administered with caution. This is due to the fact that after this procedure, the uterus is reduced, pushing excess endometrium and rejecting its remains. This is a normal physiologically conditioned process in this situation, but it causes a rather severe pain in the lower abdomen, which persists in the first days after the intervention.
She can deliver quite strong discomfort to the patient, but it is undesirable to remove her with antispasmodics, because if the uterus does not contract, the healing process can be delayed. In severe conditions, they prescribe No-shpu, etc. drugs.
Antibiotics are always prescribed after curettage of the uterus. They are taken in a course of five to ten days, one or two tablets per day, depending on the selected drug. Depending on the condition of the patient, the course may begin on the day of the cleaning or a day or two earlier.
Why is antibiotics prescribed at all? Drinking them is necessary in order to avoid the accession of any co-infection. The fact is that with this intervention not only a wound surface is formed, but local immunity is also greatly reduced. All this in combination significantly increases the likelihood of infection in the uterus. To prevent this, strong broad-spectrum antibiotics are prescribed, such as Ciprolet, Ceftriaxone, Amoxiclav, etc.
How to restore the uterus after scraping? In general, it is able to recover by itself, this is a normal process, similar to the restoration of the endometrium after menstruation, when it almost completely rejected and refreshed. The growth of the mucous layer within the cycle and after scraping occurs under the action of the hormone estrogen produced by the ovaries. The larger it is, the more actively the endometrium grows.
Estrogen preparations can cause hormonal imbalances, but the use of herbs rich in phytoestrogens (plant estrogen analogues) has a very positive effect. You can drink broths and infusions of boron uterus and red brush. Borovy uterus after curettage is especially indicated, as it contains phytoestrogens more than other herbs.
Anti-inflammatory drugs are not always prescribed, but in most cases they are still shown. They are needed approximately for the same reason for which antibiotics are needed - they prevent the development of the inflammatory process on the wound surface. Such drugs are prescribed as Nurofen, Ibuprofen, which are taken 2-3 tablets per day during the week, starting from the day of the procedure. Diclofenac may be administered by injection for the same period. In addition to direct anti-inflammatory action, they also relieve pain.
If there is a temperature after curettage, then this may indicate the beginning of the inflammatory process. Therefore, it is necessary to immediately consult a doctor.
Having sex can be a week after the procedure, but it is better to coordinate it with a doctor. In addition, if the patient feels pain during intercourse, you should immediately contact a specialist. It is important to carefully observe hygiene and use barrier methods of contraception in order to avoid various infections in the uterus.
You can do sports as usual about a month after the intervention. At the same time, light loads, such as gymnastics or aerobics, can be returned earlier - after about a couple of weeks. The start time of sports needs to be discussed with a specialist, as much depends on the individual characteristics of the body and the rate of healing.
Sample day regimen
For quick recovery, it is important to properly balance work and rest. In the ideal case, you need to sleep at least 8 hours a day, no more than 8 hours of work, and at least 8 hours of rest. In this case, if the work is associated with physical exertion, then you need to take sick leave for at least several days after the procedure. If the work is not hard physically, then usually you can return to it the next day. But it is necessary to coordinate with the doctor.
You need to eat natural healthy foods, avoiding fried, fatty and smoked. An example of a diet may be:
- Breakfast - yogurt or cottage cheese, egg, whole-grain bread, weak coffee,
- The second breakfast - fruit,
- Lunch - vegetable or low-fat meat soup, a side dish of cereals and white lean fish, tea,
- Snack - fruit bacon, kefir, or yogurt,
- Dinner - vegetable side dish and chicken breast, rosehip broth.
It is desirable to include in the diet foods rich in phytoestrogens - corn, soybeans, yams.
Pregnancy after curettage is possible, and often even more likely if the pathological endometrium is removed. Usually, menstruation starts around the third week after the procedure, since during this time the mucous layer of the uterus has time to recover. In this case, the menstrual cycle is fully normalized and becomes regular after about 4 months. It is generally possible to plan conception in half a year after the procedure, but before starting any attempts it is better to consult a doctor.
Scraping is a traumatic but necessary procedure. Avoid it, if it was prescribed by a doctor, it is impossible, since this can have unpleasant consequences for health. Provided that the recovery period is properly carried out, complications after curettage are extremely unlikely, and this procedure affects the health only from a good side.
Uterus cleaning is most often carried out several days before menstruation (6-4 days), which helps prevent heavy bleeding and speeds up the recovery period of the mucous layer. Before the procedure, a standard research spectrum is prescribed:
- Blood: general analysis, coagulation rate, HIV, microreaction (for syphilis, Wasserman reaction).
- Urine: general analysis.
- Smear: microflora and degree of purity.
Prior to the appointment of the procedure, it is necessary to inform the attending physician about the presence of chronic diseases (diseases of the kidneys, liver, stomach, cardiovascular system, etc.), about taking the drugs. It is necessary to list all the medicines taken by a woman. After all, there is a list of drugs that violate blood clotting. Such information will allow the gynecologist to correctly plan the event, to prevent possible complications.
The length of hospital stay will depend on the general well-being of the woman. Usually stay does not exceed three days. After vacuum aspiration, a woman can send home after just a couple of hours, unless the doctor recommends otherwise.
The condition after curettage of the uterus will depend on the overall health and the amount of the intervention.
What can be considered normal indicators:
- Pains: pulling, cramping, but not strong. This is a sign of a contracting uterus.
