Curettage is a gynecological operation that is used both for therapeutic and diagnostic purposes. Intervention is carried out in a hospital under anesthesia. During the operation, only the upper layer of the endometrium is removed, which grows, dies and is removed monthly in a natural way. The cleaning procedure is simple, but subsequently certain complications may arise, so you need to know what the discharge should be, how you feel, and so on.
When is the cleaning
Curettage is a small operation, but still a surgical intervention, so treatment is prescribed when the medications no longer help. Cleaning is carried out both for diagnostic and therapeutic purposes. Most often, the procedure is prescribed in the presence of residues of the embryo in the uterus after an unsuccessful abortion or partial miscarriage, to remove a dead fetus during a frozen pregnancy. Curettage is indicated for severe uterine bleeding or removal of polyps, sometimes prescribed after childbirth, with uterine myoma, endometritis, and after abortion. For diagnostic purposes, the procedure is carried out to take biological material for histology, if endometrial pathologies are detected by ultrasound, suspected cancer of the cervix or uterine body.
How long does an abortion take?
If unwanted or frozen in the early stages of pregnancy, it is necessary to clean the uterine cavity to remove the fetus or its remains. How long does an abortion take? Up to twelve weeks of pregnancy can be terminated at the request of a woman. Up to six weeks of gestation, medical interruption is possible; at a later date, interruption can be performed only by surgical intervention.
If the gestational age exceeds twelve weeks, an abortion is performed if there are serious indications: fetal pathology, maternal diabetes, social indications (husband’s death, mother’s imprisonment, rape, court decision on deprivation of parental rights). The maximum term for terminating a pregnancy is 22-23 weeks, and in fact, as early as the twentieth week of gestation, if necessary, an abortion is performed, but a labor stimulation or a small caesarean section.
Preparation for the procedure
Before curettage of the uterine cavity, how much to lie in the hospital? What preparation is needed for this procedure? If surgery is performed in the absence of pregnancy, then it is best to carry out it a few days before the expected menstruation. So the blood loss will be minimal, and the body will recover faster. To remove the polyp, the operation is performed immediately after the end of menstruation, so that the location of the polyp can be accurately determined on the thin endometrium.
The procedure is not emergency, it is scheduled. Despite the fact that curettage of the endometrium of the uterine cavity is a small operation, it is necessary to conduct thorough preparation for the procedure. The patient is carefully examined and all the necessary tests are collected: total blood count, bacteriological smear, HIV tests, syphilis, hepatitis, biochemical blood test, smear for oncocytology, ECG, blood for Rh factor and group.
Two weeks before the procedure, you need to cancel all pharmacological preparations that a woman takes to exclude a negative effect on the blood coagulation system. Two to three days before the operation, it is recommended to refrain from douching, use only warm water (without soap) for hygiene procedures, stop sexual contact and use of suppositories that are inserted into the vagina. 8-12 hours before curettage, you need to refuse food in order to safely conduct anesthesia.
Curettage
The procedure is performed in the operating room on a gynecological chair. During the operation, the upper layer of the mucosa is completely removed, if necessary, the remains of the embryo or polyps are removed. First, neck expansion is performed. This is a rather painful process, so everything is done under general anesthesia. If curettage is necessary immediately after childbirth, then this stage can be skipped, because the neck is already expanded naturally. Then, an expander and a special probe with a circular end are inserted into the vagina.
After sufficient expansion, an ultrasound scan or a hysteroscope (special video camera) is performed. The doctor may skip this step - it all depends on the evidence. Then the curettage is carried out directly. A curette is used to remove the mucosa. This tool looks like a spoon with a long handle. The resulting samples are collected in a test tube for further research. Separate diagnostic curettage of the uterine cavity involves the collection of material from the uterus and from the cervix separately.
The duration of the procedure is about 40 minutes. In some cases, cleaning of the cervical canal may be necessary. This is a separate diagnostic curettage of the uterine cavity and cervical organ. Then the epithelial particles are sent for analysis.
