Diagnostic curettage is the most informative procedure. What is uterine rdv recovery after rdv

Diagnostic curettage of the uterus- One of the forms of biopsy, during which the doctor takes samples of the mucous membrane from the uterine cavity for cytological examination.

Curettage is considered a minor gynecological operation and is widespread in the practice of gynecologists. It allows you to accurately diagnose and carry out effective treatment for many diseases of the female reproductive system.

The procedure is carried out under intravenous anesthesia, so the woman does not experience pain at the time of curettage. The operation is not considered highly traumatic, in fact, curettage is the mechanical removal of that part of the mucous membrane that itself is rejected during menstruation. After scraping, the growth layer of the endometrium remains, from which a new mucous membrane grows in 2-3 weeks.

Synonyms... You can find various names for this procedure: endometrial biopsy, diagnostic cleaning of the uterine cavity.

Types of curettage of the uterus

diagnostic curettage of the uterus- an operation that is performed to diagnose the state of the endometrium. The inner layer of cells lining the uterine cavity is removed, followed by a study of their structure;
separate diagnostic curettage- removal of the inner layer of the cervical canal and uterine cavity. At the first stage, the upper layer of the mucous membrane of the cervical canal is removed, on the next the upper layer of the mucous membrane lining the uterine cavity.

Scraping goals

diagnostic- allow you to take material for the study of cell characteristics. The main task is to confirm or deny the presence of cancer cells in the thickness of the endometrium;
medicinally-diagnostic- when scraping the endometrium, polyps, pathological foci and growths of the endometrium are removed, which became the reason for the appointment of scraping. In the future, the received material is sent for research.

Uterus anatomy

The uterus is a hollow muscular organ located in the pelvic cavity between the bladder and intestines.

The uterus performs two main functions:

reproductive- here a fertilized egg is attached, from which the fetus subsequently develops;
menstrual- if fertilization has not occurred, then the inner lining of the uterus exfoliates at the end of the cycle, which is manifested by menstrual bleeding.

In shape, the uterus resembles an inverted triangle, the size of which does not exceed 7 cm.There are three parts of:

Bottom- the upper part, lying above the entry point of the fallopian tubes, through which the egg enters the uterus;
Body- the lateral walls of the uterus, which taper towards the cervix. In the body of the uterus is cavity, in which the fetus develops during pregnancy. Due to the significant thickness of the walls, the size of the cavity does not exceed a few cubic centimeters;
Neck- the lower part of the uterus, which is a tube 2-3 cm long, connecting the uterine cavity with the vagina. The cervical canal or cervical canal passes inside the cervix.

In the uterus, several layers

Outer- the perimetry is the peritoneum, the connective membrane that covers the uterus from the outside.
Average- myometrium - muscle layer. It is represented by non-striated smooth muscle fibers that intertwine in different directions, forming a dense muscle wall.
Interior- endometrium - a mucous membrane, abundantly supplied with blood vessels. In the body of the uterus, it is smooth and is represented by ciliated epithelium. In the canal of the cervix, the mucous membrane is collected in folds and lined with a cylindrical epithelium.

Endometrium or mucous layer - the inner mucous membrane of the uterine cavity. It has a smooth surface and contains uterine glands that open into the uterine cavity. The endometrium is hormonally sensitive tissue, therefore it undergoes changes depending on the phase of the menstrual cycle. So after menstruation, its thickness is 2 mm, and in the second half of the cycle it can exceed 2 cm.
In the endometrium, there are:

Functional layer- the outer layer of the endometrium, which lines the uterine cavity and is rejected with each menstrual cycle. Its thickness and structure largely depend on the phase of the cycle and the hormonal state of the woman, which must be taken into account when analyzing the results of curettage. Ciliated cells with numerous cilia make up the majority of epithelial cells. Their function is to propel the fertilized egg to the attachment site.
Basal layer the lower layer of the endometrium, adjacent to the muscle. Its function is to restore the mucous membrane after menstruation, childbirth, curettage. Contains bubble cells, from which ciliated cells of the functional layer are later formed. The bases of the glands and blood capillaries are also located here. Weakly reacts to cyclical fluctuations in hormones.
Stroma- the base of the endometrium, which is a network of connective tissue cells. It is dense and rich in connective fibers. In the basal layer are uterine glands... Meet light cells- immature cells of the ciliated epithelium. True lymphatic follicles- accumulations of lymphocytes without signs of inflammation.
Uterine glands simple tubular glands that secrete a mucous secretion that ensures the normal functioning of the uterus. They have a convoluted, but not branched structure. The glands are lined in one row with a columnar epithelium. They are subject to changes under the influence of hormones.

The mucous membrane of the cervical canal(endocervix) is collected in folds. It is lined with a cylindrical or goblet epithelium capable of producing mucus. The properties of the mucous secretion change depending on the phase of the cycle, which allows it to perform various functions. So during ovulation, the pores in the mucus enlarge, which promotes the movement of sperm into the uterus. The rest of the time, the mucus has a denser consistency to prevent bacteria from entering the uterine cavity.

Indications for separate diagnostic curettage

Diagnostic curettage of the uterus is indicated for the following conditions:

menstrual irregularities;
intermenstrual (acyclic) spotting;
spotting after menopause (menopause);
suspicion of endometrial tuberculosis;
suspicion of endometrial cancer;
ultrasound of the uterus within 2 cycles revealed changes that require clarification;
suspicious changes in the cervix;
after spontaneous abortion;
to establish the causes of infertility;
preparation for planned gynecological surgery for fibroids.

Contraindications for diagnostic curettage:

inflammatory processes in the uterus or in other genitals;
common infectious diseases;
suspicion of pregnancy.