- Discharge: first bloody, as with menstruation (with clots), duration up to 6-7 days. Gradually decreases the abundance of blood secreted. By 7-8 days, the nature of the discharge changes: they become brown, smearing. After 12 days, normal clear (white) highlights should appear.
- Increase in body temperature to 37-37.3 ° C in the first 2 days.
- Dizziness, weakness (in the first few days).
Recovery after cleaning the uterus is completed after one menstrual cycle. When will menstruation go after uterine cleaning? Menstruation can be expected in 26-40 days. If the cycle is regular, then the next menstruation may well begin on time. The regularity of the menstrual cycle should return to normal within 3-4 months.
If the uterus has been cleaned due to pregnancy pathologies (frozen, miscarriage, medabort), then menstruation should be expected after 7-9 weeks. This may change the nature of the monthly. They may become a little more abundant than usual and painful. The duration of menstruation may increase slightly, by about 1-2 days. After stabilization of the cycle, menstruation should go as before.
If the following symptoms appear, you should contact your doctor:
- Bleeding that lasts a long time (over 14-18 days).
- Change in color and odor of discharge. Discharge acquires an unpleasant (sometimes putrid) smell, and the appearance can be described as "meat slop."
- Pain in the abdomen, which increases (does not disappear) 7 days after surgery.
- Very rapid cessation of bleeding (on the first day, 2-3 days). This is a likely sign of cervical spasm and the development of hematometers (accumulation of blood in the uterine cavity).
- Increased body temperature after cleaning the uterus, not only in the first two days, but also in the following days. The temperature can reach high values from 37.8 to 39.9 ° C.
- Chills, loss of consciousness (fainting).
The appearance of such symptoms indicates the development of complications after cleaning the uterus.
After cleaning the uterus complications should arise. However, it should be borne in mind that after extensive intervention, the inner surface of the uterus is a continuous wound that becomes easily accessible for the penetration of disease-causing agents.
It is for this reason that a smear test is conducted to eliminate the presence of inflammatory processes in the vagina and uterus, and after the intervention, antibiotics are prescribed.
Cleaning for abortion provokes the development of hormonal disruption, which leads to a decrease in immunity. For these reasons, you must be especially careful to monitor changes in health and secretions.
Patients with a history of inflammatory diseases of the reproductive organs (endometritis, colpitis, salpingoophoritis, etc.) are at risk. In connection with a complex of disorders in the body, the likelihood of a relapse of transferred inflammatory diseases increases.
The occurrence of uterine bleeding. Most often associated with poor uterine contraction and low blood clotting.
The accumulation of blood in the uterus - hematometer. Most often associated with spasm of the cervix, which is why bleeding can not leave the uterus and begin to accumulate.
Endometritis, endomyometritis - inflammation of the mucous and / or muscular uterine layer. Infection can penetrate both from the outside during the operation and from the organism itself.
Perforation of the uterus. Scraping is performed blindly, that is, the specialist measures the size of the uterus with a special probe and performs all the manipulations by touch. Therefore, sometimes there is a perforation of the uterus. Fortunately, this is a rare complication, but it is necessary to know about this probability.
Many women are concerned about the question of why the uterus is not reduced after scraping. Such a picture may indicate incomplete cleaning of the uterus (for example, after an abortion) or the accumulation of blood. In any case, it is necessary to contact your doctor for examination and prescription of additional treatment.
Scraping indications and preparation for it
Gynecological cleaning with diagnostic or therapeutic purposes. During curettage, only the surface layer of the uterus is removed, with the result that it is quickly restored after a certain period of time. Therapeutic cleaning is used to remove polyps in the uterus, the ovum, and a malignant tumor. In addition, endometritis (inflammation of the endometrium) and uterine bleeding can become a cause for curettage of the uterine cavity.
Approximately 20% of patients have endometrial hyperplasia, the risk of which increases during menopause. Treatment in this case should be compulsory, since there is a possibility of the degeneration of a benign tumor into a malignant one. Endometrial hyperplasia occurs on the background of metabolic disorders, frequent abortions and endocrine pathologies.
If a woman has endometrial hyperplasia, separate diagnostic curettage (EFD) is usually prescribed. The resulting material is sent for histological examination to exclude cancer pathology. Scraping for endometrial hyperplasia is performed using a hysteroscope, which allows you to control the actions of medical professionals.
In the presence of emergency indications, special preparation for the operation is not required. If gynecological cleaning is carried out in a planned manner, it is necessary to pass a blood test, an electrocardiogram and a smear for flora. Usually cleaning is carried out on the eve of the beginning of menstruation. Three days before curettage, it is necessary to abandon sex. 12 hours before the operation, you should refuse to eat and reduce fluid intake.
Contraindications to this procedure are inflammatory processes occurring in the woman’s body (including in the uterus, except for those that have become an indication for the purpose of cleaning).
In the absence of complications after gynecological cleaning of the uterine cavity, recovery usually does not take much time. In this case, the physiological recovery of the organism occurs (as after menstruation), but it proceeds with some peculiarities.
The first days of the postoperative period in women are marked with slight bleeding. Such a phenomenon is considered absolutely normal, and should not be disturbed. Over time, they may become brown or yellowish. The discharge is accompanied by pain by the type of menstrual cramps, which can be removed with the help of antispasmodics. The menstrual cycle is restored approximately 4 months after the date of the gynecological cleaning, and the first menstruation begins after 3 weeks.
