Preparation for rdv of the uterine cavity. Why do scraping? Consequences of cleaning that may occur

Curettage of the uterine cavity - removal of the upper layer of the endometrium with a sharp loop-shaped blade (curette). The procedure is known to patients as "cleansing". To maintain the correct hormonal status, manipulation is prescribed a few days before menstruation. With massive bleeding, the intervention is carried out immediately, regardless of the phase of the cycle.

This procedure belongs to a small operation, so it should be as useful as possible for the patient. All changes detected during medical and diagnostic curettage are eliminated, and tissue samples are sent for histology to determine the type of cells and changes in them.

Indications

Clarification of the state of the endometrium with frequent irregular intermenstrual bleeding, infertility, miscarriage;
Determining the cause of a frozen pregnancy;
Stopping uterine bleeding;
Incomplete removal of the fetal egg and its membranes during miscarriage or induced abortion;
Obtaining tissue samples for histological examination: diagnosis of malignant tumors of the uterus and cervix;
Inflammation of the uterine mucosa; (endometritis), endometriosis;
Elimination of adhesions inside the uterine cavity - synechia;
Suspicion of the presence of polyps in the uterine cavity or cervix, identified by ultrasound. The examination is carried out on different days of the cycle - if changes after menstruation are not detected, it was the folding of the overgrown endometrium. If suspicious formations persist, diagnostic curettage is necessary;
Preparation before removal of uterine fibroids

Types of scraping

Treatment and diagnostic - complete removal of the surface layer of the endometrium of the uterine cavity and epithelium from the cervical canal. All detected pathological growths are eliminated. The received material is sent for examination;
Separate diagnostic curettage. Similar to the previous one with one exception: the material obtained from the cervix and from the uterine cavity is sent to the laboratory in separate test tubes. This allows the doctor to get information about changes in each of these departments, so it is preferable;
Separate curettage under the control of a hysteroscope. The most advanced and diagnostically valuable type of research. A hysteroscope is an endoscopic instrument that is inserted into the uterine cavity. For a better view, it is filled with a sterile liquid or gas. Hysteroscopy allows you to control the work of a doctor with a curette. At the end of scraping, the device makes sure that the endometrium is completely removed.

Training

The amount of tests before the procedure depends on whether it is planned or applied urgently. In case of acute bleeding, the list will include only the most necessary parameters:

To carry out, if necessary, a blood transfusion, the group and Rh factor are determined;
General analysis of blood and urine;
duration of bleeding and clotting;
The level of glucose in the blood.

A planned operation requires an extended examination of the patient. In addition, there are:

Determination of antibodies to hepatitis C and B, HIV and syphilis;
Biochemical analysis - assesses the function of the liver and kidneys, the level of protein in the blood, the ratio of different protein fractions to each other;
Assessment of the degree of purity of the vagina. If pathological microflora, especially sexually transmitted, is detected, antimicrobial therapy is prescribed. Otherwise, with the expansion of the cervical canal and manipulations inside the uterus, the infection will penetrate inside and cause inflammation already there;
Gynecological ultrasound in different phases of the menstrual cycle;
Pass a fluorography, do an ECG and be examined by a therapist.

After doing all the necessary research, you need to prepare yourself:

Take a shower, remove all pubic hair and labia;
Empty the bowels the day before - make a cleansing enema or take a mild laxative;
You can use herbal sedatives: Novopassit, tincture of valerian or motherwort;
Prepare a bag for the hospital: clean shirt, gown, socks. Be sure to grab pads, as there will be spotting after the procedure.

On the day of the intervention, you can’t eat or drink; just before the manipulation, you need to empty the bladder

Separate diagnostic curettage technique

It is carried out in a small operating room on a gynecological chair. After consultation with the anesthesiologist, the type of anesthesia is selected - local anesthesia or intravenous anesthesia. The doctor conducts a gynecological examination (internal and bimanual) - determines the location and estimated size of the uterus. The external genitalia are disinfected with antiseptics. Mirrors highlight the cervix, fixed with forceps. The neck channel is expanded by inserting in turn special cylinders (Hegar expanders) of increasing diameter. The cervical epithelium is scraped out, material is collected for histology. The probe determines the depth of the uterine cavity, the endometrium is separated with curettes. The resulting tissues are also transferred for research. At the end, all surfaces are once again treated with disinfecting solutions, the instruments are removed from the genital tract. The woman is under observation from several hours to several days.

Video clip of the research clinic "MedHelp": what is separate diagnostic curettage, indications, contraindications and research methodology

Recovery

After the intervention, a sparing regimen is prescribed:

2 weeks without physical activity and sex;
Allocations persist for up to two weeks, moderate pain may disturb;
Antibiotics are prescribed to prevent infection;
Water procedures - only a shower and washing twice a day.

The next menstruation usually comes at the right time of the cycle. It is urgent to consult a doctor if the temperature rises, there is no discharge against the background of severe pain in the lower abdomen, or their character has changed: an unpleasant odor has appeared, an unusual color.

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

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

Indications for diagnostic curettage

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

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

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

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

How to prepare for a diagnostic curettage?

