Scraping the uterine cavity is performed at endometrial hyperplasia to obtain research and analysis for detection of pathologies at an early stage of development. In the absence of timely treatment is likely the risk of degenerative diseases in oncology.
The most frequently detected in women with glandular cystic endometrial hyperplasia. The transition probability of the disease in cancer with timely treatment is only 1%.
Content
- The essence of the procedure,
- How is scraping
-
Indications and contraindications
- Contraindications
-
Method of operation
- blindfold
- With the help of a hysteroscope
- separate scraping
- Possible consequences
- rehabilitation period
- possible complications
- recurrence risk
The essence of the procedure,
The process of scraping the development hyperplasia It means upper layer cleansing endometrium. Such treatments can relieve for some time on the disease, if it is provoked bleeding and had a greater probability of malignant transformation.
Also, remote shell after microscopic examination allows accurate determination of the diagnosis and the severity of the disease. The doctor, based on the results of the research can prescribe the right treatment.
How is scraping
Manipulation is performed in the operating room. The woman is on the gynecological chair. The procedure is very painful, so the operation is performed under general anesthesia. Curettage after delivery or miscarriage as a result does not require intravenous anesthetic, the cervix and so is in the expanded state.
In other cases the cervical canal disclose using a special dilator is removed and the mucosa surgical spoon. They can also use a vacuum aspirator or hysteroscope. In the latter case, the machine is equipped with a camera that allows you to see all areas that require cleansing.
When curettage immediately take a biopsy to study and sent to the histology lab.
For the upcoming surgery woman carefully prepared. Analyzes before curettage:
- KLA;
- blood clotting;
- blood RW, HIV, hepatitis C;
- swab from the vagina to identify viruses and infections;
- blood for thyroid hormones.
Besides it is necessary to limit sex a few days before the operation.
Without test results curettage allowed if the woman was taken to hospital with heavy bleeding.
Indications and contraindications
Scraping the uterine cavity is indicated for the study of pathology and medicinal purposes.
For the diagnosis of upper layer cleansing endometrial recommend:
- hyperplasia. Pre endometrial thickening and appearance of tumors detected by ultrasound. Scraping administered to clarify the nature or eliminating tumors;
- endometriosis, when the endometrium of the uterus is located behind the border;
- endometrial polyps;
- cervical dysplasia. The study was conducted when the doctor questioned the benign nature of the disease;
- the formation of fibroids in the uterus;
- failure of the menstrual cycle.
Histology is essential for studies of the structure and condition of the tissues, the definition of pathological changes in the endometrium.
As a cleaning treatment is recommended:
- at endometrial polyps. From them can be removed only by removing the entire top layer of the endometrium;
- excessive bleeding during menstruation or before. Scraping prevents blood loss and anemia. The operation does not depend on the day of the cycle;
- infertility and gynecological pathologies that develop without obvious hormonal changes;
- uterine bleeding during menopause in women.
Also, the cleaning process is carried out at abortion, missed abortion and miscarriage to remove the placenta from the uterine cavity and remnants of the ovum.
Contraindications
there are limitations to conduct curettage. The doctor may refuse to surgery if detected genital infections, exacerbated chronic diseases, any inflammatory processes.
Method of operation
Scraping the formation of hyperplasia is usually carried out for a few days before the start of menstruation. This tactic reduces the risk of bleeding and allows the body to recover more quickly.
During curettage removes the top layer of the endometrium. He also rejected during menstruation.
During the procedure, injury can occur, damage to healthy tissue and fallopian tubes. Investigation of the uterus with scraping followed carried out in several ways. Which method is best for cleaning the upper layer of the endometrium, determined by the physician.
blindfold
Scraping blind hyperplasia when compared to hysteroscopy, greatly injure the other layers of the uterus. Such injuries cause the development of various complications. For example, there are often bleeding after curettage.
Cleaning is performed under anesthesia. Special gynecological device pushing the cervix and scraping do curette (an instrument, having the form of a loop). Specialist thoroughly scrapes off the surface layer of the endometrium.
For the diagnosis of taking a piece of cloth, which is placed in a sterile jar. Analysis was examined in histological laboratory.
With the help of a hysteroscope
This optical device which is inserted into the vagina, the uterus and further supplies the air. Apart under its pressure reproductive organ wall. The presence of the camera allows you to view a picture of what is happening on the screen. The whole process is controlled by scraping, and the doctor knows exactly which areas of the endometrium with pathological changes should be removed.
Duration of treatment is about 15 minutes. Held hysteroscopy in a certain day of the cycle. Usually it is performed on the 6th day of the menstrual cycle. During this period, the endometrium is less prone to bleeding.
separate scraping
There are times when you need to perform the surgery curettage in 2 stages. It involves careful removal of the top layer of the endometrium from the uterine wall, and then with the cervix.
Purification of the mucosa surface layer can be accompanied by adverse effects. The occurrence of complications after surgery require re-curettage. The procedure is painless due to the anesthetic action. The whole process takes 15 to 25 minutes.
Possible consequences
Endometrial hyperplasia at the wrong treatment can degenerate into cancer. Therefore, when uterine fibroids, polyps, detection of pathology of pregnancy curettage procedure is performed to exclude malignancy.
Fully body is recovering from surgery for a month. During this time, there may be different effects on the lead curettage:
- For a few hours can continue profuse bleeding. Quick jump to weak secretions after dilatation and curettage may indicate the occurrence of uterine spasm and congestion of blood clots inside.
- Pain in the abdomen, as in the month. Such a woman may feel discomfort for 6-8 days. For relief of spasms appointed painkillers.
- General weakness and malaise.
Help your doctor is required a woman if she has:
- fever;
- appeared isolation having an unpleasant smell;
- ceased completely discharge;
- condition worsened.
Prevent negative consequences after the purification of the endometrium can be, if you follow all the doctor's instructions.
rehabilitation period
How quickly it recovers the body after surgery depends on the implementation of recommendations of the doctor.
Treatment after curettage the uterus is shown as follows:
- first time should take hemostatic agents;
- it is important to undergo a course of antibiotic therapy;
- within three months it is necessary to carry out hormonal agents. They are selected based on the age and nature of the pathological changes in the endometrium;
- to eliminate the accumulation of blood should be used drugs designed to relieve spasm of cervical;
- You need to undergo physiotherapy.
The menstrual cycle is completely restored after brushing over 28-30 days. Failure monthly for several months requires inspection gynecologist.
possible complications
Effects after curettage occur in exceptional cases. They may appear:
- inflammatory changes against the backdrop of blood stasis;
- damage at the time of scraping the walls of the uterus a surgical instrument;
- injury inner layer of the endometrium. This can result in infertility;
- development of endometritis.
All kinds of complications can be avoided with timely treatment. In the case of ignoring a woman expect irreversible consequences.
recurrence risk
Therapy given after curettage, aimed at preventing the occurrence of hyperplasia. Therefore, the risk of recurrence is greatly reduced. That the disease is not renewed, it is necessary to bring the hormones back to normal.
Re-curettage procedure is assigned:
- 6 months in order to diagnose and determine the effectiveness of the therapy;
- at occurrence of unpleasant signs of bleeding and fever.
Incomplete removal of polyps can also lead to the need for re-cleaning, because they tend to grow again.