In order to reduce the risk of complications and negative consequences of surgical intervention, it is necessary to adhere to some rules:
- lack of intimate life,
- periodic examination by a gynecologist,
- ban on exercise.
It is not recommended to become pregnant earlier than 6 months after cleaning. You can plan a pregnancy considering the main reason for curettage.
Avoid possible bleeding will, if the first day after the procedure to spend at home in bed. The exclusion of sexual contact is necessary for complete closure of the cervix and prevent infection from entering it. In the presence of pain during sex, it is necessary to seek help from a medical institution. It is possible to speed up the process of endometrial recovery with the help of various drugs, which the doctor selects individually for each patient.
Without the permission of the doctor is prohibited to take any drugs. Also, you can not go to the sauna, take hot baths and engage in intense physical exertion. Good rest, sleep and proper nutrition will help to recover faster.
The reason for contacting a doctor should be the following symptoms:
- temperature more than 38 degrees
- discharge after scraping from the uterus, having an unpleasant odor,
- the absence of any discharge
- deterioration of the general condition.
For the prevention of endometrial hyperplasia, it is recommended to visit the gynecologist twice a year and promptly treat concomitant extragenital diseases (diseases and syndromes in pregnant women who are not gynecological).
Tip: It is necessary to consult a doctor if after a gynecological surgery a woman does not have any discharge, as this indicates the development of pathology.
Treatment of endometrial hyperplasia with gynecological cleansing helps prevent the transformation of benign pathology into malignant. Proper behavior in the postoperative period reduces the risk of complications to a minimum. Before planning a pregnancy after cleansing, you need to undergo a full examination and wait a certain time from the time of this procedure.
What is scraping
The procedure is prescribed in cases where the disease is not amenable to medical treatment. In addition, scraping can be prescribed in the event of various complications.
Indications for the procedure are:
- Endometrial hyperplasia.
- Violation of the menstrual cycle.
- Fading pregnancy.
- Spontaneous miscarriage.
- Uterine hemorrhages, triggered by various causes of the incomprehensible nature of origin.
- The combination of several pathologies.
Cleaning the uterus - a procedure that involves the removal of a surgical layer of the functional layer. That is why women are prescribed treatment after curettage. The procedure itself is quite common and is assigned in every third case. Is carried out three days before the expected menstruation.
In some cases, scraping is performed not for the purpose of tissue removal, but for diagnosis. This is necessary to obtain a tissue sample for laboratory testing to establish the presence of cancer cells.
The possible consequences and duration of the rehabilitation period depend on the professionalism of the doctor, the general condition of the woman and the individual characteristics of the organism. Complications can occur in the presence of various comorbidities. For this reason, before the procedure, the doctor determines their presence or absence, and also determines the possibility of using other methods of treatment.
General recommendations after curettage of the uterus
Many women are interested in what to do after scraping the uterus and how to restore the work of the organs. To the recovery period was uneventful, and the functional layer of the uterine mucosa quickly recovered, doctors recommend to follow a number of recommendations. These include:
- The exclusion of sex life for at least three weeks. This is necessary in order to prevent the infection from penetrating into the uterus, since after the procedure it remains open and it takes time to recover. In addition, the semen contains a special substance that has a relaxing effect on the muscle tissue of the uterus.
- For six months to use condoms during sexual intercourse in order to avoid pregnancy.
- For one month after scraping, do not take a bath, do not swim in open ponds and do not use saunas and swimming pools.
- Immediately after the procedure, there may be a slight bleeding from the uterus. At the same time using tampons is strictly prohibited. They absorb not only secretions, but also cause infection and inflammation.
- Limit physical activity.
- Assigned antibacterial drugs should be taken at regular intervals.
- Correctly observe the dosage and duration of medication.
- In case of any pain that may occur within the first 2-3 days, it is recommended to take painkillers, for example, Diclofenac.
- Completely eliminate the use of alcoholic beverages.
In addition, the doctor may prescribe such drugs as "Longidase" or "Wobenzym." Medicines are intended to eliminate the formation of adhesions. During the recovery period of the uterus after scraping, it is important to follow all the recommendations of a specialist.
An important step after the procedure is the restoration of the menstrual cycle, as the body is very sensitive to various interventions. As a result of surgical intervention when removing the endometrium, it starts to work incorrectly. Physiotherapy procedures and medications may be prescribed to establish the functions of the genital organs.
During the recovery period after cleaning the uterus, methods of physiotherapy are prescribed, which have a positive effect on the body, accelerating the process of tissue regeneration. The most effective procedures include:
- Ultrasound therapy. Appointed to prevent the formation of adhesions in the pelvis and uterus. They can be formed as a result of injury to the mucous during the cleaning process.
- EHF-therapy. It is considered one of the most effective procedures aimed at improving the immunity and body resistance. Also carried out as prevention of the formation of endometritis.
- Phototherapy Exposure occurs with the help of a special apparatus, which emits infrared rays. They help stop a minor inflammatory process and prevent its spread.
Many experts recommend after cleaning the uterus to conduct sorption therapy. The essence of the method lies in the fact that a special antiseptic solution is injected into the cavity. Often used a mixture of "Dioxidin" and "Enterosgel".
The finished solution is injected with a catheter, and due to its thick consistency, it does not flow back. Therefore, no restrictions on physical activity is not installed.
In some cases, a biopsy may be required. The procedure is performed under anesthesia. Using a special fine needle, a piece of fabric is taken. The material is sent to the study in the laboratory. The procedure is assigned to establish the state of the cells.