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

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

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

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

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

Recovery period rules

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

Possible complications after diagnostic cleaning

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

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

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

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

Content

Any upcoming gynecological manipulation causes some fear and excitement in a woman, especially if this procedure is invasive.

Curettage of the uterus or curettage is one of the types of surgical interventions in gynecology, accompanied by a violation of the integrity of the endometrium. Cleansing the uterus, as this manipulation is simply called, is done for both diagnostic and therapeutic purposes, and the pursued intentions are represented by a whole list of diseases and suspicions of them.

Indications and contraindications

For any operation, there are a number of indications and contraindications, and cleaning the uterus is no exception.

Indications for scraping:

Bleeding, associated or not associated with menstruation.
Unions or synechia in the cavity of the reproductive organ.
Chronic endometritis.
Remains of fetal membranes and parts of the fetus in spontaneous miscarriage or after induced abortion.
The presence of polyps in the uterus.
Endometriosis of the cervix and body of the uterus.
Cancer of the body of the uterus.
subserous myoma.
Artificial termination of pregnancy for medical reasons and the desire of a woman.
The remains of the placenta after childbirth.
Preparation for IVF.

Cleaning of the uterus is done both when a disease is suspected to confirm it, and to control the ongoing treatment.

Bleeding is one of the most common causes of uterine scraping.

Contraindications for cleaning:

In the presence of an infectious process in the gynecological tract, the operation is not performed, except for vital situations (bleeding).
Widespread cancer.
3rd and 4th degree of purity of the vagina.

Only in the presence of certain symptoms, the attending physician recommends curettage. IVF planning is considered an exception - in this case, curettage is mandatory, which significantly increases the chances of a complete diagnosis, treatment and subsequent attachment of the embryo.

Types of scrapings

Since they clean the uterus, pursuing various goals and under ambiguous circumstances, there are several varieties of this surgical intervention.

Types of scrapings depending on the purpose:

Diagnostic routine cleaning of the uterus.
Therapeutic scraping.

Diagnostic also has its own types:

Separate diagnostic curettage (RDV).
Cleaning the uterus with hysteroscopy.

The main task of diagnostic curettage is considered to be establishment or exclusion of a gynecological disease.

If the doctor suspects hyperplasia, endometriosis, synechia, polyps, endometritis, cancer in his patient, he will prescribe a curettage, during which the removed endometrium is examined under a microscope, chemical reactions will be carried out and the correct diagnosis will be established. Such intervention is done in a planned manner.

Therapeutic cleaning is done with the onset of bleeding, symptoms of a foreign body in the cavity of the organ (remnants of the placenta and fetal egg). Such conditions are life-threatening and are carried out urgently. Planned therapeutic curettage is done to remove polyps, synechiae, hyperplastic or inflamed inner layer, dissection of the uterine septum.

When a curettage of the uterus is done, the gynecologist may need to examine the inner surface of the organ to assess the appearance of the structures of the endometrium, the degree of its growth, the presence of adhesions, polyps, endometrioid foci. This procedure is carried out using a hysteroscope - a special device equipped with an eyepiece for examining the cavity.

Since curettage is done, pursuing a diagnostic goal, it is possible to carry out separate cleaning sequentially: first, the mucous membrane of the uterus is removed, and then the cervix. Most often, WFD is done with suspicion of cervical endometriosis and polyposis.

Preparation for curettage

Do curettage of the uterus both at the beginning and at the end of the menstrual cycle. Emergency curettage is carried out regardless of time, and the timing of the planned procedure depends on the purpose:

When diagnosing the causes of uterine bleeding - immediately after they begin.
If you suspect hyperplasia, infertility (synechia, polyps) - in the second half of the cycle.
If the doctor assumes cancer, then the operation is done any day.

As with any operation, before cleaning should be discarded from sexual intercourse 5 days before the manipulation, do not eat 12 hours before the appointed time, do not douche and lay vaginal suppositories.

On the eve of the research and testing:

General analysis of blood and urine.
Coagulogram.
Blood for syphilis, HIV and hepatitis.
Colposcopy.
FGDS.
Ultrasound of the pelvis.
Blood type and Rh factor.
Bak. sowing from the vagina and a smear for the degree of purity.

If pathological abnormalities are detected, planned cleaning is not done, but the treatment of underlying diseases is carried out.

Cleaning technique

Each patient who expects such a manipulation is interested in how the uterus is cleaned.

The course of the curettage is as follows:

The external genitalia are treated with an antiseptic.
A two-handed study determines the position of the uterus (anteflexio, retroflexio) for the subsequent correct location of the curette.
Mirrors are placed in the vagina.
Anesthesia is carried out by general anesthesia (intravenous anesthesia).
Using a metal probe, determine the length of the body of the uterus.
Gradually expand the cervical canal with the help of Hegar dilators. These instruments have different incremental diameters, designed to smoothly increase the diameter of the canal.
Hysteroscopy is done if necessary. To do this, liquid is injected into the cavity of the organ in order to expand it, and the inner surface is examined with the device.
A curette - an instrument that looks like a pointed spoon - is a curettage of the uterus. The inner layer is gradually removed first from the front wall, then from the back and side walls. Curettage is carried out until the walls become smooth.
The neck is treated with an antiseptic.
After the end of the manipulation, the patient is put ice on the lower abdomen to stop bleeding from the uterine artery as soon as possible.
The removed endometrium is immersed in formalin and sent for histological examination, the result of which will be known in 10-14 days.
Conduct postoperative analgesia with antispasmodics.

