Often, with gynecological diseases, it is necessary to examine the endometrium of the uterus to confirm the diagnosis. The most important processes occurring in the organs of the reproductive system depend on its condition and development. Cleaning is also prescribed for medicinal purposes. How the procedure goes, how painful it is, what the consequences may be, worries many women who are faced with the need to perform curettage of the uterine cavity. The risk of complications is minimal if after the procedure the patient strictly follows the doctor’s recommendations.
Content:
The uterus is lined from the inside with a membrane (endometrium), consisting of 2 layers. One of them borders directly on the muscles of the wall. On top of it there is another layer, the thickness of which regularly changes in accordance with the functioning of the ovaries and the production of female sex hormones. Curettage is the complete removal of the functional layer. This procedure allows you to diagnose pathological neoplasms, as well as clean the organ cavity.
There are several methods for carrying out such cleaning.
Normal cleaning consists of removing the mucous membrane only inside the cavity.
Separate differs in that the mucous membrane is first removed from the cervix, and then from its cavity. Selected materials are collected in different containers and examined separately. This allows us to clarify the nature of the pathology in each part of the organ.
An improved method is curettage simultaneously with hysteroscopy. Using a special optical device (hysteroscope), the uterus is illuminated from the inside, and the image of its surface is magnified. Thus, the doctor does not act blindly, but purposefully. Hysteroscopy allows you to perform a preliminary examination of the cavity and act more accurately. This significantly reduces the risk that endometrial particles will remain in the uterus and complications will arise after surgery.
It is used as an independent procedure, as well as as an auxiliary one, allowing one to assess the nature of the tumors and the volume of the upcoming abdominal surgery to remove tumors.
For diagnostic purposes, curettage is performed in the presence of the following pathologies:
Indications for curettage for therapeutic purposes are:
Carried out in the following cases:
Planned curettage is not carried out if a woman has infectious diseases or acute inflammatory processes in the genitals. In emergency cases (if, for example, bleeding occurs after childbirth), the procedure is carried out in any case, since it is necessary to save the patient’s life.
Cleaning is not performed if there are cuts or tears in the uterine wall. This method is not used to remove malignant tumors.
Curettage is usually performed in the last days of the cycle before the onset of menstruation. During this period, the cervix is most elastic and easier to dilate.
Before the procedure, a woman must undergo a general blood and urine test for the presence of inflammatory processes. A blood clotting test is performed. Tests are taken for syphilis, HIV and hepatitis.
Before the procedure, a microscopic analysis of a smear from the vagina and cervix is performed to determine the composition of the microflora.
3 days before cleaning, the patient must stop using vaginal medications, and also stop douching and abstain from sexual intercourse. The procedure is carried out on an empty stomach.
Curettage of the uterine cavity is carried out exclusively in a hospital, under conditions of maximum sterility. Pain relief is carried out by using a mask with nitrogen dioxide or intravenous administration of novocaine. Sometimes general anesthesia is used.
During the procedure, the uterus is expanded with special devices, and its internal size is measured. The upper mucous membrane of the organ is scraped out using a curette. If diagnostics are necessary, the material is sent for histological examination.
When performing an abortion or cleansing after a miscarriage, frozen pregnancy, or childbirth, the aspiration method is used. The contents of the uterine cavity are removed using a vacuum. In the same way, blood is removed from it in case of dysfunctional uterine bleeding or stagnation inside the uterus. This method is more gentle than curettage, since there is no risk of damage to the cervix or uterine wall.
During hysteroscopic curettage, a tube with a video camera is inserted into the uterus to examine the surface. After removing the top layer of the endometrium, make sure that the mucous membrane is completely removed.
After the procedure, ice is placed on the lower abdomen. The patient remains in the hospital for several hours so that doctors can be completely sure that there is no risk of bleeding.
Immediately after the anesthesia wears off, the woman may feel quite severe abdominal pain for 2-4 hours. Then, for another 10 days, feelings of mild nagging pain persist. The discharge of blood in the first hours is strong and contains blood clots. Then they become spotting and may appear for another 7-10 days after surgery. If they stop too quickly, and at the same time the woman’s temperature rises, this indicates the occurrence of blood stagnation (hematometra) and an inflammatory process. Treatment is carried out with oxytocin, which increases uterine contractility.
To eliminate pain, painkillers and antispasmodics (no-spa) are prescribed to help speed up the removal of residual blood. Antibiotics are taken for several days to prevent inflammation in the uterus.
2 weeks after cleaning, a control ultrasound examination is performed to ensure that the procedure was successful. If the study shows that the endometrium has not been completely removed, cleaning must be repeated. The result of a histological examination of the cells of the removed material is ready in about 10 days, after which the doctor will be able to make a conclusion about the need for further treatment.