The period of rehabilitation after curettage also involves the use of drugs. First of all, sedatives and antidepressants are prescribed, for example, Azafen, Coaxil. The course of treatment ranges from 10 to 20 days, depending on the condition of the woman.
In addition, it is recommended to brew herbal preparations with a calming effect. These include sedative fees, tea with melissa. In certain cases, the patient may need the help of a psychologist.
Menstruation after curettage
The first menstruation often occurs 3-5 weeks after the procedure. The term depends on the general condition of the patient and the rate of recovery of the organism, as well as the individual characteristics of the organism. When performing a medical abortion, a slight delay is possible, since the restoration of reproductive functions takes a lot of time.
The cycle fully returns to normal after 3-6 months. This requires regular visits to the gynecologist.
In cases where the cleaning of the uterus was carried out with a frozen fetus, miscarriage, polyps or endometriosis, menstruation can be long and plentiful. Their absence is a reason to visit a specialist. You should also contact your doctor if you have elevated body temperature, heavy bleeding and severe pain in the lower abdomen.
A slight increase in body temperature after surgery is a protective reaction of the body. However, it should not be above the mark of 37.2.
This condition after curettage is observed only on the first day, and its increase may be a reason for going to the doctor. High temperature, which does not decrease for several days, indicates the development and spread of the inflammatory process.
After discharge, if the temperature rises to 38 degrees, which is accompanied by severe pain, there should be a doctor. This may indicate the appearance of complications.
Discharge and pain after curettage
At the end of the first menstruation, the body begins to reject the endometrial layer. Discharge by its consistency and color is similar to menstrual and many women confuse them.
The duration of the discharge depends on the blood clotting, the cause of the surgical intervention, the general condition of the woman’s body and the hormonal background. The norm is the selection with a number of features:
- Duration from 6 to 10 days.
- With the passage of time, they acquire a smearing character.
- The presence of pulling pain in the lower abdomen.
The color of the selection is also important. If they are brownish, then the healing of the uterus is correct. But in cases where they are bright red and last more than 10 days, you should contact a specialist. The following signs may be cause for concern:
- The presence of an unpleasant smell.
- Yellow color of discharge.
- The appearance of bleeding.
- Liquid discharge.
Most often, a large amount of discharge suggests that the healing process is quite difficult. With the penetration and spread of infection in the uterus, the exudate becomes yellowish. This requires the use of antibacterial drugs.
Many women are interested in how to recover from scraping. In the process of rehabilitation, it is important to follow all the recommendations of a specialist and be attentive to your health.
Scraping is a fairly common procedure, which is carried out in every third case. Surgical intervention can be prescribed for various reasons when drug treatment does not bring results. With the proper course of the recovery process, complications arise in exceptional cases.
The reasons for scraping
Curettage is performed for therapeutic and diagnostic purposes. During the operation, only the superficial mucous layer is removed, due to which the organ is fairly quickly restored. At the same time in the first hours of pain after scraping. Over time, they become less pronounced and completely disappear.
For therapeutic purposes, surgery is carried out to remove polyps, embryo residues after spontaneous abortion, and if cancer is suspected. Often, an abortion is done this way. In addition, indications for cleansing are missed abortion, symptoms of endometritis, and severe uterine bleeding.
Curettage is prescribed for endometrial hyperplasia. The cause of this pathology - hormonal failure. The danger of the disease is that there is a risk of cell degeneration into malignant ones. With its development, separate diagnostic curettage is performed.
Tissues obtained during the operation are sent to the histological laboratory in order to exclude oncology.
Scraping after abortion
The reasons for the removal of the endometrial layer are spontaneous miscarriage and complications after abortive measures. Such manipulations are necessary when parts of the embryo remain in the organ.
After cleaning the uterus, the woman notes that she has a sore back and lower abdomen, and there are bloody discharges. They will be observed until the process of restoration of the cervix and the genital organ itself is fully completed. Sometimes the temperature rises after scraping. With such changes, doctors prescribe antibiotics. With their help, it is possible to prevent the development of inflammation.
Reguli after cleaning the uterus appear after 4-5 weeks. The timing depends largely on the general condition of the body and the rate of recovery of the cervix and endometrium. After abortive measures are often delayed. This is due to the fact that it takes a little longer to restore reproductive function in this case.
The menstrual cycle is fully restored after curettage only after three months. In some cases, it takes about six months. In the first few months, intensive contractions of the uterus cause soreness on critical days. Often the regulatives become scarce or excessively abundant.
Changes should be alerted when a stomach ache is severe, acyclic bleeding appears and body temperature rises. To postpone the visit to the doctor in this case is strictly prohibited. The reason for visiting a gynecologist is also a prolonged absence of menstruation.
The nature of the discharge after cleaning
The appearance of bleeding after curettage is a variant of the norm. It is caused by damage to the small vessels in the cavity of the body. Due to the contraction of the uterus, they may be accompanied by pain. Often, women pulls the lower abdomen during this period. Bleeding should stop a maximum of ten days.
Within a few days there is a heavy discharge from the vagina. Normally they are odorless. Pain after hysteroscopy may also be of concern.
After a time, the nature of the discharge becomes scarce, then they completely stop.
The initial appearance of daub or a sharp decrease in blood volume should guard. Such symptoms often indicate the development of complications.
Normally in women, after the uterus was scraped, a brown discharge appears. The duration of bleeding does not exceed ten days. Thick, yellowish discharge from the uterus and nagging pain are disturbing symptoms. Often they indicate the penetration of infection into the genital organ and the beginning of the inflammatory process.