If the procedure is completed without complications, then its duration does not exceed 30 minutes.

The scraping process takes place very carefully so as not to damage the growth layer and not disrupt the uterine function - this is especially true for women of reproductive age who are planning a pregnancy.

If the manipulation is carried out in the presence of fibroids, then the operating doctor does the curettage of the uterus carefully so as not to violate the integrity of the tumor capsule.

After the curettage is completed, the patient begins to have bloody discharge, ending after 2 weeks.

anesthesia

Curettage is performed under general anesthesia. In modern times, there are occasionally situations when anesthesia is done locally.

The highest quality and most efficient Propofol is considered an anesthetic drug.

The anesthetic is administered intravenously in an amount of 15-20 ml. This is enough to clean the uterus. If complications arise during curettage and an extension of anesthesia is required, mask anesthesia is performed with a mixture of Fluorothane and nitrous oxide with oxygen.

Benefits of General Intravenous Anesthesia with Propofol:

Smooth and soft entry into anesthesia.
Quick and easy awakening.
Absence of nausea after anesthesia.
Elimination of influence on the processes of thinking and memory.

Any patient is interested in what kind of anesthesia is carried out when scraping the uterus, so the issue of planned curettage should be taken seriously and find a modern clinic. Some specialists use the strong sodium thiopental barbiturate for this short-term operation. The drug has a pronounced effect on the nervous system, will provide a difficult awakening after anesthesia and poor health in the postoperative period.

The period after cleaning and possible complications

Most often, the uterus is cleaned as a minimally invasive gynecological intervention and does not lead to complications.

In some cases, the consequences of a mini-operation are possible:

Perforation of the uterus.
Damage to the pelvic organs.
Bleeding during and after brushing.
Attachment of infection (endometritis) and, as a result, the appearance of synechia.
Destruction of the germ layer of the endometrium.
Damage to the cervix, which in the future may cause isthmic-cervical insufficiency.
Allergic reaction to anesthesia.

After the procedure for cleaning the uterus, antibacterial drugs are prescribed for 5-7 days. You should refrain from sexual intercourse and taking a bath for 2 weeks, do not carry out hot water procedures. Anesthesia is carried out with non-steroidal anti-inflammatory drugs (Ibuklin, Diclofenac), but not with Aspirin.

If the spotting stopped abruptly, there were strong abdominal pain and high fever, you should immediately consult a doctor.

Normally, the duration of postoperative bleeding is 2-3 weeks, so its cessation may indicate the presence of clots in the organ cavity.

Control ultrasound and examination should be done 2 weeks after curettage.

“I was cleaned” or “I was cleaned” - these phrases I often hear from my patients, and they sound to me as unbearable as the movement of foam on glass. "Cleaning" we colloquially call curettage of the uterus - the most frequent procedure performed in gynecology in the vast majority of cases without any indications for it.

This accustomed name itself - "purge" - already reflects a rough, clumsy and primitive approach to solving the problem. By the way, the term has smoothly moved from medical jargon into the lexicon of many women, who even believe that they need to “go through cleaning” or “clean up” from time to time. Perhaps they put the same meaning in this as in the notorious "cleansing the body of toxins", assuming that "dirt" accumulates in this organ.

Before continuing the story, it is necessary to explain what exactly is at stake.

Curettage is an outpatient medical procedure performed under intravenous anesthesia, during which a special curette is used to remove (scrape) the lining of the uterus. The procedure is called a diagnostic and treatment procedure, since it removes disease-modified tissue (if any), which can be examined under a microscope and an accurate diagnosis made. From the previous sentence, it is clear that curettage is carried out not only in the presence of a disease, but if it is suspected, that is, for the purpose of making a diagnosis.

While everything is clear, logical and obvious. However, there is another side to this manipulation. The procedure is performed with a sharp iron curette, with the help of which the mucous layer of the uterus is actually “torn off”, and the inevitable injury of the uterus itself occurs. As a result, there is a risk of several serious complications: damage to the growth layer of the endometrium (which disrupts its growth in the future), the appearance of adhesions in the uterine cavity, and the development of inflammation.

In addition, this procedure contributes to the development of such a disease as - due to violation of the boundary between the layers of the uterus, which contributes to the germination of the endometrium into the uterine muscle. As a result, the transferred curettage can lead to problems with conception or trigger the development of adenomyosis.

It is quite obvious that such a procedure should be done strictly according to the indications and the benefit-risk ratio should be seriously assessed. But this is possible anywhere, but not here, and this is very sad.

Scraping "just in case"

I think that in more than 80% of cases, curettage is carried out in vain, that is, either completely without indications, or in cases where the problem can be solved with medication or through a simple outpatient procedure.

Here are the situations in which you may be asked to perform scraping.