When curettage of the uterine cavity how much to lie in the hospital? If everything went well, then the patient is released the next day after the procedure. From twelve hours to a day, you need to stay in the hospital so that doctors can provide help with a sharp bleeding, deterioration of the general condition of a woman, the appearance of negative consequences from anesthesia, and so on.
Recovery period
Recovery after cleaning is quick enough. Bleeding after curettage stops for several hours due to the high contractility of the uterus, but during the recovery period a woman can feel many unpleasant sensations. The result of anesthesia is increased weakness and drowsiness. Pain may occur within a few days. With severe discomfort, Ibuprofen or Paracetamol can be taken. Over the next ten days after the intervention, scanty discharge from a yellowish to brown tinge can be observed.
General recommendations
Within two weeks after the intervention, you need to follow some recommendations to make the restoration of the body easier. You can not do douching, use tampons (replace with pads), go to the sauna or take a bath (shower only). Recommended sexual rest, lack of exercise. In addition, you can not take medications with acetylsalicylic acid.
Normal discharge
Bleeding after curettage is the norm. During surgery, the upper layer is removed, so that the organ cavity becomes a continuous wound surface that will bleed for a certain time. This is the main cause of bleeding after curettage. Discharge in essence does not differ from menstrual flow. How long does bleeding continue after abortion (cleaning) or curettage for diagnostic purposes? The duration of bloody discharge may be different. Normal discharge is considered, which lasts about five to six days, but no more than ten. There should be no pungent odor. Gradually, the intensity of bleeding decreases. Normally, the lower abdomen can hurt, these sensations are associated with a reduction in the uterus.
Pathological bleeding
Complications after curettage of the uterine cavity can occur for various reasons: too long surgery, insufficient processing of the hands of medical personnel or instruments, poor-quality work of the doctor. Fortunately, complications are now becoming less and less common. With an optical device or an ultrasound device, the doctor can see the organ from the inside and determine how well the surgical procedure is performed.
Pathology can be distinguished by a number of characteristic signs:
- Duration Bleeding after curettage should not last longer than ten days. Complications are usually associated with hormonal imbalance, mid-cycle surgery, and tissue remnants in the uterus.
- Endometritis. The inflammatory process develops when pathogens enter the uterine cavity in the event that the instruments were not processed adequately. The cause of inflammation can be the remains of the ovum and other pathological inclusions. In this case, the discharge has a sharp unpleasant odor, the temperature rises after curettage, there are severe pains.
- Accumulation of blood in the uterus. Blood clots are not removed because the canal is closed. The pathology is characterized by fever, severe pain, cessation of discharge two days after the procedure.
Treatment after curettage
The doctor prescribes hemostatic drugs and medicines that reduce the uterus. In some cases, some traditional medicine may be recommended. Herbal decoctions and infusions act no worse than medicines, have no contraindications and save money. In severe cases, antibiotics are prescribed, a blood transfusion or repeated curettage may be necessary. In case of hormonal imbalance, endocrinologist consultation is required.
After the operation, a special diet is mandatory. In the menu you need to include more products that positively affect blood formation. These include buckwheat, red meat, beef liver, pomegranate. Recommended bed rest or lack of physical activity (depending on the patient's condition).
When urgent help is needed
In some cases, bleeding after curettage becomes pathological. As soon as possible, consult a gynecologist in the following cases:
- body temperature increased;
- the woman’s condition sharply worsened, severe weakness, dizziness, fainting appeared;
- the discharge has a pungent smell and color of meat slops (this indicates the presence of infection);
- blood stopped flowing two days after the operation, abdominal pain appeared (blood clots may have formed in the uterus);
- the bleeding is profuse and lasts quite a while;
- the discharge does not stop, although after the procedure more than ten days have passed;
- pain does not go away after taking pain medication.
The symptoms listed above in most cases indicate a serious pathology that requires medical attention.