Method of conducting separate diagnostic curettage of the uterus

Dates of curettage

2-3 days before your period- in most cases with infertility, with suspicion of a malignant neoplasm. The procedure is carried out within these terms, so that the removal of the mucous membrane approximately coincides with the physiological process of its rejection.
On the 7-10th day after the start menses and with menorrhagia - prolonged heavy menstrual bleeding;
Immediately after the onset of bleeding with acyclic bleeding in the middle of the cycle;
Between the 17th and 24th day of the cycle- to assess the reaction of the endometrium to hormones;
Immediately after the end of your period- with polyps of the uterus. In this case, the polyp is clearly visible against the background of a thin endometrium.

With menstruation, diagnostic curettage is not carried out, since at this time necrosis (death) of the mucous membrane occurs, which makes the collected material uninformative for laboratory research.
Not recommended carry out the procedure in the middle of the cycle, since the hormones secreted by the ovaries will inhibit the growth of the mucous membrane, which will lead to prolonged bleeding.

Pain relief when scraping the uterus

Intravenous anesthesia- short-term general anesthesia - the patient is injected with sodium thiopental or propofol. She falls asleep for 20-30 minutes. Painful sensations are completely absent;
Local paracervical anesthesia- a kind of local anesthesia. The tissues around the uterus and cervix are soaked in anesthetic. Pain sensations are significantly dulled, but do not disappear.

Where and how is curettage of the uterus carried out

The procedure for separate diagnostic curettage of the uterus is carried out in a small operating room on a table equipped with the same leg holders as a gynecological chair. The whole process takes no more than 20 minutes.
The gynecologist sequentially performs several stages.

Two-handed examination of the uterus to determine its size and position.
Treatment of the external genital organs with alcohol and iodine solution.
Expansion of the vagina with gynecological speculum.
Fixation of the cervix with bullet forceps.
Investigation of the depth and direction of the uterine cavity using a probe - a metal rod with a rounded end.
Dilation of the cervical canal with the help of Gegar's dilators - metal cylinders of small diameter. The width of the canal should correspond to the size of the curette (surgical tray).
Scraping of the mucous membrane of the cervical canal. The curette (a metal spoon with a long handle) is gently inserted to a depth of 2 cm up to the internal pharynx. The curette is pressed against the wall of the cervical canal and vigorously brought out. In this case, the curette scrapes out the epithelium. The action is repeated until all the mucous from the walls of the cervical canal is collected.
Collection of material from the cervical canal into a container filled with a 10% formalin solution.
Scraping of the mucous membrane of the uterine cavity. With the help of a curette of the largest size, the mucous membrane is scraped out, vigorously pressing on the wall of the uterus. They start from the front wall, then move on to the back and side walls. The gynecologist consistently uses smaller and smaller curettes until the uterine wall feels smooth.
Collection of material from the uterine cavity into a container with formalin solution.
Treatment of the cervix and vagina with an antiseptic solution.
Stopping bleeding. Ice is placed on the stomach for 30 minutes to stop bleeding.
Postoperative rest. The woman is transferred to the ward, where she rests for several hours. The first 6 hours check the pressure, the nature of the vaginal discharge on the pad, the possibility of emptying the bladder.
Extract. At the day hospital, the discharge is carried out on the same day. At the hospital, the woman is discharged the next day.

Modern version of the procedure - separate diagnostic curettage under the control of hysteroscopy(WFD + GS). If the usual scraping is performed "by touch", then in this case a hysteroscope is introduced into the uterine cavity - a miniature device that allows you to see everything that happens in the uterine cavity. This makes it possible to reduce the trauma and control whether there are no remote areas of the mucous membrane and formations.

In the laboratory, the resulting material is treated with paraffin and cut into thin sections, which are then examined under a microscope.

How do I prepare for the procedure?

Curettage of the uterus is considered a minor gynecological operation, therefore, requires preliminary preparation. The examination allows you to identify diseases that can cause complications after performing diagnostic cleaning. At the preliminary consultation, it is necessary to inform the doctor about the drugs taken, especially those that affect the blood coagulation process (aspirin, heparin).

Research Needed:

gynecological examination;
Ultrasound of the uterus and pelvic organs.

At the stage of preparation for scraping, it is required get tested:

clinical blood test ;
blood clotting test - coagulogram;
blood test for HIV;
blood test for syphilis - RW;
blood test for hepatitis B and C;
bacteriological examination of the contents of the genital tract;

Do not eat or drink a lot of fluids 12 hours before the procedure.
In the evening before the operation, it is advisable to do a cleansing enema. This will help avoid postoperative flatulence - painful bloating due to flatulence.
Before the procedure, you must take a shower and remove the hair around the genitals.

What are the results of histology?

After examining the samples in the laboratory, a written opinion is made. You will have to wait 10-20 days for it. 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. The color of the fabric, its consistency, and the weight of the sample are indicated. The presence of blood, mucus, blood clots, polyps. For example, material from the uterine cavity in large quantities may indicate the proliferation of the mucous membrane - endometrial hyperplasia.
Microdescription- a description of the detected cells and deviations in their structure. The detection of atypical cells indicates a precancerous condition (the risk of developing a cancerous tumor), the appearance of malignant cells indicates endometrial cancer.

In order to understand what is indicated in the cytological report, you need to know what structure it has normal endometrium at different periods of the menstrual cycle.