Contraction of the uterus as a result of excision of its mucous layer leads to the fact that there are pains in the lower abdomen after curettage and bloody discharge from the vagina is observed. This is a normal condition that will soon pass.
Alert due to heavy bleeding. Sometimes it is accompanied by itching, unpleasant smell. Such changes indicate the development of complications. Seek help from a doctor without delay.
Discharge is the norm after cleaning the uterus and removing its mucous layer. If they are absent, then, most likely, there is a barrier to the normal outflow of blood, which begins to accumulate in the genital organ. This condition is dangerous. It is necessary to consult with your doctor and conduct a full diagnosis.
Bleeding from the uterus
In the process of treating gynecological pathology, after bleeding, bleeding may begin. During surgery, the cervix and organ cavity are injured, due to which they can not fully function. Among the main signs of the development of this complication are the following:
- no brown discharge,
- the blood has a scarlet color, not like normal menstruation, there are many clots in it,
- hygiene items have to be changed every hour
- moderate or pronounced abdominal pain,
- pale skin
- severe dizziness, and in some cases loss of consciousness.
If these symptoms appear, urgent hospitalization is necessary. Such a state threatens not only the health of the woman, but also of life.
Inflammation of the endometrium
After curettage of the cervix and the reproductive organ, endometrial disease such as endometritis can develop. This is due to the fact that in the process of recovery after surgery, the uterus is more susceptible to various diseases. It can easily get pathogens and provoke the development of inflammation.
The main clinical manifestations of pathology are as follows:
- feeling chill,
- abdominal pain,
- general malaise and weakness
- the appearance of uncharacteristic secretion.
In the process of treating this disease, antibiotics are prescribed.
If during the recovery of the uterus, the discharge has completely ceased or has drastically decreased in volume, one can suspect the development of this pathological condition. There is a hematometer after curettage due to spasm of the cervical canal and creating an obstacle to the normal outflow of blood. При этом выделения могут приобрести неестественный цвет и неприятный запах, а в случае проникновения инфекции наблюдаются озноб и сильные боли в нижней части живота.
With the development of this pathological condition, urgent hospitalization is needed. In the process of therapy, Longidase suppositories, antimicrobial and antispasmodic medications are used. Repeated cleaning is also carried out.
Drugs for treatment
The course of treatment depends on the reason for the curettage. To restore recovery after cleansing passed without complications, resort to antibiotic therapy. Antispasmodics are also prescribed. In some cases, hormonal medication is needed. In order to restore the background of hormones often prescribed tablets Regulon.
During the recovery period, various herbs are often used. With their help, it is possible to strengthen the immune system, saturate the body with vitamins and normalize the vaginal microflora.
Borovy uterus, dioecious nettle and red brush are used most often. Broths based on them are daily taken orally. At the expense of it the hormonal background is normalized and the general condition improves.
In order to avoid undesirable complications, it is extremely important to systematically undergo an ultrasound examination, promptly treat any diseases, eat right, avoid excessive physical exertion and follow all medical recommendations.
Proper organization of the diet will help improve well-being and reduce the risk of complications. The diet should not be hard. It is imperative that enough vitamins and trace elements are ingested. It is desirable that the menu were vegetables, fruits, dairy products, fish and meat. The use of carbonated and alcoholic beverages, fatty, spicy and fried foods at the same time should be minimized.
Briefly about the body itself
Everyone knows that the uterus is an important organ that is found only in the body of a woman. It performs a vital reproductive function.
The uterus is located in the pelvic area, between organs such as the intestines and the bladder. This is where the embryo (fertilized egg) is attached, after which the fetus develops over nine months. If conception did not occur, then at the end of the monthly menstrual cycle, the inner layer of the uterus exfoliates and leaves the woman’s body. Thus, menstrual bleeding occurs.
What is this body? Externally, the uterus is very similar to a small inverted triangle (the size of which does not exceed seven centimeters). The upper part of the body is called the bottom, through which the egg gets inside.
The body is the side wall of the organ in which the cavity is located, where the embryo develops.
The lower part of the uterus is the neck. This is a thin tube with a length of two to three centimeters, which connects the organ cavity and the vagina and in which the cervical canal is located.
The uterus consists of several layers:
- External (or perimetry) is the so-called peritoneum, which protects the organ from external stimuli.
- Medium (or myometrium) - a layer of smooth muscles, which is a kind of dense wall.
- Internal (or endometrium). It is a mucous membrane, richly supplied with blood vessels. It is this layer that interests doctors when it comes to separate diagnostic curettage of the uterus.
A few words about the endometrium
This mucous membrane is hormonally sensitive, as it undergoes changes in accordance with the phase of the menstrual cycle. For example, immediately after the critical days, the thickness of the endometrium can vary within two millimeters, whereas by the end of the cycle this figure may exceed two centimeters.
Before understanding what constitutes diagnostic curettage of the uterus, let's find out what the endometrium consists of:
- Functional layer It is the outer layer, rejected at every monthly cycle. The thickness of this layer and its structure are individual, as they depend on the hormonal background of each woman.
- The basal layer is the lower layer of the endometrium, which is adjacent to the muscular. It practically does not respond to hormonal changes in the body associated with critical days, and performs the restorative function of the mucous after delivery, menstruation and scraping.
- The stroma is considered the basis of the endometrium, as it consists of cells and fibers of connective tissue. This layer is a dense mesh.