You have been bleeding for a long time or have uterine bleeding.
On ultrasound, you have been diagnosed with endometrial hyperplasia, adenomyosis, uterine fibroids, or chronic endometritis.
You are planning to spend.
You suspect an ectopic pregnancy.
You complain that you have heavy periods, intermenstrual spotting or brown "smearing" discharge before and/or after your period.

In general, they are sent for "cleaning" very often, even in the absence of the reasons that I listed above. Curettage is often accompanied by any surgical treatment in gynecology. As if they are trying to do it all the time "at the same time", in order to "just in case check" whether everything is fine. It shouldn't be like that, it's too frivolous an attitude to a rather traumatic procedure.

So the instruction how to avoid scraping.

If you do not have profuse uterine bleeding (as they say, “pouring down your legs”), but just prolonged spotting and pregnancy (uterine and ectopic) is excluded, check with your doctor about the possibility of stopping the bleeding with medication. Yes it is possible. Against the background of taking the drug (I will immediately warn you that this is a hormonal drug, but it is safe), the bleeding may stop, and you will need to re-evaluate your condition after the next menstruation. In many cases, the treatment will be enough, and nothing else will need to be done.
If during an ultrasound scan you have found a polyp or endometrial hyperplasia, do not rush to agree to curettage. Ask your doctor about the possibility of prescribing you the drug in this cycle and then repeat the ultrasound after the end of the next menstruation. If a polyp or hyperplasia is confirmed, alas, curettage under the control of hysteroscopy must be done. But you have a very high chance that after menstruation there will be no indications for the procedure.

Polyp- this is an outgrowth on the mucous membrane of the uterus (looks like a finger or a mushroom), most often benign. There are polyps that are themselves rejected during menstruation, and those that grow from the germ layer. The latter need to be removed.

Hyperplasia- thickening of the mucous membrane of the uterine cavity. There are two types: simple and complex. Simple hyperplasia is the most common, it is not dangerous, for its development there must be a mandatory reason (functional cyst in the ovary, polycystic ovary syndrome, and a few more). Usually, 10 days of taking the drug is enough for it to pass and not recur.

Complex hyperplasia - poor hyperplasia, an error in the structure of the endometrium, usually occurs after 35 years, more often against the background of overweight. It is treated first by removing the mucous membrane (curettage) and then by a multi-month course of hormonal preparations or by installing an intrauterine hormonal spiral "Mirena". An accurate diagnosis is possible only with histological examination.

If you are offered a curettage only for diagnostic purposes before surgery or to clarify the condition of the mucous membrane, ask your doctor to start with an endometrial biopsy (another name is "pipel biopsy" or "aspiration biopsy"). This is a simple outpatient procedure that does not require any anesthesia. A thin tube is inserted into the uterine cavity and a small amount of tissue is sucked out, which is then sent to a laboratory for examination. This is a fairly informative analysis.

Important: the material obtained as a result of curettage or biopsy is only the mucous membrane of the uterus, it does not carry any information about other diseases. The fact is that often scraping is prescribed for the purpose of its characteristics; and so - scraping will not give any information.

Remember, almost all modern ultrasound machines allow you to evaluate the uterine mucosa and identify signs of pathology in it. If the doctor writes during an ultrasound scan that the endometrium is not changed, and you do not have heavy menstruation, intermenstrual bleeding, then the likelihood that you have a pathology that requires curettage is close to zero.
In general, the main manifestations of the pathology of the endometrium (curettage is directed to this tissue) are bleeding, heavy menstruation and intermenstrual spotting. Thus, if you do not have this, discuss with the doctor how justified his desire to treat you is.
"Chronic endometritis" is a common diagnosis on ultrasound and in the results of the histological conclusion after curettage. This is a chronic inflammation of the uterine mucosa. However there are no generally accepted criteria for making this diagnosis by ultrasound in evidence-based medicine. Simple histology also cannot reliably confirm this diagnosis.. Often this diagnosis is made where there is none, since they are guided by "leukocytes".

A reliable diagnosis is possible only when conducting a special type of study - immunohistochemistry. This study is not available in all laboratories, and the material for it can be obtained by biopsy, and not by curettage. I think it is now clear that scraping is not necessary to confirm the diagnosis of "chronic endometritis". In general, the diagnosis and treatment of this endometrial disease makes sense only within the framework of the problem of infertility and miscarriage.

In what situations to agree to curettage?

Severe uterine bleeding: yes, curettage is a way to stop it.
Suspicion of an ectopic pregnancy (difficulty in making a diagnosis).
A polyp or hyperplasia of the endometrium that has not disappeared after menstruation or drug treatment.
The remains of the membranes (after an abortion, miscarriage, pregnancy).
Any spotting after menopause.

Now, I hope you have reliable instructions on how to avoid, perhaps, an unnecessary operation for you. Don't be afraid to ask the doctor questions. Offer alternatives (endometrial biopsy, drug treatment). Ask to justify the need for just scraping. The answer "this is how it is with us" should not be accepted. Of course, all this applies only to those situations in which you do not have a threat to life and health (profuse bleeding).

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Discussion

If he appoints, then he agrees. Usually such a procedure is simply not prescribed.