After cleaning, your period will begin in 4-5 weeks. The frequency of their onset is restored after approximately 3 months.
Warning: You should consult a doctor immediately if blood in the discharge does not disappear after 10 days, and the abdominal pain intensifies. The appearance of elevated temperature a few days after curettage should alert you. It is imperative to visit a doctor if menstruation after cleansing the uterus becomes too heavy or very scanty, and their pain also increases.
After the operation, until its consequences completely disappear, it is necessary to avoid douching, inserting tampons into the vagina, and medications not prescribed by the doctor. You should not put a hot heating pad on your stomach, visit a sauna, take a bath, or stay in a hot room or in the sun for a long time.
Aspirin and other anticoagulants should not be taken for 2 weeks after cleansing. Sexual relations can be resumed 3-4 weeks after curettage, when the pain and risk of infection disappear.
Curettage that takes place without complications usually does not affect the course of pregnancy and childbirth. A woman can become pregnant within a few weeks, but doctors recommend planning her pregnancy no earlier than 3 months after cleansing.
After a qualified curettage procedure, complications occur extremely rarely. Sometimes, due to impaired muscle contractility, a condition such as hematometra occurs - stagnation of blood in the uterus. The inflammatory process begins.
During the procedure, the neck may be torn by instruments. If it is small, then the wound will quickly heal on its own. Sometimes you have to stitch it.
When performing a blind operation, damage to the uterine wall may occur. In this case, the gap needs to be sutured.
Damage to the basal (inner layer of the endometrium, from which the superficial functional layer is formed) is possible. Sometimes restoration of the endometrium becomes impossible because of this, which leads to infertility.
If polyps are not completely removed, they may grow again and require repeated curettage.
There are many types of cleanings (the most popular are the first three): mechanical, combined, ultrasonic, vacuum, atraumatic.
Mechanical cleansing is traumatic, but indispensable in the fight against deep comedones and blackheads. At the same time, the best option is considered to be combined cleaning, which combines ultrasonic cleansing of pores and then removing comedones using a medical spoon.
After combined facial cleansing You can get the perfect combination of clean pores, even skin and a refreshed complexion.
Regardless of what kind of cleaning was carried out (mechanical or combi), facial care will be the same.
The main goal is to support the skin during the recovery period, not to close cleaned pores with cosmetics and pollution, and not to cause additional irritation through improper care.
Let us remind you that proper cleaning looks like this:
The care in question is suitable both after skin cleansing by a cosmetologist and at home.
For two to three days after cleansing your facial skin, you should refrain from spending a long time outside if there is a strong wind outside, too hot or, on the contrary, frosty.
There are often questions Is it possible to sunbathe after cleansing your face?. No, solarium and tanning in the open sun are prohibited for 3-7 days. After cleansing, the skin is exposed to sunlight and there is a risk of pigmentation.
You can only go outside with sunscreen applied, even in cloudy weather.
You should also refrain from baths, saunas and swimming pools for about a week. The visit should be postponed until the skin has recovered, so as not to introduce bacteria into the pores and cause inflammation.
Sports training should be postponed for two to three days.
Everything is approximately clear with care, but here are some procedures you can combine with facial cleansing and bring your skin to a fantastic condition.
Complications after cleansing the skin are transient in nature and if all care recommendations are followed, they pass quickly and without a trace.
So, what can we expect:
Endometritis after curettage is a common complication that occurs in women after an abortion, removal of uterine polyps, frozen pregnancy or remnants of the fertilized egg during spontaneous miscarriage. This disease poses a great danger to women's health and therefore requires prompt consultation with a doctor and mandatory drug treatment.
Curettage (curettage) is a complex gynecological procedure during which the endometrium, the upper mucous layer lining the uterine cavity, is removed.
When terminating a pregnancy, the organ is thoroughly cleaned, removing not only the mucous membrane, but also the fertilized egg. During the operation, the integrity of the upper layer of the uterine cavity is violated, as a result of which, during the rehabilitation period, an inflammatory process may occur on the walls of the uterus, characterizing the development of endometritis.
This disease is caused by the addition of a secondary bacterial infection, provoked by improper conduct of the procedure, failure to comply with the rules of asepsis during curettage and refusal to use antibiotics in the postoperative period.
If the cleaning was not carried out thoroughly enough, the uterine cavity contains blood clots, remnants of the fertilized egg and placenta, which are a favorable environment for the proliferation of microbes that cause inflammation. Infection can also be caused by non-sterile instruments directly during curettage.