Phase of the menstrual cycle	Cycle days	Normal results	Pathologies with similar signs
Endometrium in the proliferation phase	Early stage of the proliferation phase 5-7th day of the cycle	Cubic epithelium on the mucosal surface. The glands are in the form of straight tubes with a narrow lumen. In cross section, they have rounded contours. The glands are lined with low prismatic epithelium with oval nuclei. The nuclei are intensely colored and located at the base of the cells. Stromal cells are fusiform with large nuclei. The spiral arteries are weakly twisted.
	Middle stage of the proliferation phase 8-10th day of the cycle	The prismatic epithelium lines the mucosal surface. The glands are slightly convoluted. Border of mucus around the edge of some cells. In the nuclei of cells, numerous mitoses (indirect cell division) are detected - the distribution of chromosomes between two daughter cells. The stroma is loosened and edematous.
	Late stage of the proliferation phase 11-14th day of the cycle	Ciliated and secretory cells on the mucosal surface. The glands are tortuous, their lumen is widened. Nuclei in prismatic epithelium at different levels. Some glandular cells contain small vacuoles with glycogen. The vessels are tortuous. The stroma is juicy and loose. Cells grow and stain less intensely than at an early stage.	a) Anovulatory cycle - a menstrual cycle during which there was no ovulation and the developmental phase of the corpus luteum. The anovulatory cycle is evidenced by these results of cytolology, preserved during the second half of the menstrual cycle. b) Dysfunctional uterine bleeding against the background of anovulatory processes - bleeding not associated with menstruation. If curettage was performed during bleeding. c) Glandular hyperplasia - overgrowth of the glandular tissue of the endometrium. This pathology is indicated by the detection of tangles of spiral vessels against the background of changes characteristic of the proliferation stage. This is possible if the functional layer of the endometrium was not rejected during the previous menstruation, but it underwent a reverse development.
Endometrium in the secretion phase	Early stage of the secretion phase 15-18th day	In the epithelium of the glands, large vacuoles containing glycogen are found, which push the nuclei to the center of the cell. The cores are located at the same level. The lumens of the glands are enlarged, sometimes with traces of secretion. The stroma of the endometrium is juicy, loose. Crimped vessels.	Pathologies that are accompanied by similar changes: a) Endocrine infertility associated with a defective corpus luteum. In this case, these cytological signs are found at the end of the menstrual cycle. b) Acyclic bleeding caused by early death of the defective corpus luteum.
	Middle stage of the secretion phase 19-23rd day	The lumens of the glands are enlarged. The walls are folded. The epithelium of the glands is low. The cells are filled with secretions released into the lumen of the gland. The nuclei are round, pale in color. The vessels are sharply twisted and form tangles. A decidua-like reaction occurs in the stroma - edema, the formation of new blood capillaries.	In other periods of the cycle, this structure of the endometrium may be associated with: a) with increased function of the corpus luteum - an excess of its hormones; b) taking large doses of progesterone; c) with an ectopic pregnancy.
	Late stage of the secretion phase 24-27th day	The glands have a star-shaped cross-section. A secret is visible in the lumen of the glands. The vessels form tangles that are closely adjacent to each other. By the end of the cycle, the vessels are overflowing with blood. The height of the functional layer decreases. Infiltration (soaking) of the stroma with leukocytes. Perivascular decidua-like reaction of the stroma - edema, accumulation of nutrients and the formation of new vessels. Focal hemorrhages in the superficial layer of the mucosa.	A similar picture is observed with endometritis. However, in the case of illness, cellular infiltration (leukocyte infiltration) is found around the vessels and glands.
Endometrium in the bleeding phase	Stage of desquamation (exfoliation of the functional layer of the endometrium) 28-2nd day	Accumulations of lymphocytes and leukocytes in the stroma. Endometrial necrosis. Collapsed glands with stellate outlines in necrotic tissue.
Endometrium in the bleeding phase	Regeneration (recovery) 3-4th day	Diagnostic cleaning is not carried out so as not to damage the basal layer, which is responsible for the restoration of the endometrium.

Terms that can be found in the cytological report:

Endometrial atrophy- Thinning of the endometrium of the uterus associated with age-related or hormonal changes in the body.
Endometrial hyperplasia without signs of atypia- Thickening of the lining of the uterus. An increase in the size and number of cells of the uterine mucosa without disrupting the structure of these cells.
Endometrial hyperplasia with atypia- in the thickened mucous membrane of the endometrium, atypical cells are found that differ from normal ones, which indicates a precancerous condition. In 2-3% of women, cancer can develop on its basis.
The remains of the ovum(of the membranes surrounding the embryo in the early stages) - the detection of remnants indicates the termination of pregnancy.
Cystic dilated glands- glands with an enlarged lumen. May be a variant of the norm at a late stage of proliferation (11-14th day of the cycle) or indicate endometrial hyperplasia.
Multinucleated epithelium- can be a sign of hyperplasia, as well as endometrial cancer.
Lymphoid Clusters- accumulations of lymphocytes, which can appear in healthy women before menstruation, and in other phases of the cycle indicate inflammation - chronic endometritis.
Endometritis- inflammation of the lining of the uterus.
Focal inflammation- foci of lymphocytes and leukocytes are found in the endometrium, which may indicate chronic inflammation.
Endometrial metaplasia- degeneration of the epithelium. Uncharacteristic cells appear in the endometrium. If abnormal cells are present, it may be a precancerous condition. In some cases, it can talk about cancer.
Endometrial adenocarcinoma- malignant tumor of the endometrium.