- Uterine glands are tubular glands that secrete mucous secretion, thereby ensuring the normal functioning of such an organ as the uterus.
So, we have a little understood the structure of the female genital organ. And now let's find out what is curettage of the uterus. According to reviews of both doctors and patients, this procedure is considered to be a fairly common manipulation, so you should not be afraid of it in panic.
The concept and classification of the procedure
In gynecology, there are two types of curettage of the uterus:
- Diagnostic. This type of procedure involves the removal (curettage) of the inner layer of the endometrium for the purpose of further research. Thus, the biomaterial is sampled to determine the presence of cancer cells.
- Separate diagnostic curettage of the uterus. Manipulation is carried out in two stages. First, the inner layer of the cervical canal is removed, and then the upper layer of the uterus. Therefore, very often this procedure is also called curettage of the uterus and the cervical canal. Most often, this mini-operation is carried out not for diagnostic purposes, but for therapeutic purposes. For example, this method is actively used to remove tumors in the form of polyps, pathologically dangerous foci, or overgrown endometrium. Obtained after separate curettage of the uterus, the biomaterial is sent to the necessary research.
Recently, during manipulations, the attending physician uses a device such as a hysteroscope, thanks to which the organ is illuminated from the inside. Moreover, the image of the surface is optically enlarged, thereby improving visibility. This affects the operation, since the specialist can see the situation more accurately and act according to circumstances.
Further we will discuss each of the methods described above in more detail.
What is diagnostic scraping necessary for?
This procedure can be either self-manipulation or auxiliary (before the operation).
The most common indications for diagnostic curettage are such factors:
- Endometrial hyperplasia. Most often, abnormalities are detected on ultrasound, when there is a thickening of the mucous membrane of the uterus. To identify an objective picture, curettage of the uterus can be prescribed. With endometrial hyperplasia, various neoplasms can be detected. The cleaning procedure just reveals their nature and etiology.
- Endometriosis. This condition is characterized by the spread of the mucosal layer beyond the organ.
- Various violations of the menstrual cycle.
- Uterine fibroids.
- Cervical dysplasia.
According to reviews of patients, most often the procedure is carried out with bleeding. Scraping the uterus helps not only to eliminate it, but also to determine the true cause.
What is the need for separate scraping
This method is also actively used in gynecology for various kinds of bleeding. For example, emergency cleansing for heavy bleeding can help prevent heavy blood loss. Another reason for the appointment of this procedure may be infertility, but only in the case of not detecting obvious hormonal pathologies that provoke a similar condition.
Are there any contraindications to the procedure?
This is a very important question. Routine cleaning is not carried out if the patient suffers from infectious diseases or acute inflammatory processes in the genitals are found. If an emergency curettage is required, then the operation is carried out for health reasons.
Also, cleaning is not performed if it is necessary to remove a malignancy from the uterus.
When doing a separate scraping
According to women, most often the operation is carried out a couple of days before the onset of menstruation. This is necessary in order for cleaning to at least approximately coincide with physiological rejection of the mucosa. However, there are exceptions. For example, with polyps, the procedure can be scheduled according to plan in the first two days after the end of the critical days. This is due to the fact that the neoplasm is well visualized against the background of thin endometrium.
And what about when you can not manipulate? It is best not to clean in the middle of the cycle. Why? The hormones that secrete the ovaries during this period will prevent the mucous from re-growing, which can cause heavy bleeding.
During menstruation, also try not to carry out. This is explained by the fact that during this period the mucous membrane dies off and becomes uninformative as a biomaterial for further research.
Do I need pain relief?
Since cleaning is a painful and long enough procedure, it is performed under local or general anesthesia.
Most often, as the patients say, the second type of anesthesia is used. Anesthesia is administered intravenously to the woman (for this purpose, sodium iopental or Propofol is used). Anesthesia lasts only twenty to thirty minutes, during which a woman sleeps and feels nothing. This type of anesthesia is also convenient for doctors, as it is more convenient for them to perform the operation when the patient is not fully moving.
Very rarely, local anesthesia can be used when the tissues around the cervix and the organ itself are impregnated with a specific anesthetic. At the time of the operation, the woman is conscious and has unpleasant feelings.
How is the procedure
Many women experience before scraping, and it is not surprising, because cleaning is a kind of mini-operation. However, do not worry too much. The procedure is simple and uncomplicated.
All manipulations are carried out on a special table equipped with holders for the legs (as in a gynecological chair). What is the doctor doing?
At the very beginning, with the help of palpation, he examines the uterus, its position and size. Then proceeds to an internal inspection. To do this, a specialist treats the external genitals with a solution of iodine and alcohol, after which expands the walls of the vagina with the help of gynecological mirrors. Then the cervix is fixed with special bullet forceps.
Then a metal probe with a rounded end is inserted inside, thanks to which the uterus is examined in more detail. In order to carry out curettage, it is necessary to expand the cervical canal. For this, the gynecologist uses small metal cylinders, called Gegar extenders. The passage must be increased so that you can push the surgical spoons (curettes).
After that, proceed to cleaning. The curette is injected very carefully, then it is pressed against the wall of the mucous membrane of the cervical canal and the epithelium is scraped out. This action must be carried out several times until all walls are completely cleaned. The resulting material is folded into a special container, pre-filled with a ten percent solution of formalin.
After that, the gynecologist proceeds to curettage of the uterus. Clear mucous need careful, but energetic movements, starting from the front wall. As you clean, smaller curettes are used until all the mucous is removed. The biomaterial also folds into a container with a formalin solution.