Comment on the article "Gynecologist prescribes curettage of the uterus: agree or not?"

Hospitalization for an operation is scheduled for tomorrow and menstruation has just begun (((). RFE with hysteroscopy can be done when not the usual RFE is done "blindly", but with hysteroscopy - examination of the uterine cavity with a mini-camera before the RFE and after - so nothing. ..

Discussion

I was put off hospitalization in this case

I also had. They did a gentle scraping.
Yes, and then it is also done for polyp and myoma bleeding, etc., which means that this does not interfere.
If there is a doctor's phone number, call in the morning just in case and ask

Did a hysteroscopy with curettage to remove the polyp. RDV + GS - separate diagnostic curettage under hysteroscopy control - is a modern ...

Discussion

You know, the point is not in the RFE (which is done in many places), but for an intelligent doctor to do hysteroscopy (this is an analogue of gastroscopy, inserting a mini-camera into the cavity and examining it before and after the RFE). It's like an ultrasound will be done by an intelligent doctor, or a stupid one, they see everything differently.
I can’t tell you the place, I did it according to compulsory medical insurance in the 17th maternity hospital about endometriosis at the head of the department Ostapishina.
In principle, there are commercial services, you can find out.

As far as I remember, RDV is done immediately after menstruation (7-10 days). The analyzes are valid for 2 weeks for the most part.
In general, these are all conventions. RFE is done to almost everyone admitted to the ambulance with bleeding without any tests.
Planned, at least for a fee, at least for free, you still have to take all the tests. And a good doctor will not do this procedure without a minimum set of tests (this is actually a risk).
I do not recommend you to contact those who do it without tests and hassle, it is still an operation.
And I'm afraid the order of prices will be about the same. You can take all the tests during your period, only smears are needed a little in advance.
If you have heavy periods, arrange with your doctor to send you to the ambulance, as with bleeding, you will be done urgently and quickly.

Section: Diagnostics (weight gain after curettage). Scraping. Can you put on weight? Tell me, please, if anyone knows.

It is possible to make a laparotomy with an examination, checking the patency of the tubes and curettage in one anesthesia. Doubts are driven by the proposal of another doctor not ...

Discussion

IMHO, lapar is more effective in your case. The spikes will be removed immediately.
The first time I did a laparo about polyps, endometritis, the tubes were checked, small adhesions were removed.
Last year, when she removed polyps again - just hystroscopy.

Find a specialist in gynecological massage. The adhesions are well removed and the mobility of the organs returns.

The dumbest question? Tomorrow I'm going for curettage (endometrium) to the 52nd hospital. So do you have a curettage or some sort of biopsy? What will be the drug?

Discussion

Went to give up! Can I have fists, please!

26.05.2011 08:08:30, Today is anonymous

did 2 times. for the first time, like a fool, she lay for 10 days (50 GKB). the second time they did it in the 17th maternity hospital of the HS + RDV, they discharged the next day. On this day, to leave by car myself - no, no, I woke up after anesthesia in the ward, I wanted to call - I don’t remember how I fell asleep again, and so until the evening I couldn’t really get well, crawl away to drink and pee and again drowsiness attacks, anesthesia was good without heavy dreams and echoes, I just had something previously injected into my vein from nerves and pressure, maybe that's why I wasn't adequately cheerful to the end.

Discussion

Let him extend the sick leave in the residential complex. you need to come to the doctor with "acute pain" then without a queue ...

After cleaning in the hospital, they also gave me sick leave for one day. I went with an extract to the clinic, where they gave me a sick leave for a week. It was about 5 years ago. I don't think anything has changed in this board.

11/14/2010 00:25:11, anonymous_

Scheduled a follow-up for Monday. if the doctor is not clean-handed, then there is no trust in him. Do not go to him. She prescribed curettage due to the fact that if there is a cervical polyp, then there may be polyps in the uterus itself, and scraping this will help ...

Discussion

HORROR. Maybe your mom will talk to him about a refund? He will say that they decided to receive a tax deduction, and you are collecting checks. And you are stressed, and you forgot about it .. I sympathize ..

if the doctor is not clean-handed, then there is no trust in him. Do not go to him.

Issues of women's health - diagnosis, treatment, contraception, well-being. Advise - how much to pay a doctor? Curettage (polyp) is coming - the first time since...

Discussion

I just left the hospital, lay on Tulskaya in the 55th. So no one asked for money, everyone was treated well. But at discharge, everyone thanked the doctor with something ... In our ward, someone gave a set of cups, someone had a Letual certificate of 1500 rubles, a bag of champagne and sweets, a parker pen, money from 1500 to 3000 rubles. No one else gave as far as I know from ours. They also removed the polyp, did a curettage. I gave a large beautiful bouquet of flowers, 5000 rubles in an envelope and a good cake to doctors and a cake to nurses. Everyone was happy, the doctor left her phone number, asked to contact me in case of emergency)) I had 2 surgeries, so I would have given less

I was recently in the gin hospital.
there is no hype about the fact that you have to pay. People do their thing
well-known doctors immediately treated me, so I thanked me at discharge when they were alone
Before that, the doctor was always surrounded by sisters and interns

diagnostic curettage. In short: the previous ultrasound of the pelvic organs was done in Scraping, she prescribed due to the fact that if there is a cervical polyp, then there may be ...