What diseases can be detected by this study

Disease	Signs of Endometrial Microscopy
Hyperplastic conditions
Endometrial glandular hyperplasia- Thickening of the lining of the uterus.	The epithelium of the glands is multinucleated, located in several rows. The lumen (mouth) of the glands is enlarged. The cysts of the dilated glands are absent.
Glandular cystic hyperplasia of the endometrium- overgrowth of thickening of the endometrium, accompanied by blockage of the glands.	Large cells of a cubic or columnar epithelium with a large, sometimes polymorphic (irregularly shaped) nucleus. Dilated cystic glands. The cells are arranged in groups in a glandular substance. There are no cells in a state of mitosis. Thickening of the basal (lower) layer of the mucous membrane due to the proliferation of glands is possible.
Atypical endometrial hyperplasia(synonyms: adenomatosis, adenomatous endometrial hyperplasia) - a condition in which there is an active restructuring of the glands located in the uterine mucosa. It is considered a precancerous condition - without treatment, after a few months or years, atypical cells can turn into cancerous cells.	The glands of different sizes are separated from each other by narrow strips of the stroma. The epithelium of the glands is multinucleated. Individual nuclei are enlarged, of different shapes. The cylindrical epithelium forms growths in the lumen of the glands.
Endometrial polyps- local growths of the uterine mucosa.	Tangles of thick-walled vessels. The epithelium is tubular or villous. Atypical epithelial cells are rare.
Hypoplastic conditions
Endometrial atrophy- Thinning of the endometrium of the uterus.	The epithelium is single-layered. Cells with signs of atrophy - a decrease in cell height, small nuclei. Small single glands or scraps of glands. There are no light cells in the basal layer of the endometrium.
Hypoplastic endometriosis- a disease manifested by the underdevelopment of endometrial cells.	Underdevelopment of cells of the functional layer. Glands of an indifferent type in the functional layer of the uterus. In some areas, there are signs of mitosis.
Nonfunctioning endometrium- there are no signs of the influence of estrogen hormones.	The structure of the epithelium does not correspond to the phase of the menstrual cycle. In some glands, the cells are arranged in one row, in others, the arrangement is multi-row. Uneven density of the stroma in different areas.
Inflammatory processes of the endometrium
Endometritis- inflammation of the mucous membrane of the cervix	After staining, leukocytes are found in the preparations. Diffuse focal lymphocytic infiltration is an accumulation of lymphocytes and plasma cells in limited foci of the mucous membrane.
Endometrial cancer
Adenocarcinoma	Highly Diffused adenocarcinoma- an increase in the size of endometrial cells. Elongation of the nuclei and their hyperchromia (excessively intense staining). Sometimes vacuoles are found in the cytoplasm of cells. Cancer cells are arranged in groups in the form of a rosette, which form glandular structures. Moderately differentiated adenocarcinoma- pronounced polymorphism of cells (variety of forms and other characteristics). Large cell nuclei contain several nucleoli. Many cells are found in a state of mitosis. There are no glandular structures. Poorly differentiated adenocarcinoma- pronounced polymorphism of cells and clear signs of malignancy. Large cells containing vacuoles in the cytoplasm are found. The nuclei of cells are of various shapes and sizes. A large number of multinucleated cells.
Squamous cell carcinoma- a cancerous tumor, the basis of which is squamous epithelium.	Large cells of various shapes and sizes, which can be located separately or in groups. The kernels are large, rich in color. Chromatin is unevenly located in the nuclei. The cytoplasm is dense and may contain various inclusions.
Undifferentiated cancer - a high degree of atypia of cells does not allow to determine which tissue became the basis of the tumor.	Violation of cell reproduction - signs of mitosis. Cells of all shapes and sizes. Enlarged multiple nuclei of irregular shape.

What to do after scraping

After scraping for several days, pain is felt in the vagina, lower abdomen and lower back. For the first 1-2 days, cold can be applied to reduce pain. Use a heating pad filled with cold water every 2 hours for 30 minutes.

Bloody discharge, as with menstruation, can last up to 10 days. During this period, use pads. Tampons are prohibited.

Genital hygiene must be carefully observed. Water procedures are recommended in the morning and in the evening, as well as after each bowel movement.

It is advisable to stay in bed during the first days after the operation. The sitting position is limited to relieve pressure on the uterus.

Medications after curettage:

Analgesics(baralgin, renalgan, diclofenac) - eliminate pain syndrome, somewhat reduce bleeding. The first 1-2 days are taken after meals 1 tablet 3 times a day. On the 3rd day, analgesics are taken 1 time per day - at night.
Antispasmodics(no-shpa) - for the prevention of spasm of the uterus and the accumulation of blood in its cavity. Apply 1 tablet 2-3 times a day for 3 days.
Antibiotics a short course of up to 5 days (cefixime, cedex) to prevent the development of infection in the uterus. It is taken orally 400 mg once a day, regardless of the meal.
Candles with iodine(iodine oxide, betadine) prevent the development of infection in the vagina. 7 days for 1 suppository at night.
Anti-bending drugs(fucis, fluconazole). Prevention of the development of fungal infections - thrush. Inside 150 mg after meals, once.

Healing after curettage of the uterus takes about 4 weeks. The site where the endometrium was removed is an open wound, so there is a high risk of bacteria entering there. To prevent the development of infections and bleeding for 4 weeks it is recommended to refrain from:

sexual intercourse;
physical activity - lifting weights over 3 kg, visiting the gym;
swimming in the pool and open water;
taking a bath, only a shower is allowed;
visits to the baths, saunas, solarium;
the use of vaginal drugs without the consent of the doctor.

It is necessary to consult a doctor if the following symptoms appear:

The absence of bloody discharge for the first 2 days with severe abdominal pain - indicates a spasm of the uterus and the accumulation of blood in its cavity;
An increase in temperature above 37.5 - may indicate inflammation;
Severe pain in the abdomen and lower back - inflammation or infection;
Deterioration of the general condition - may indicate an infection. It should be borne in mind that on the first day, weakness and dizziness are the result of intravenous anesthesia;
Abundant spotting after scanty - may indicate bleeding that has opened.

Scraping is a procedure used in gynecology to diagnose and treat various diseases. And, despite the popularity of this procedure, not all women have knowledge of what kind of discharge they should have after curettage and how long they can be observed.