Then comes the final stage - the vagina and cervix are treated with a special anesthetic. In order to stop the bleeding, ice is placed on a woman's stomach. You can keep cold for half an hour.
Then the patient is transferred to the ward, where she moves away from anesthesia and rests for another six hours. Many women are interested in the question of how much time it takes to carry out the procedure and how much to stay in the hospital. Scraping the uterus can not be called a difficult operation, so if it was successful and without complications, and if the patient feels satisfactory, then she is discharged on the same day when the procedure was performed. Close the sick-list to the woman can next day.
As you can see, this is a fairly simple operation - curettage of the uterus. How much a woman will be in the hospital depends on how well the manipulation has gone and how well the patient herself feels. According to many women, in a few hours after cleaning they were able to get home on their own. The next day, in accordance with their desire, they were able to begin their professional duties. Some women still preferred to rest a bit longer after the procedure, as they felt slight dizziness and fatigue.
What is required from the woman herself
Despite the fact that cleaning is a simple and common procedure, it is a mini-operation and requires the necessary training not only from the gynecologist, but also from the patient herself. What should a woman do to manipulate safely? Of course, your doctor will tell you in more detail about the preparation for the procedure, however, it is useful to get acquainted with the information presented below.
According to the reviews of many experts, before carrying out the operation should conduct additional surveys. For example, to pass the necessary blood tests (this includes a general analysis, biochemistry, an analysis of HIV, hepatitis, coagulogram). Also mandatory will be urinalysis and bacteriological smear from the vagina.
Also, a woman should be warned by the attending physician about what medications she takes on a regular basis and tell about her concomitant chronic diseases.
Three days before the procedure, the patient is best to give up sex, stop douching and use vaginal suppositories. The operation is recommended on an empty stomach (most often, doctors ask women not to drink or eat for twelve hours). Before the procedure is best to hold a cleansing enema and take a shower. Hair removal around the genital lips will be useful.
How to behave after the procedure
This is also an important question. Since women are not always serious about cleaning, they may not behave properly after it. However, it is very important to follow the recommendations of the doctor, and then the postoperative period will pass without complications.
So, after cleansing, a woman may experience painful feelings of a whining character, which can be localized not only in the pelvic area, but also in the lower back. To reduce pain, you can apply a cold heating pad in the lower abdomen.
Does the woman worry about discharge after curettage of the uterus? Of course. According to reviews of many patients, the discharge is abundant, with large bloody clots, as during normal menstruation. This phenomenon is considered normal when cleaning the uterus, and should be prepared for it. Therefore, a woman must stock up on gaskets. Remember, using tampons in the postoperative period is strictly prohibited!
How long will a woman be bothered by discharge after curettage of the uterus? Abundant bleeding is possible in the first days after the manipulation. Then the strong discharge will gradually turn into thin. They can be allocated another week, or even ten days after the procedure.
What to do if a woman does not have such a discharge? Scraping the uterus is a kind of operation. It should be accompanied by bloody discharge. If they are not there, or they are very quickly over, and the patient is worried about the high temperature, then these symptoms may indicate a blood stasis or inflammatory process. In this case, you need to consult a doctor. He may decide to stimulate the uterus by prescribing a course of oxytocin.
Is it possible to wash after scraping? Of course, but you can't take a bath. Hygiene procedures should be carried out twice a day and after each bowel movement.
Do not forget about the rest! It is best to spend a day or two in bed. Avoid sitting posture, so as not to put pressure on the uterus.
Briefly about medications
Naturally, your doctor will prescribe pharmacological drugs. He will write down the dosage and regimen in detail. The following are general guidelines for which medications are prescribed most often.
First, painkillers. These include “Diclofenac”, “Renalgan”, “Baralgin”. The drugs not only eliminate pain, but also slightly reduce bleeding. Most often, doctors recommend taking pills after meals. The first couple of days taken by mouth on one pill three times a day. Then another two days take one tablet at bedtime.
As a spasmolytic take "No-shpu". It enhances the contraction of the uterus and accelerates the excretion of bleeding remaining in the organ cavity. Tablets are taken one or two times a day for three days.
Для профилактики возникновения послеоперационной инфекции назначают антибактериальную терапию. Чаще всего врачи выписывают таблетки “Цедекс” либо “Цефиксим”. Антибиотики можно принимать по четыреста миллиграмм один раз в сутки. The course of treatment is at least five days.
Sometimes the attending physician may find it appropriate to prescribe suppositories, which include iodine. These may be drugs such as Betadine or Iodoxide. Candles are used to prevent the onset of inflammation and infection in the uterus. A specialist may prescribe one suppository per day for a week. It is best to insert a candle into the vagina at night.
Antifungal drugs prescribed as prophylaxis for thrush are also often recommended remedies for patients after curettage. “Fluconazole” or “Fucis” can be taken orally at a dosage of 150 milligrams one time.
As mentioned above, curettage is a mini-operation, therefore, where the endometrial layer was removed, there is an open bleeding wound. To avoid infection or complications, you must follow simple rules.
First of all, women, after cleaning the uterus for a month, cannot have sex, lift weights over three kilograms, sunbathe, take baths, swim in a pool or a river, go to saunas and so on.
At elevated temperature, severe pain, no bleeding, deterioration of the general condition of a woman should always consult a doctor.
When to expect the next menstruation? According to reviews of patients and doctors, the critical days will come four to five weeks after the operation. The regular cycle will be three months after the procedure.