Discussion

I did the hystera 5 times exactly. 2 times under general anesthesia, and the rest not. Then I calmly went to work on the same day. The main purpose of the hystera is to examine the uterine cavity for inflammation, polyps, adhesions, and fibroids. Look also at the mouth of the pipes. But now there are many varieties of hystera. Therefore, if you just look, then general anesthesia is not needed. For the words "Scraping" you most likely took a scraping for an aspiration biopsy of the endometrium - an analysis of the endometrium for inflammation and flora. In this case, a small injury to the uterus is applied, but not fatal :) They pinch off a piece of the endometrium. If there are polyps, then they will be removed aimingly and the uterus will not be completely scraped.
I don’t know why you are prescribed this procedure (most likely the spikes want to see), but in general this procedure is well informative and not very traumatic.

I did such a thing, though a long time ago, about 4-5 years ago. But my hystera was immediately prescribed along with curettage, because. a polyp to a heap to all the nasty things found.
It was done under general anesthesia. in theory, if everything is OK, on the trail. they can let me go for a day, but my temperature rose to 39 kopecks, so they left me under supervision for another day.
Then, in theory, if there is a curettage, it is necessary to do a physio recovery course. But for some reason I was prescribed some kind of antibiotic instead.
Then 3 months. were protected so that the endometrium came to its senses a little.
I won’t say about the consequences - at that time I trusted the doctors so much that I didn’t bother much, apparently in vain :(

Scraping needed - where? Preparation for conception. Planning for pregnancy. Scraping needed - where? Good day.

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I was in the Ministry of Foreign Affairs hospital. Scraping is done in the afternoon, the next morning they are released to do an examination, ultrasound if necessary. Single rooms with a good repair, televisions, a refrigerator. The service is good. The doctor is a super-gynecologist Rokhlina Elena Viktorovna. The price is about 8k.

I did it last week in a paid center at the 11th gynecological clinic, 1st Shchipkovsky lane, Dinamed clinic. The operation costs + 5 days in the hospital 30500. I recommend. Doctors of 11-tsy operate. I advise you to go for a consultation with Tolstova Larisa Yurievna.

Then do a diagnostic curettage. Curettage is not an abortion. Diagnostic procedure - not useful, of course, but necessary for the diagnosis.

This is a banal operation of separate diagnostic curettage (RDV) - the endometrium of the uterus is cleaned out (it is better to do it before doing it 2 times - at 50 GKB (horror, they still give ...

Discussion

In the 68th, you don’t need it either :) do you pay or not? in the MMA named after Sechenov very good gynecology, for a fee. They did this procedure for me there for 1 day: I arrived in the morning, left in the evening.

04.10.2007 18:25:43, shsh

Hello! I did scraping - I also had polyps ...... In general, polyps are a precancerous condition, because of them there may be bleeding and other problems of a serious nature! I did and have no regrets! I answer your questions: 1. you can have children, 2. I can’t say anything about hospitals, because I live in the north (YNAO)! Write if you have any questions for me!

uterine cleansing. Diseases. Women Health. Issues of women's health - diagnosis, treatment, contraception, well-being. The doctor after an ultrasound of the uterus suggested cleaning due to endometrial hyperplasia. Can anyone shed some light on this matter?

Discussion

Separate diagnostic curettage (RDV) is performed:
- to clarify the diagnosis (according to the results of histology, otherwise the doctor may doubt it, yet hyperplasia is not a very good diagnosis, I have the same one)
- with bleeding (when the uterus cannot reject the endometrium, it is scraped off, so to speak, and thus stop the bleeding)
- to remove polyps detected on ultrasound or too thick endometrium
If there are no listed reasons, there is no heavy bleeding during menstrual or intermenstrual bleeding, pain, then it’s better not to do the RFE once again, it’s not good for the body, now I won’t restore my balance after almost 5 months.
I recommend that your friend do another ultrasound on the 5th day of the cycle and in a good place (much depends on the doctor and on the day of the cycle) and consult there.

In any case, the histology is done for several days and then given to you in your hands - no one will hold you because of it.

I recently did it at the Central Clinical Hospital - it felt like it was quite possible to leave after that, but, because. the first time, I decided to play it safe and spend the night there :).

No, if the doctors had prescribed it, I would have drunk. But they hit the road on Friday (they didn’t say anything. They don’t bring it in during surgery, if they brought it in during surgery, the person would leave the hospital with sepsis and they would immediately cut off his uterus, if they saved him at all. Why say ...

They found a polyp in the uterus and said that it should be removed. how painful?

Discussion

The same thing happened to me. True, curettage was done after the fetal egg came out (miscarriage). There is no need to be afraid of this. I didn't have any inflammation. Only now the first menstruation came after that after 2 months.
Is there any point in waiting a little longer? After all, the heartbeat is not always heard at 6 weeks, or was it established by a more error-free method?
Fanny had it. She didn't give in. True, the pregnancy turned out to be really frozen and she carried it off for another month already with a threat to her own life.
Is there bloody discharge? As far as I understand, the frozen fetus itself begins to be rejected ...
In any case, Natasha, hold on! Do not be afraid of this operation - you will not feel anything. The main thing is not to fall into a protracted depression later. And there will definitely be a baby. and confirmation of this by Joo. Ask her.
I wish you good luck and keep your fingers crossed!