Since during abrasion (the second name of the procedure) a wound is formed in the uterine cavity, the appearance of bloody discharge and pulling pains is considered normal. But everything has its limits. Sometimes the discharge becomes very strong, and the abdominal pain is pronounced, which indicates the development of complications. And by what other symptoms you can determine their appearance and how many days the discharge should go after abrasion, you will now find out.

Briefly about the procedure

Curettage is a type of surgery performed under general anesthesia to cleanse the uterine cavity:

With a frozen pregnancy.
From unwanted pregnancy (performed at 9-12 weeks of gestation).
With the onset of postpartum complications, when elements of the placenta remain in the uterus.
From pathological formations.
After miscarriage in case of incomplete release of the ovum.

Also, this procedure is often used to diagnose diseases when it is necessary to obtain uterine tissue for laboratory research, for example, when there is a suspicion of the development of cancer.

But regardless of the purpose for which abrasion is used, a slight bleeding after curettage is the norm. Since during its implementation, the living cells of the endometrium are removed and, accordingly, this leads to the formation of wounds that begin to bleed. The only difference in this case is the amount of tissue removed.

For this reason, the scanty periods that appear after scraping a frozen pregnancy are no different from the discharge that occurs after abrasion, for example, in the postpartum period. However, by the nature of the discharge and the appearance of other symptoms in a woman, doctors determine how successful the procedure was, and whether complications arose after it. Women who have been prescribed abrasion need to know about these "parameters" in order to determine the occurrence of a problem in time and inform the doctor about it.

Normal condition after abrasion

As already mentioned, spotting is considered common. Moreover, if the procedure took place without complications, they are no different from uterine bleeding that occurs during menstruation. The only thing is that after cleaning the uterus, a woman can notice dark clots in her vagina in a small amount, which is also not a deviation.

At the same time, menstruation after cleaning may be accompanied by minor abdominal pain, which is also often observed during menstruation. They arise due to contraction of the uterus and are easily eliminated by antispasmodic drugs.

Important! Opened bleeding after curettage in the absence of complications should not be accompanied by "rolling" pain or high fever. Their appearance is not the norm and requires immediate medical attention!

If the body is restored normally, a woman has brown discharge for 3-5 days, which lasts for several days. This shade signals a normal level of blood clotting and the successful restoration of the uterus. But! If scanty periods after curettage are observed for more than 10 days, then this has nothing to do with the norm and requires immediate medical attention.

How many days is bleeding after abrasion?

The question of how much discharge is going on, probably, worries women most of all. It is impossible to answer it unequivocally, since each organism is individual and it is difficult to say how long the discharge lasts after abrasion. The duration of bleeding depends on:

The initial level of hormones in the body.
Blood clotting rates.
How quickly the body is able to recover, etc.

Normally, profuse menstruation after curettage lasts about 2 days. Then the number gradually decreases and after a week they become few, then they completely stop. However, in some women, daubing after abrasion can last about 9-10 days, which is also not a deviation.

Do not forget that every woman has her own cycle, which directly depends on the work of the ovaries and pituitary gland. If the abrasion was carried out 2-4 days before the estimated date of the onset of menstruation, bleeding after cleaning can completely stop on the 6-7th day.

But if this procedure is carried out at the beginning or middle of the cycle, then the first menstruation after curettage will go on time and it turns out that a woman will have two menstruation at once in one month.

What changes indicate complications?

After mechanical damage to the endometrium, inflammatory or infectious processes can occur in the uterine cavity, which, naturally, affects the nature of the discharge. They may be:

Excessively thin, slimy and copious.
Yellow or pink.
Unpleasant odor.

After cleaning, wounds appear on the mucous membranes of the uterus, which secrete a liquid exudate interspersed with blood (ichor). If the secretions are observed in very large quantities, then this indicates poor wound healing.

In this case, special attention should be paid to the color of the secretion released from the vagina. If a woman has yellow discharge after cleaning, then she needs to immediately inform the doctor about it, since their appearance indicates the development of a bacterial infection that can endanger the patient's life.

It should be noted that yellow discharge that occurs against the background of the addition of a bacterial infection always depletes an unpleasant aroma. The appearance of such a smell occurs as a result of the active vital activity of pathogenic microorganisms that produce volatile compounds that mix with uterine secretions and give them such an unpleasant odor.

Important! If a woman has yellowish vaginal discharge on the second or third day after the abrasion, she must undergo a course of antibiotic therapy without fail to prevent infection. However, in no case should you start taking antibiotics on your own. This can only make the condition worse. What antibacterial drugs to prescribe is decided exclusively by the doctor, taking into account the individual characteristics of the patient.

Given that after abrasion, the likelihood of complications always remains high, a woman needs not only to know how long the discharge after cleaning normally lasts, but also what symptoms may appear when complications develop.

So, a woman needs to immediately visit a doctor if, after an abortive cleansing of the uterus:

There is a high temperature (over 38 degrees).
There is severe pain in the lower abdomen.
The nature of the discharge (consistency, aroma, shade) changes.
Severe weakness is noted, frequent dizziness occurs, nausea is felt, etc.

It should be noted that after a woman has been cleaned, her temperature may rise slightly. After scraping is a type of surgical intervention, and after it, an increase in temperature to 37-37.2 degrees is considered quite normal. Moreover, it can be observed for 2-3 days. At this time, the very state of a woman can hardly be called normal. She may be plagued by abdominal cramps and slight weakness.

This state can persist throughout the entire period while the daub is going on. And as soon as it ends, the woman will feel a significant improvement. But if this does not happen, it is necessary to urgently inform the doctor, even if no pathological changes are observed in the secretions themselves.