Other factors also contribute to the occurrence of endometritis after curettage. Among them:
The greatest risk of developing an inflammatory process in the postoperative period occurs during surgical curettage, which is considered the most traumatic, and during vacuum aspiration. With pharmaabortion, such a complication practically does not occur if, after taking appropriate medications, the uterine cavity is completely cleansed.
After curettage, it most often develops, which has very pronounced symptoms and causes a deterioration in the woman’s well-being. The first manifestations of the disease occur 3-4 days after cleaning.
Symptoms of acute endometritis include:
If a woman is not given timely help, endometritis quickly becomes chronic, which is characterized by a sluggish inflammatory process in the uterus, accompanied by frequent aching pain in the lower abdomen, serous vaginal discharge, and uterine bleeding. Subsequently, the woman experiences disruptions in the menstrual cycle, becoming abundant or too scanty, and severe discomfort occurs during sexual intercourse.
Acute post-abortion endometritis is the basis for hospitalization in a hospital, where the patient is provided with complete rest, bed rest, and medication is prescribed. An ultrasound scan of the uterus is required at a medical institution.
If during the study it is determined that there are remnants of the fertilized egg or blood clots in the organ, the woman is sent for repeated cleaning, after which therapy is immediately started.
The basis of treatment is antibacterial agents, selected taking into account the sensitivity of the infectious agent to antimicrobial substances. The following medications are used:
It is possible to simultaneously prescribe several drugs belonging to different groups of antibiotics. Also, along with antibacterial agents, antiprotozoal drugs are often used to eliminate anaerobic flora in the uterus (Metronidazole).
For symptomatic therapy, anti-inflammatory, antipyretic and painkillers are prescribed (No-spa, Indomethacin, Ibuprofen, Baralgin). In order to prevent the development of candidiasis infection provoked by taking antibiotics, antifungal drugs are used, probiotics are used to restore the body's microflora, and immunomodulators and multivitamin supplements are used to increase immune defense.
If endometritis is accompanied by severe intoxication, droppers with protein and saline solutions are prescribed.
At the final stage of treatment, to accelerate the regeneration processes of the mucous layer, it is recommended to undergo a course of physiotherapy (UHF, electrophoresis, magnetic therapy).
Similar treatment regimens are used for chronic endometritis. First of all, the causative agents of infection are eliminated with the help of antibiotics, then a course of restorative treatment is carried out, aimed at regenerating the uterine mucosa. During this period, hormonal drugs and agents with metabolic effects are used, which improve metabolism and accelerate the healing of the endometrium. It is strongly recommended to undergo physiotherapeutic procedures, mud and hydrotherapy.
In the absence of adequate timely treatment of endometritis, pus begins to accumulate in the uterine space, which can then penetrate the ovaries, fallopian tubes and abdominal cavity, which jeopardizes not only the functioning of the reproductive system, but also the life of the woman, increasing the risk of developing sepsis. The disease can cause the formation of cysts and polyps in the uterus, promote the appearance of adhesions in the pelvic organs, disrupting their functioning.
Endometritis that develops after curettage often causes partial or complete infertility, prevents normal pregnancy and provokes miscarriages. As a result of the disease, the processes of renewal of the mucous layer of the uterus are disrupted, and thinning or hyperplasia of the endometrium may be observed. These disorders prevent the attachment of the fertilized egg to the wall of the organ and the onset of pregnancy.
To prevent the development of endometritis after curettage, doctors carefully follow the rules of asepsis and antisepsis during the operation. After the procedure, the patient is prescribed antibacterial drugs to prevent the development of pathogenic flora in the uterus. An ultrasound examination is performed to ensure that there are no blood clots or fetal debris in the organ.
Throughout the entire rehabilitation period, the woman herself must carefully monitor intimate hygiene and refuse sexual intercourse. When the first signs of endometritis appear, you should immediately seek medical help.
The procedure for cleaning the uterus is a fairly frequently prescribed operation. Curettage, which is what this manipulation is called, is carried out for therapeutic (removal of pathological formations) and diagnostic (sampling of material for research) purposes. It is quite natural that questions arise about the recovery period after cleaning, the prescription of medications and the possible consequences of the operation.
Depending on the purpose, the uterus is cleaned in two different ways: curettage (scraping with a curette) and vacuum (using a special vacuum apparatus) cleaning.
The vacuum method is considered less traumatic and safer. Unfortunately, the obtained material cannot be studied in the laboratory, so this method is used for therapeutic purposes:
Curettage is often a diagnostic procedure, but can also be prescribed for the indications listed above. In addition, this procedure is prescribed in the following situations:
The range of indications is quite wide, but curettage is sometimes the only way to help a woman or establish an accurate diagnosis.