Natasha, they did it to me last October. In order not to get upset, I’ll say right away that now my pregnancy is 14 weeks and everything is in order. So, in the clinic where they did the scraping, they gave me a reminder of what and how to drink, and all the pills were sold right there. I honestly drank them all. Be sure to drink Nystatin with antibiotics, otherwise you will suffer with the intestines later. After scraping and taking all this filth, gardnerellosis was discovered, and I had to be treated for it. Then I didn’t have my period for two months, and when they came, I almost bent over from pain - I had a hematometer. But this is already the individual characteristics of my body. And no more complications happened, and having passed all the tests and treated the hormones, I got my current state.
And about mental trauma ... the biggest one I received in the clinic, looking at the number of girls (namely, young ones) having abortions. By the way, if possible, be sure to do a histological examination of what is scraped out. I am very sorry that I did not do it - it was difficult to identify the cause of the fading. If you have any questions - ask. And listen to the doctors - do everything they say - everything should be fine))

Curettage of the uterine cavity is prescribed for therapeutic or diagnostic purposes. It allows you to identify the exact cause of some diseases and get rid of neoplasms (polyps, adhesions, etc.).

Curettage is a manipulation that comes down to the removal of the restored layer of the uterine mucosa with special instruments (curettes or vacuum aspirators).

The full procedure sounds like “separate diagnostic curettage”. “Separate” - since tissues from the wall of the cervix and the uterus itself are examined separately.

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During the intervention, it is preferable to use a hysteroscope - a system for a detailed examination of the uterus.

For a better understanding of the essence of the procedure, some definitions should be disclosed:

Scraping as such is only an instrumental manipulation, i.e., the designation of the action itself. The operation, depending on the method and purpose of the implementation, has a variety of names.
Separate scraping includes sequential removal of the biomaterial first from the cervical canal, then from the uterine mucosa. After the operation, the removed tissue will be sent to the histological laboratory, at the same time, the neoplasm, for which the operation was scheduled, is excised.
RDV + GS (hysteroscope) is an improved, more informative procedure. Previously, curettage was carried out mostly "blindly". The tool also allows you to examine the uterine cavity in detail for pathological formations. Excision of tissue or neoplasm is carried out at the end of the manipulation. The final stage is the doctor's assessment of the work done.

What female organ is scraped?

The uterus is scraped. This is a hollow pear-shaped organ in which three sections are distinguished:

body- the largest part;
isthmus- located between the body and the neck;
neck- narrowed lower end of the uterus.

The wall of the uterus is three-layered:

the inner layer (mucous) is the endometrium;
the middle layer is represented by smooth muscle tissue (myometrium);
the upper layer is serous (perimetry).

The uterus performs important functions:

childbearing;
menstrual;
participates in the birth act.

The operation consists of the following steps:

Technique

The operation is carried out according to the following technique:

The procedure is prescribed in all cases of suspected oncology. First, tissue is obtained from the cervical canal. The material is collected in a separate container. Next, they proceed to curettage of the mucous membrane of the uterus itself, the material is placed in the second container. In the direction of histology, it is necessary to indicate where exactly the tissue was taken from.

Traditional curettage

Traditionally, curettes are used for scraping. The forward movement of the instrument must be very careful to prevent perforation of the uterine wall. The reverse movement is carried out more vigorously, with a slight pressure on the wall. In this case, parts of the endometrium or the fetal egg are captured and excised.

The sequence of curettage of the uterine cavity is as follows:

front wall;
back;
side walls;
corners of the uterus.

The size of the toolkit is gradually reduced. Manipulation is carried out until a feeling of smoothness of the uterine wall appears.

If the patient is shown a curettage with a hysteroscope, an optical instrument is inserted into the uterine cavity after the expansion of the cervical canal. The hysteroscope is a thin tube with a camera. The doctor carefully examines the uterine cavity, its walls.

After that, scraping of the mucosa is performed. If the patient has polyps, they are removed with a curette in parallel with curettage. At the end of the procedure, the hysteroscope is inserted again to evaluate the result. If not everything is removed, the curette is inserted again to achieve the proper result.

Not all neoplasms can be removed with curettage (some polyps, adhesions, myoma nodes). At the same time, special instruments are introduced into the uterine cavity through a hysteroscope, and the formation is removed under supervision.

Curettage with myoma

The technique of curettage of the uterine cavity depends on the problem. An uneven, bumpy surface of the walls occurs with submucosal or interstitial myoma.

Manipulation in this case is carried out very carefully so as not to violate the integrity of the capsule of the myoma node.

Damage to the latter can provoke bleeding, necrosis of the node and infection.

If uterine cancer is suspected

If a malignancy is suspected, the seized material can be very abundant. If the tumor has grown through all layers of the wall, the intervention can seriously injure the uterus.