It must be said that no less dangerous is the condition when after curettage there is no discharge or a transparent mucous vaginal secret is observed. This is also not the norm, and therefore the woman urgently needs to be re-examined.

Possible complications

If complications arise after abrasion, signs of the development of pathological conditions appear almost immediately. As mentioned above, in the event of complications, discharge with an unpleasant odor may occur and be accompanied by fever or severe pain. All these symptoms are direct indications for ultrasound examination, which will confirm / deny the presence of complications after the procedure.

In addition to ultrasound, it is mandatory to pass a vaginal smear for bacterial culture, which will detect the bacterial flora and recognize the causative agent of the infection. Also, depending on the woman's symptoms and the results described above, the doctor may prescribe other diagnostic measures that will allow you to get the most complete picture of the state of the uterus and the organs of the reproductive system.

Speaking about what complications can arise after cleaning, it should be noted that most often, uterine bleeding opens in women. It is very important to identify it in a timely manner, since if you do not take any measures, this can turn into sad consequences.

When uterine bleeding is opened, a lot of blood is released from the vagina. In this case, it becomes necessary to change the sanitary napkins every 1.5-2 hours, or even more often. Bleeding can last for a long time, and be accompanied by weakness, dizziness, fainting, etc. The danger of this condition is that with a lack of oxygen, the cells of the body begin to die, and it is the brain cells that first of all suffer, and this can lead to serious effects.

Important! If a woman has a heavy menstrual period after abrasion, she needs to be urgently hospitalized. The bleeding uterus should be examined immediately and the patient should be given intravenous oxytocin to stop the bleeding.

After cleansing, some women have a hematometer. Its main symptom is a spasm of the cervical canal, which prevents the normal removal of blood from the uterus. As a result, women have either light pink discharge or brown discharge, which are secreted in very small quantities (sometimes there is no discharge at all).

The danger of hematomas is that it provokes the development of stagnation in the uterus, against which the risks of attaching a bacterial infection increase several times. And in order to rectify the situation, it is required to clear the way for blood. This is done in two ways - medication or surgical. And since the risks of attaching a bacterial infection remain high, in any case, treatment includes a course of antibacterial drugs.

Endometritis is considered an equally dangerous complication. With its development, inflammatory processes occur in the uterine cavity. They appear due to the active vital activity of pathogenic microorganisms that penetrate into the uterus from the vagina or during abrasion when poorly sterilized instruments are used.

A sign of the development of endometritis is the presence of yellow discharge. Moreover, they may not arise immediately after the procedure, but in a month. In this case, the clinical picture is complemented by sharp abdominal pain and fever. Endometritis is easily treated - by taking antibacterial drugs. But if you do not start taking them on time, this will lead to serious consequences.

Remember that little bleeding after abrasion is considered natural. Normally, they last no longer than 10 days. If the daub after cleaning continues and is supplemented by other symptoms (unpleasant odor, pain, fever, etc.), an urgent need to visit a doctor. After the examination, he will prescribe a treatment that will prevent the occurrence of serious complications and maintain health for many years.

Diagnostic curettage of the uterine cavity, what kind of procedure many women know. This is the so-called cleaning of the uterus in the common people. This procedure is performed for the purpose of diagnosis, as the name implies, and the treatment of some gynecological diseases. Let us consider in more detail what indications the therapeutic and diagnostic curettage of the uterine cavity has, how painful it is, and how the body is restored after it.

Endometrial hyperplasia and polyp

Hyperplasia, in short, is an overgrowth of the lining of the uterus. It occurs in women of reproductive age mainly due to an excess of the hormone estrogen. An overabundance may occur when taking certain hormonal drugs and as an independent phenomenon.

Endometrial hyperplasia can be diffuse and focal, this is when a polyp forms in the uterus. Symptoms of the disease are intermenstrual bleeding, heavy menstruation, and often infertility. But although hyperplasia in young women very rarely turns into cancer, it needs to be treated. Diagnostic curettage of the uterine cavity with endometrial hyperplasia is performed. As a result, the pathologically enlarged endometrium and focal formations in the uterine cavity, if any, are removed. The material is sent for histological examination. If everything is normal, no atypical cells were found, oral contraceptives are prescribed. The term of their admission will depend on the personal wishes and reproductive plans of the patient. The tablets can be taken for a long time without any complications. If there is a pregnancy in the plans, then it is usually recommended to take it for three months, and then, on discontinuation of the drug, to become pregnant. It is believed that in this way it is easier to become pregnant, since ovulation will most likely occur on the withdrawal of drugs.

Oral contraceptives are used to prevent ovarian hyperplasia and benign neoplasms.

Doctors pay special attention to patients who have already entered menopause, but the endometrium, for some reason, continues to increase. This may indicate an oncological process. Without curettage, it is impossible to diagnose and decide on further treatment tactics.

Separate diagnostic curettage of the uterine cavity (WFD), the first word in the name of the procedure means that material is taken not only from the uterine cavity, but also from the cervical canal, first from it - this is a very useful procedure if it is performed to remove a polyp or submucous myoma ... Since these neoplasms can play the role of intrauterine contraceptives and prevent the fertilized egg from entering the endometrium for further development.

By the way, a polyp can be not only hormonally conditioned, but also be the result of an incomplete miscarriage. In this case, histology is used to diagnose "placental polyp". And sometimes women do not even understand where it came from, this polyp, if there were no pregnancies, there were no delays. It so happens that a pregnancy is terminated almost immediately after the implantation of a fertilized egg into the wall of the uterus. Therefore, there are no symptoms either. But such a "gift" in the form of a polyp may remain.