Pregnancy is possible within a few weeks after cleaning. However, experts recommend planning conception after two or three months.
A couple of days after curettage, it is necessary to visit the attending physician for an ultrasound examination and control of well-being, and after ten or twelve days you can find out the result of a laboratory analysis of the endometrium.
Briefly about the complications
They occur extremely rarely, but nevertheless undesirable manifestations can be, and you need to know about them. Complications after scraping include:
- blood stasis in the uterus, provoking an inflammatory process,
- tearing or damage to the walls of the uterus tools (the resulting wound doctor sews up),
- damage to the inner layer of the endometrium, which can cause infertility.
Such undesirable postoperative consequences are extremely rare and most often do not pose a threat to the life or health of the patient.
Indications for diagnostic curettage:
• Violation of the menstrual cycle,
• Miscarriages in history
• Found on ultrasound examination of uterine myoma, adenomyosis, endometrial hyperplasia, uterine polyp, endometrial cancer, synechia and adhesions in the uterus,
• Before planned gynecological surgery.
Indications for therapeutic curettage (with removal):
• blues and adhesions,
• To remove fetal membranes (for complicated abortions, childbirth),
The success of the operation of hysteroscopy (curettage) depends on the professionalism and delicacy of the gynecologist. It is in our clinic that highly specialized gynecologists work, who carefully carry out this manipulation.
Hysteroscopy may cause complications. Allocate early and late complications.
Early complications after curettage:
• Perforation of the uterus. It may occur with a strong pressure on the probe or forceps, perforation is also possible if the uterus wall is changed and becomes loose. Small perforations are able to tighten themselves, larger doctors sew in place,
• Cervical tears. Occurs when sliding bullet forceps. Often occur when the body wall looseness.
Late complications after curettage:
• Inflammation of the uterus. It occurs if the operation was carried out in the presence of an inflammatory process (smear III-IV purity), or if the rules of asepsis and antiseptics were violated,
• Hematometra - accumulation of blood in the uterus. After the curettage procedure, cervical spasm may occur, then the blood secreted from the uterus accumulates in its cavity. To prevent this complication, gynecologists prescribe antispasmodics for several days,
• Pyometra - occurs when the hematometer begins to suppurate. Accompanied by lower abdominal pain and an increase in body temperature above 37.5. Doctors prescribe in prophylactic doses antibiotic therapy,
• Damage to the endothelium of the uterus. If the procedure is carried out by an accurate gynecologist, then this complication should not occur. If curettage is performed, affecting the deeper, sprout layers of the endometrium, the restoration of the functional layer of the endometrium is disturbed. This is manifested by the non-occurrence of menstruation. Normally, after the curettage procedure, menstruation should begin at 4-5 weeks after this manipulation. In the absence of menstruation in this period, you should immediately consult a doctor. Endometrial repair treatment is a long-term conservative treatment procedure,
• When scraping after an abortion (miscarriage) - residual elements of the fetal membranes. A month after the manipulation, the gynecologist prescribes a control ultrasound. If there are residual membranes of the ovum, then re-scraping is prescribed with their removal.
After scraping, what to do? A woman gynecologist prescribes prophylactic doses of antispasmodics and antibacterial therapy for the prevention of complications. Also, the doctor recommends to refrain from douching, using tampons and sex for two weeks. It is necessary to immediately consult a doctor if a woman has mucous discharge of yellowish color, or bloody discharge with an unpleasant smell, this indicates the development of an inflammatory process in the uterus. Spotting for two to three days is a variant of the norm. If the bleeding lasts longer, you need to consult a doctor, this indicates uterine bleeding. Non-occurrence of menstruation within 45 days after hysteroscopy is also a terrible symptom - indicates damage to the deeper layers of the endometrium.
A woman can plan a pregnancy after hysteroscopy after 2-3 weeks. Non-invasive pregnancy for 6-9 months requires consultation and examination by a gynecologist.
How to prepare for the procedure?
Scraping the uterus is considered a minor gynecological surgery, therefore, requires prior preparation. The examination allows you to identify diseases that can cause complications after performing a diagnostic cleaning. At the preliminary consultation it is necessary to inform the doctor about the drugs taken, especially those that affect the process of blood coagulation (aspirin, heparin).
- gynecological examination,
- Ultrasound of the uterus and pelvic organs.
- clinical blood test,
- blood chemistry,
- blood coagulation test - coagulogram,
- blood test for HIV
- blood test for syphilis - RW,
- a blood test for hepatitis B and C,
- bacteriological examination of the contents of the genital tract,
- general urine analysis.
The evening before the operation, it is desirable to make a cleansing enema. This will avoid postoperative flatulence - painful bloating due to accumulation of gases.
Before the procedure, you must take a shower and remove hair around the genitals.
What are the results of histology?
After examining the samples in the laboratory make a written conclusion. He will have to wait 10-20 days. You can find out the results from the doctor who did the scraping or from the local gynecologist.
The conclusion contains two parts:
- Macro description - description of tissues and detected fragments. Indicates the color of the fabric, its consistency, the weight of the sample. The presence of blood, mucus, blood clots, polyps. For example, material from the uterine cavity in large quantities may indicate growth of the mucous membrane - endometrial hyperplasia.
- Microdescription - A description of the detected cells and abnormalities in their structure. Detection of atypical cells indicates a precancerous condition (risk of developing a cancer), the appearance of malignant cells indicates endometrial cancer.