Hysteroscopy with separate diagnostic curettage (abbreviated as RFD) is a method for diagnosing gynecological diseases and removing various neoplasms. Many women are confronted with this procedure, and it scares almost everyone, since the term “curettage”, used in simple speech, sounds somewhat unpleasant. Today we will consider this method in more detail, find out how it is carried out, in which cases it is shown and what are its consequences.
A bit about anatomy ...
The uterus is an organ covered with a mucous membrane that is different from the mucous membranes of other organs. After all, her main task is to maintain pregnancy. Every month, the thickness of the uterus gradually increases. If conception does not occur (after all, nature often has different plans), this thickened layer comes out in the form of menstrual blood. Then the process is repeated.
What is hysteroscopy?
You can call this procedure a "golden mean." It makes it possible to visualize the uterine cavity, revealing various neoplasms - polyps, adhesions, adhesions, submucous nodes (uterine fibroids) and other neoplasms, including malignant ones. But the goal of the study is not only diagnostic. During the procedure, adhesions can be dissected, cryodestruction of polyps can be carried out (exposure to them at low temperature), an intrauterine device can be removed or detected.
Hysteroscopy with RDF resembles an abortion - all the lesions in the uterus along with its upper layer are removed. However, if before the procedure was very painful, today curettage is carried out with the use of analgesics, which help eliminate painful sensations. Previously, hysteroscopy was also actively performed, but due to the impossibility of visualizing the manipulation, frequent complications were observed, up to the removal of the basal layer of the uterus and the inability to become pregnant. Today, thanks to hysteroscopy, the doctor sees everything that happens inside. The risk of any damage in this case is minimal. Although in many respects everything depends on the qualifications of the doctor.
Attention! In 90% of cases, the method allows you to confirm a previously made diagnosis.
To begin with, curettage is carried out under the control of hysteroscopy of the mucous layer of the cervix, and then the uterus itself.
Hysteroscopy: indications for use
Hysteroscopy is indicated:
- In case of menstrual irregularities, the causes of which could not be diagnosed by other studies.
- Myoma (a benign tumor on the muscle layer of the uterus).
- Tumor processes.
- Endometrial dysplasia (excessive proliferation of the inner uterine layer).
- Eliminate the effects of incomplete abortion, which resulted in inflammation.
- Infertility.
- Spontaneous abortion.
Diagnosis of many diseases with hysteroscopy with RDV greatly facilitates the treatment process, since the doctor can remove the neoplasm immediately when they are detected. Or send histological material taken from the uterine cavity to the laboratory. That is why the procedure is performed under general anesthesia.
Is there a risk of complications?
Previously, hysteroscopy with RDF was really fraught with serious complications. Today, the procedure is almost completely safe, and only in 1% of cases are complications observed. Among them are the following:
- Injury to the uterus or its cervix. It is accompanied by a sharp pain in the abdomen, a decrease in blood pressure up to a swoon.
- Infection or the occurrence of exacerbation of those diseases that were not diagnosed before the study. Often, inflammation occurs with an untreated illness or poor hygiene.
- Endometritis (inflammation of the upper inner layer of the uterus) reports about aching pains in the abdomen, fever and bloody discharge from the vagina. It appears within a few days after surgery.
- Oxygen enters the uterine blood vessels.
- Heavy bleeding. Bloody discharge after surgery is observed for 3-5 days, but if they are very plentiful and last several days, you should immediately consult a doctor.
- Side effects as a reaction to anesthesia.
- Hematometer. Accumulation in the uterine cavity of the blood can occur when hysteroscopy with RDF was performed to eliminate uterine spasm. If the uterus remains in a state of spasm, the blood in it, which should be released within a few days, accumulates, causing painful sensations.
There is also a risk of damage to the uterine mucosa. The doctor may accidentally hook a deeper layer of the organ mucosa. It can no longer be restored, so it is very important that such a gynecological operation is carried out by an experienced doctor who is guaranteed not to catch anything superfluous.
How is the procedure going?
Many women are primarily interested in this issue, since the upcoming surgical intervention scares them. But in fact, you have nothing to fear - the operation takes place under general anesthesia and usually does not cause a woman any discomfort. The description is based on the reviews of women who have already done gynecological operations before. Before the procedure, it is important to take smears for the degree of purity of the vagina, to exclude the likelihood of syphilis and HIV infection.
You need to come to the gynecological center 30-40 minutes before the operation. In the morning, it’s important not to eat any food. Blood and urine are taken for analysis, an ECG is performed (shows the work of the heart and blood vessels), and blood pressure is measured. Consultation with a surgeon and anesthetist. Bandage the legs to the knee to avoid blood clots.
In the operating room they make an injection into a vein - a light anesthesia, which allows the procedure to be performed completely painless for the patient. After 20 minutes, the curettage itself, like the effect of anesthesia, ends. The patient is given a dropper. If hysteroscopy with RDF was performed in the morning, then in the evening you can go home with a calm mind. The very next day after her, women go to work. Hysteroscopy (the price will be indicated below) does not require a long recovery.
After the operation, as the doctors warn, there is the possibility of a pulling pain and spotting in small quantities. It is forbidden to have sex and exercise for about 2 weeks. They also prescribe medication. First of all, an antibiotic (Amoxiclav, etc.) and a drug based on lactic acid bacteria. If there is an increased level of spotting, appoint "No-shpu."
Are there any contraindications to hysteroscopy?
Hysteroscopy (or curettage) is strictly contraindicated:
- With severe uterine bleeding.
- Pregnancy
- Oncology of the cervix.
- Inflammatory processes of the genital organs (vaginitis, endometritis, cervicitis, bacterial vaginosis).
Hysteroscopy before IVF
IVF - artificial insemination that occurs outside the body of a woman. A fertilized egg from a test tube is transplanted into the body of the expectant mother. One of the most common methods of solving the issue of infertility. Hysteroscopy with RDF before IVF makes it possible to exclude uterine pathologies and prepare the body for future pregnancy. It is recommended that IVF be performed within a few months after the procedure.
Hysteroscopy prices
Hysteroscopy, the price of which varies widely from clinic to clinic, is performed in each city. In Moscow clinics, the cost of the procedure can cost from 5,000 to 40,000 rubles. The price depends on the level of the clinic, the quality of the equipment, the procedure itself and other factors. Before choosing an institution, be sure to read the reviews about it.
Hysteroscopy is performed in the following clinics in Moscow:
- "Delta Clinics" (5000 rubles).
- OJSC “Medicine” (43 000 rubles).
- GMS Clinik (25 000 rub.).
- MC "Petrovsky Gate" (18 000 rubles).
- "ABC-medicine" (10 000 rub.).
Choose any gynecological center of Russia that suits you according to reviews and prices. Be healthy!