Diagnosis of endometriosis (adenomyosis)

Endometriosis is a disease in which cells of the endometrium, the inner layer of the uterus, spread into the muscular layer of the uterus or even beyond the main reproductive organ. If endometrial cells invade the inner layer of the uterus, lesions form. In this case, the disease is called adenomyosis. A woman often has uterine bleeding, pain occurs during, before and after menstruation. Menses are always profuse. But most importantly, with widespread adenomyosis, it is very difficult to get pregnant.

How is the diagnosis made? The doctor can suggest it by symptomatology. In general, adenomyosis is a very common pathology among women of different ages. If the ultrasound confirms its probable presence, plus the pathology of the endometrium, then the woman may be offered an examination. Diagnostic curettage of the uterine cavity is indicated for such problems, but to identify the prevalence of adenomyosis - it would be better to perform this procedure under the control of hysteroscopy - with a visual examination of the uterine cavity using a special device.

It will not be possible to completely get rid of adenomyosis at reproductive age. Its symptoms will disappear only with the onset of pregnancy. And they will completely disappear - with the onset of menopause or after the removal of the uterus. But you can significantly improve your condition and increase the chances of pregnancy if you take hormonal drugs prescribed by your doctor according to special schemes. Some of them put a woman into an artificial menopause, but this is part of the treatment process. After that, the foci of adenomyosis are placed less, and pregnancy may occur.

Myoma of the uterus

Diagnostic curettage of the uterine cavity with fibroids is performed in two cases:

if the tumor grows inside the uterus, that is, it is submucous, it can be removed through the vagina;
if there is a suspicion of endometrial pathology;
this procedure is performed before the removal of uterine fibroids to make sure that there is no endometrial cancer.

But diagnostic curettage of the uterine cavity and cervical canal is useless if the doctor thus wants to diagnose between myoma and sarcoma, and the tumor itself is in the muscle layer or even grows on the uterus, that is, it is subserous. Even if the histology is good, it is not a fact that this is not a sarcoma. At the initial stages of the development of a malignant tumor, its cells in the endometrium may be absent.

In general, distinguishing a fibroid, a benign tumor, from a sarcoma, a very aggressive, malignant tumor, is a difficult task even for an experienced physician. In most cases, the main difference is the very rapid growth of the tumor. When it grows literally one centimeter a month. With sarcoma, the entire uterus is removed, and often the appendages along with it. Sarcoma of the uterus is a rare finding in young women. It is most often diagnosed in women over 50.

Removal of uterine fibroids is carried out not only because of the rapid growth of the tumor and its significant size, but also if it interferes with conception. This happens with submucosal, submucous myoma. Just to remove it, a woman is given a so-called hysteroresectoscopy and immediately diagnostic curettage.

Before the procedure

In the case of a planned intervention, a woman first takes blood tests, urine tests, a smear for flora, necessarily undergoes an ECG and visits a therapist with all the results. Such "complications" are necessary because the procedure is likely to be performed with general anesthesia. And for its implementation, there are many contraindications. The anesthesiologist must know everything about the health of his patient in order to give her the safest possible anesthesia.

At the same time, smear results are important. If they are bad, the procedure may be postponed. The only thing when smear results are not taken into account is emergency cleaning. It is performed, for example, with heavy intermenstrual bleeding in order to stop it. But after the procedure, antibiotics are necessarily prescribed.

Possible complications and consequences

Immediately after the procedure, the woman will have to recover from anesthesia. This can take up to three hours. You should not get up on your feet earlier than two hours after scraping, as your head will be dizzy.

There may be pulling pains in the uterus. You can remove them with any antispasmodic quite quickly.

Discharge after diagnostic curettage of the uterine cavity continues for several days. And sometimes they can be quite intense, especially if the procedure was more therapeutic, for example, if a woman had a polyp or fibroid removed. As with menstruation, at first the discharge will be bright red, gradually it will become smaller, their color will be brown, and finally everything will end with a slight daub. Sometimes complications occur during diagnostic curettage of the uterine cavity in the form of severe bleeding. Then the woman is prescribed a hemostatic drug: "Vikasol", "Dicinon", "Tranexam", etc.

And if you do not take antibacterial drugs prescribed by your doctor, you may experience endometritis, inflammation of the uterus, leading to the formation of adhesions, infertility. Simultaneously with them, a woman is also prescribed antifungal pills for the purpose of prophylaxis, they will protect against thrush, which will probably appear otherwise while taking antibiotics.

Another common complication is cervical injury. They can occur due to its mechanical damage as a result of careless use of instruments by the doctor. For example, if bullet forceps are torn off, with which the cervix is pulled downward before its instrumental opening. As a result, isthmic-cervical insufficiency and miscarriages in late pregnancy in a woman.

Recovery process

Menstruation after curettage diagnostic begins at different times. They depend on what day of the cycle the intervention was. Usually, doctors prescribe the procedure for the last 1-2 days of the cycle so as not to disrupt the cycle. In this case, menstruation should be expected after about 30 days.

If you start taking oral contraceptives, then bleeding will begin within a week after taking the last, 21st tablet from the package. The start of taking contraceptives is 1-5th day after brushing.

Sometimes there is a delay in menstruation - these can be the consequences of diagnostic curettage of the uterine cavity. Due to a too carefully performed procedure, intrauterine synechiae, adhesions may form, this is the result of an endometrial injury. Symptoms are prolonged absence of menstruation or very scanty discharge. Surgical treatment - dissection of adhesions.

Pregnancy can be planned 3 months after the procedure. Usually, it is this period that gynecologists advise to wait for their patients.

08.05.2019 20:31:00
Want to build muscle? Discard these products!
If you want to build muscle, you should not only give full throttle in your workouts, but also pay attention to your diet. For maximum success, cross out the following foods.