Cleaning the uterus is most often carried out a few days before menstruation (6-4 days), which helps prevent heavy bleeding and speed up the recovery period of the mucous layer. Before the procedure, a standard range of studies is prescribed:
Before prescribing the procedure, you must inform your doctor about the presence of chronic diseases (kidney, liver, stomach, cardiovascular diseases, etc.) and about taking medications. It is necessary to list all medications taken by the woman. After all, there is a list of drugs that interfere with blood clotting. Such information will allow the gynecologist to correctly draw up an action plan and prevent possible complications.
The length of stay in the hospital will depend on the woman’s general well-being. Usually the stay does not exceed three days. After vacuum aspiration, a woman can go home after a couple of hours, unless the doctor recommends otherwise.
The condition after curettage of the uterine cavity will depend on general health and the extent of the intervention performed.
Recovery after cleansing the uterus is completed after one menstrual cycle. When will I get my period after cleaning my uterus? 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 was cleaned due to pregnancy pathologies (frozen, miscarriage, medical abortion), then menstruation should be expected in 7-9 weeks. This may change the nature of your periods. They may become a little heavier than usual and painful. The duration of menstruation may increase slightly, by about 1-2 days. After the cycle has stabilized, menstruation should continue as before.
If the following symptoms appear, you should consult your doctor:
The appearance of such symptoms indicates the development of complications after cleansing the uterus.
There should be no complications after cleaning the uterus. However, it should be borne in mind that after extensive intervention, the inner surface of the uterus is a continuous wound, which becomes easily accessible for the penetration of pathogenic agents.
It is for this reason that a smear is examined to exclude the presence of inflammatory processes in the vagina and uterus, and after the intervention antibiotics are prescribed.
Cleaning for the purpose of abortion provokes the development of hormonal imbalance, which leads to a decrease in immunity. For these reasons, it is necessary to especially carefully monitor changes in well-being and discharge.
Patients who have a history of inflammatory diseases of the reproductive organs (endometritis, colpitis, salpingoophoritis, etc.) are at risk. Due to a complex of disorders in the body, the likelihood of developing a relapse of previous inflammatory diseases increases.
The occurrence of uterine bleeding. Most often associated with poor uterine contractions and decreased blood clotting.
Accumulation of blood in the uterine cavity - hematometra. Most often associated with cervical spasm, due to which bloody discharge cannot leave the uterine cavity and begins to accumulate.
Endometritis, endomyometritis - inflammation of the mucous and/or muscular uterine layer. Infection can enter both from the outside during surgery and from the body itself.
Perforation of the uterus. Curettage is carried out blindly, that is, the specialist measures the size of the uterus with a special probe and carries out all manipulations by touch. Therefore, sometimes perforation of the uterine walls occurs. Fortunately, this is a fairly rare complication, but it is important to be aware of this possibility.
Many women are concerned about why the uterus does not contract after curettage. This picture may indicate incomplete cleaning of the uterine cavity (for example, after an abortion) or an accumulation of blood. In any case, you need to contact your doctor for examination and prescribing additional treatment.
To quickly restore the body, you must follow simple rules.
What not to do after cleaning the uterus:
What you can do:
You can plan a pregnancy no earlier than 6 months after cleansing, although ovulation will occur in the next menstrual cycle. However, a pregnancy that occurs in the first months after curettage will be terminated with a 99% probability. You need to give the body time to recover and then pregnancy will not bring problems and complications.
Very often, women are prescribed antibiotics after curettage of the uterine cavity. . You can prescribe medications one day before cleaning or on the day of the procedure. You need to know that antibiotics are taken in a course of at least 5 days. The specialist draws up an individual treatment plan that will ensure maximum effect.
Drugs that may be prescribed:
Particular caution should be exercised when taking antispasmodic drugs (no-Shpa, drotaverine, spasmalgon, etc.). They can weaken uterine contractions and cause increased bleeding. Therefore, you should consult your doctor about taking antispasmodics.
Treatment after curettage of the uterine cavity is also carried out using herbs. Decoctions and infusions are prepared from them. Before use, consultation with a specialist is required. Be sure to check to rule out allergic reactions to herbs.
Can be used:
If the uterus contracts poorly, you can perform simple physical exercises. During classes, it is forbidden to pump up the press, lift weights and use force loads.
Cleaning the uterus is a fairly common and well-established procedure. To avoid negative consequences, you must strictly follow all the recommendations of your doctor. It is better to plan pregnancy after an abortion after 5-6 months. A rested and restored body will ensure a normal pregnancy.
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