Women, due to structural features of their bodies, often encounter diseases. Pathological processes can have a different nature. Some of them are rather difficult to detect. In order not to bite your elbows later , you need to visit a doctor in a timely manner. The gynecologist will conduct an examination, listen to your complaints and, if necessary, refer you for additional diagnostics.
About half of the fairer sex in menopause and after it shows endometrial hyperplasia. Without curettage of the uterus, pathology can be defeated only under special conditions. Today's article will tell you about the origin of this disease and introduce you to its types. You will also learn whether it is necessary to curettage with endometrial hyperplasia and what it is fraught with.
What it is?
Not every woman has to endure such a manipulation as gynecological curettage. With endometrial hyperplasia, it is prescribed often, but not always. Before you learn about the features of manipulation, you need to gain an idea of the disease itself. Endometrial hyperplasia develops due to the proliferation of the internal surface of the muscular reproductive organ. Each cycle in the body of a woman is a change in hormonal levels. During menstruation, the endometrium is rejected and goes out with the blood. After this comes the time of estrogen. They contribute to the growth of follicles and the restoration of the uterine mucosa. Further, after ovulation, progesterone contributes to the proper secretion of the endometrium, it prepares the genital organ for pregnancy (attachment of the ovum). If conception does not occur, then the level of progesterone goes into decline, because of which another bleeding begins. Everything is extremely simple.
But if for some reason a woman has a hormonal failure, then the endometrium is not rejected or is not exposed to progesterone at all. Because of this, uncontrolled cell division begins, their growth. Then the doctors diagnosed “endometrial hyperplasia”.
Types of hyperplasia and features of its correction
There are several varieties of this pathology. Some of them are not so dangerous and can give in to hormonal correction. Others call for surgical interventions. In some situations, removal of the uterus is indicated . What can be endometrial hyperplasia?
- Glandular . It is considered one of the easiest, often amenable to medical treatment. The mucous surface grows evenly, without forming stromal cells.
- Cystic This form is similar to the glandular, but with it the surface of the inner shell grows lumpy, forming bubbles similar to cysts. It is treated with hormonal drugs.
- Focal or diffuse . The mucous surface grows evenly (with diffuse) or lumpy (with focal). In the emerging areas, cysts and polyps are formed. There are known cases of the development of such hyperplasia into an oncological disease.
- Atypical . This form is considered the most dangerous. With it, the growth of the mucosa occurs not only on the surface of the inner layer. Cells actively divide, penetrating into the basal layer. Curettage with endometrial hyperplasia of this nature is often ineffective. According to certain indications, it is necessary to remove the uterus.
Symptoms of the disease indicating the need for curettage
The main signs of this disease are a variety of malfunctions of the menstrual cycle. A woman may complain of a delay, heavy bleeding, daub before and after menstruation. Also during this period there are symptoms of malaise: abdominal pain, indigestion, poor health, fever and so on. Often, hypertrophy is accompanied by infertility. In what cases is curettage prescribed? With endometrial hyperplasia, the indications should be as follows:
- pain in the lower abdomen;
- lingering bleeding;
- cycle time more than 40 days;
- infertility lasting more than six months;
- blood discharge throughout the cycle;
- laboratory confirmation of hyperplasia.
Preparation for manipulation: features
Curettage of the uterus with endometrial hyperplasia is performed only after preparation. Previously, the patient should be examined by such doctors as a neurologist, cardiologist, therapist. Experts give the conclusion that there are no contraindications to manipulation. At the same time, such studies as a general and biochemical blood test, determination of antibodies to hepatitis, HIV and syphilis are carried out. Be sure to examine the heart through an ECG.
After this, the patient will have to visit a gynecologist. The doctor prescribes additional examinations, which include ultrasound, a smear to determine the purity of the vagina. It is forbidden to carry out manipulation with poor results. If there is an inflammatory process, then it must first be eliminated.
Procedure: Progress
Curettage of the uterine cavity with endometrial hyperplasia is performed only within the walls of a medical institution. The procedure itself lasts no more than 20 minutes. Manipulation requires intravenous anesthesia. During curettage, the patient sleeps or is half asleep: she does not feel unpleasant sensations. With the help of dilators, the doctor opens the cervical canal, falling into the cavity of the genital organ. The curette removes the overgrown layer, which will be further investigated.
In the process of curettage, two positive actions are carried out at once: the doctor cleans the accumulated layer and can further determine its composition and danger (using histology). After cleaning, the patient is under the supervision of medical personnel for another 2-4 hours. If there are no complications, then the woman can go home.
After curettage
If you have cleansed due to the fact that endometrial hyperplasia is established, treatment after curettage will be prescribed. Doctors always recommend a course of antibiotic therapy. Also, if necessary, painkillers and anti-inflammatory drugs are prescribed. Further actions are taken only after receiving a histological decryption.
If the data arrived indicate that there are no malignant findings in the test material, then the patient is prescribed standard hormone therapy. When the presence of malignant tumors is confirmed, it is necessary to remove them by a separate operation. Consider the consequences of curettage.
Inflammatory process
If you have endometrial hyperplasia (treatment after curettage has not been performed), then there is a high probability of an inflammatory process. It manifests itself with the following symptoms: abdominal pain, unusual discharge with an unpleasant odor, fever. In all situations, an urgent correction is indicated. Usually, doctors prescribe a long course of antibiotics for oral, intravenous and vaginal administration.
If the inflammation that arose due to curettage is not treated, then the pathology can spread to neighboring organs: ovaries, fallopian tubes, and so on. All this is fraught with its consequences.
Perforation of the uterus or thinning of the walls of the organ
Treatment of endometrial hyperplasia without curettage is quite rare. If there is no improvement within a month of hormone therapy, then it is necessary to carry out cleaning. During the manipulation, a complication such as perforation of the uterine wall can occur. This pathology requires emergency surgical intervention.
Also, the consequence of manipulation may be a thinning of the walls of the genital organ. In the future, this leads to its complication. For example, a uterine rupture may occur during pregnancy . Often with thin walls, a planned cesarean section is prescribed .
Endometrial hyperplasia: curettage. Feedback on the consequences of the procedure
What is the opinion of patients about this procedure? Many say that endometrial hyperplasia does not disappear after curettage. After just a few cycles, the mucous membrane begins to thicken again, forming cysts, polyps. Indeed, if the patient is not prescribed the appropriate therapy, then the surgical intervention itself will not save her from the disease. Curettage does not eliminate the cause of hyperplasia, but only corrects its consequences. Therefore, it is so important to listen to the doctor’s prescriptions and follow the prescribed therapy after the operation.
Summarize
From the article you could learn that treatment of endometrial hyperplasia without curettage is possible, but only in exceptional cases. To really assess the patient's condition, it is necessary to perform a biopsy or curettage. This is the only way to find an effective treatment that will save you from the existing problem.