Curettage is an operation performed on women for several reasons. Surgical intervention is more often prescribed for a frozen pregnancy or endometritis. After the operation, a period of rehabilitation is required so that the woman can again bear and give birth to a child, as well as in order to prevent the development of complications.

The procedure is prescribed in cases where the disease does not respond to drug treatment. In addition, curettage can be prescribed in the event of various complications.

The indications for the procedure are:

Endometrial hyperplasia.
Violation of the menstrual cycle.
Frozen pregnancy.
Spontaneous miscarriage.
Uterine bleeding, provoked by various reasons of unknown origin.
A combination of several pathologies.

Cleaning the uterine cavity is a procedure that involves the surgical removal of a functional layer. That is why a woman is prescribed treatment after curettage. The procedure itself is quite common and is prescribed in every third case. It is carried out three days before the expected menstruation.

Curettage in some cases is carried out not for the purpose of removing tissue, but for diagnosis. This is necessary to obtain a tissue sample for laboratory testing to determine the presence of cancer cells.

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 body. Complications can arise in the presence of various concomitant pathologies. It is for this reason that, before carrying out the procedure, the doctor determines their presence or absence, and also determines the possibility of using other methods of treatment.

Many women are interested in what to do after curettage of the uterus and how to restore the work of organs. In order for the recovery period to proceed without complications, and the functional layer of the uterine mucosa to recover quickly, doctors recommend following a number of recommendations. These include:

Exclusion of sexual activity for at least three weeks. This is necessary in order to exclude the penetration of infection into the uterus, since after the procedure it remains open and it takes time for it to recover. In addition, semen contains a special substance that has a relaxing effect on the muscle tissue of the uterus.
For six months, use condoms during intercourse in order to exclude pregnancy.
For one month after scraping, do not take a bath, do not swim in open water and do not visit saunas, swimming pools.
Slight bleeding from the uterus may occur immediately after the procedure. In this case, the use of tampons is strictly prohibited. They absorb not only secretions, but also cause infection and inflammation.
Limit physical activity.
The prescribed antibacterial drugs should be taken at regular intervals.
Correctly observe the dosage and duration of medication intake.
In case of painful sensations that may appear during the first 2-3 days, it is recommended to take pain relievers, for example, "Diclofenac".
Completely exclude the use of alcoholic beverages.

In addition, the doctor may prescribe drugs such as Longidaza or Wobenzym. Medicines are intended to exclude the formation of adhesions. During the recovery period of the uterus after curettage, it is important to follow all the recommendations of a specialist.

An important step after the procedure is the restoration of the menstrual cycle, since the body is very sensitive to various interventions. As a result of surgery, when the endometrium is removed, it begins to malfunction. To establish the functions of the reproductive organs, physiotherapy procedures and medications can be prescribed.

Physiotherapy

During the recovery period after cleansing the uterus, physiotherapeutic methods are prescribed that have a positive effect on the body, accelerating the process of tissue regeneration. The most effective treatments include:

Ultrasound therapy. It is prescribed to prevent the formation of adhesions in the small pelvis and uterus. They can form as a result of injury to the mucous membrane during the cleaning process.
EHF-therapy. It is considered one of the most effective procedures aimed at enhancing immunity and body resistance. It is also carried out as a prophylaxis for the formation of endometritis.
Phototherapy. The exposure takes place with the help of a special apparatus that emits infrared rays. They help stop minor inflammation and prevent its spread.

The finished solution is injected using a catheter, and due to its thick consistency, it does not flow back. Therefore, there are no restrictions on physical activity.

In some cases, a biopsy may be required. The procedure is performed under anesthesia. With the help of a special thin needle, a part of the fabric is taken. The material is sent for research to the laboratory. The procedure is prescribed in order to establish the state of the cells.

Drug treatment

The rehabilitation period after curettage also involves the use of drugs. First of all, sedatives and antidepressants are prescribed, for example, "Azafen", "Coaxil". The course of treatment is from 10 to 20 days, depending on the condition of the woman.

Menstruation after scraping

The first menstrual period most 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 body, as well as the individual characteristics of the body. When performing a medical abortion, there may be a slight delay, since the restoration of reproductive functions takes a long time.

The cycle is completely back 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 prolonged and abundant. Their absence is a reason for visiting a specialist. You should also see a doctor if you have fever, profuse bleeding, or severe pain in the lower abdomen.

Body temperature

A slight increase in body temperature after surgery is a protective reaction of the body. Moreover, it should not be higher than 37.2.

This condition after curettage is observed only on the first day, and its increase may serve as a reason for contacting a doctor. A high temperature that 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, you should call 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 is similar in consistency and color to menstrual discharge, and many women confuse them.

The duration of the discharge depends on the blood clotting, the reason for the surgical intervention, the general condition of the woman's body and hormonal levels. Discharge with a number of features is considered the norm:

Duration from 6 to 10 days.
Over time, they acquire a smearing character.
The presence of pulling pains in the lower abdomen.

The color of the discharge is also important. If they are brownish, then the healing of the uterine cavity is proceeding correctly. But in cases where they are bright red and last more than 10 days, you should consult a specialist. Signs of concern include:

The presence of an unpleasant odor.
Yellow color of discharge.
The appearance of bleeding.
Fluid discharge.

Most often, a large amount of discharge indicates that the healing process is quite difficult. With the penetration and spread of infection in the uterine cavity, the exudate becomes yellowish. This requires the use of antibacterial drugs.

Many women are interested in how to recover from curettage. In the process of rehabilitation, it is important to follow all the recommendations of a specialist and be attentive to your health.

Curettage is a fairly common procedure, which is performed in every third case. Surgery can be prescribed for a variety of reasons when drug treatment fails. With the correct course of the recovery process, complications arise in exceptional cases.