Curettage for frozen pregnancy

Removal and destruction of the fetal egg is performed after the expansion of the neck with the help of curettes and abortion collet. With a gestational age of less than 6-8 weeks, parts of the destroyed fetal egg are removed from the uterine cavity by means of an abortion collet.

Scraping of the walls is carried out with a blunt curette No. 6, in the future, as the myometrium contracts and the uterus shrinks, sharper instruments of a smaller size are taken.

The curette is carefully advanced to the bottom of the uterus, movements are made towards the internal os: first, along the front, then along the back and side walls, the fetal egg is separated from the bed.

In parallel, the fallen off shell is separated and removed. With a sharp curette, the area of \u200b\u200bthe corners of the uterus is checked and the manipulation is completed.

The uterus during pregnancy cannot be scraped to the “crunch”, since such an intervention severely damages the muscular apparatus of the organ.

Postoperative period: how long to stay in the hospital?

After the procedure, an ice pack is placed on the abdomen so that the uterus contracts better and the bleeding stops. After some time, the woman is transferred to the ward, where she comes out of anesthesia.

They spend from several hours to several days in the ward, depending on the situation. With planned curettage, they are usually released home on the same day.

Normally, curettage passes without any pain, as anesthesia acts and takes about 20-30 minutes in general.

After manipulation, the muscular layer of the uterus begins to contract intensively. The body thus stops uterine bleeding.

The uterus fully recovers after curettage in about the same number of days as menstruation lasts. This process usually takes 3-5 days.

A few hours after the procedure, blood clots will be released from the vagina. At the same time, the woman experiences weakness, lethargy (side effects of anesthesia).

Along with bleeding, other symptoms may also occur.

Discharge after cleansing

In the first few hours, blood clots may be released. This is quite normal, since a wound surface has formed on the mucosa.

A few hours after the intervention, the intensity of bleeding decreases. For the next few days, the patient continues to be bothered by spotting yellow, pink or brownish discharge. The process of regeneration of the wound surface averages 3-6 days, but can last up to ten days.

The rapid cessation of discharge is not a favorable sign. This may indicate contraction of the cervix, low contractile activity of the myometrium, or accumulation of clots in the uterus.

Pain

After coming out of anesthesia, many women experience menstrual pain. Unpleasant sensations can radiate to the lumbar region.

The pain syndrome lasts for several hours or days and usually does not require additional measures.

However, doctors usually advise women to take a pain reliever and an anti-inflammatory drug (such as ibuprofen) after surgery.

sexual relations

Women who have undergone curettage of the uterine cavity are shown sexual rest. Ideally, it should last one month or at least two weeks.

The need for abstinence is due to the fact that the neck remains open for some time, and there is a wound surface on the mucous membrane. These are suitable conditions for the attachment of an infection, which can lead to complications.

A negative point that may be associated with sex after scraping is the appearance of discomfort and pain during sexual intercourse. It is considered normal only if it lasts too long. If the pain persists for several months, you need to inform the gynecologist about this.

Pregnancy and childbirth after curettage of the uterine cavity

The first menstruation after curettage may occur with some delay (in some cases up to four weeks or more), which is associated with hormonal failure. This is also considered normal after curettage.

The alarm should be sounded if menstruation does not occur for more than two months - this is a serious reason to contact a gynecologist.

In general, most women get their period after two to three weeks, which means that in a new cycle (i.e., with the onset of menstruation), there is theoretically a chance of getting pregnant.

Childbirth after the procedure, as a rule, proceeds well.

If a woman tries to conceive a child for six months or more after curettage, but there are no results, an additional examination by a gynecologist is necessary. Curettage should not adversely affect fertility, on the contrary, this procedure is often performed in the complex treatment of infertility.

The scheme of pregnancy planning after curettage is built depending on what caused the need for surgery. If a woman sets herself the goal of becoming pregnant after curettage, this must be reported to the gynecologist. The specialist will give an adequate assessment of the situation and recommend the timing of the start of pregnancy planning.

Possible complications after surgery

After scraping, the following complications may occur:

So, under what conditions should you immediately seek medical help:

Bloody discharge after the operation stopped very quickly, while the stomach hurts a lot.
The temperature rose to 38 o C and above.
Severe pain syndrome, not relieved by analgesics, antispasmodics and anti-inflammatory drugs.
Abundant bleeding that does not stop for several hours (three or more pads are consumed in two hours).
Profuse discharge with an unpleasant, putrid odor.
General deterioration of health: severe weakness, dizziness, fainting.

The appearance of an acute (or exacerbation of a chronic gynecological disease) after curettage is also a reason for a visit to the doctor.

Treatment after the procedure

Therapeutic measures after the procedure:

The results of the histological test are usually obtained on the tenth day after brushing. It is important to come to the doctor at the specified time to discuss further treatment tactics.

Rehabilitation

For at least two weeks, you need to refrain from sexual activity (ideally - a month).

What else can not be done:

Use tampons (pads - you can).
Douche.
Go to the bath, sauna, sit in a hot bath (shower - you can and should).
Engage in intense fitness, physical labor.
Drink tablets containing acetylsalicylic acid (aspirin) - contribute to bleeding.