When and how is curettage of the cervical canal done?24.05.2022
Curettage of the cervical canal is a simple gynecological manipulation. It has two goals: removal of superficial cells located in the inner part of the cervix; obtaining biological material for further detailed analysis and diagnosis clarification. The operation does not impair the quality of life of the patient, does not deprive the woman of the opportunity to become pregnant, and does not involve subsequent tissue scarring. The procedure is possible only in a medical institution and requires subsequent compliance with medical prescriptions.
The essence of the intervention
One of the most common manipulations in gynecological practice is curettage. It refers to medical and diagnostic procedures, allows you to remove pathological cells and examine them under multiple magnification.
The main organs of reproduction are the body of the uterus and appendages. The uterine cavity is connected to the vagina through a canal called the cervical canal. The hollow tube is lined with a cylindrical epithelium, whose task is the secretion of mucus. During curettage of the cervical canal , the inner surface of the cervix is cleaned from a layer of cells. The procedure is considered low-traumatic, highly effective and highly informative. Often, along with the inside of the cervix, the uterine cavity is scraped.
Indications for carrying out
Curettage of the inner lining of the cervix is performed to treat the following conditions:
- uterine bleeding of an unknown nature;
- hyperplasia of the functional layer of the uterus;
- polyps and cysts formed in the throat area;
- endometriosis of the inner part of the cervix.
If a woman is prescribed curettage of the uterus, then at the same time the doctor can get the top layer of cervical cells. For diagnostic purposes, the procedure is prescribed for the following indications:
- planned surgical interventions on the uterus;
- prolonged menstrual bleeding, accompanied by the release of clots;
- suspicion of cystic formations, polyps or tumors of a different nature in the canal cavity;
- absence of pregnancy for no apparent reason for one year or more.
If the doctor suspects that a woman has a pathological process of a malignant nature, then she prescribes a separate scraping. The procedure involves the separate taking of biological material from different parts of the cervix, followed by curettage of the functional layer of the uterus.
The operation is not performed in women with infectious and inflammatory diseases of the vagina, as this can lead to the spread of pathology to the cervical canal and uterus. Manipulation is not prescribed during pregnancy or if conception is suspected.
Preparation for the procedure
Scraping from the inner surface of the cervix is performed only after a preliminary examination, which allows to exclude contraindications and reduce the risk of adverse effects.
- Blood study. General analysis, biochemistry, coagulogram are prescribed. Also, the patient needs to be examined for TORCH infection.
- Vaginal smear. Determines the degree of purity, the nature of the microflora and allows you to exclude inflammatory diseases. Cytological examination makes it possible to determine the presence of atypical cells on the surface of the vaginal part of the cervix.
- Ultrasound of the pelvis. The state of the functional layer, cervical canal, appendages is assessed. Scanning allows you to determine neoplasms and their location.
- Consultation of narrow specialists. Before the intervention, the patient must obtain a conclusion from the therapist, neurologist and cardiologist that she has no contraindications for this type of operation.
The day before the manipulation, it is necessary to clean the intestines. This can be done with a laxative or an enema. If the bowel is full, this can cause difficulties in the curettage process. Before the operation, it is necessary to empty the bladder, shave off the hair from the perineum and perform hygiene procedures.
The procedure can be carried out on any day of the menstrual cycle, but more often it is prescribed for the first half. The doctor may conduct an examination during menstrual bleeding in order to reduce the force of the intervention, since during the period of menstruation the mucosa is rejected on its own. At the same time, menstruation is a dangerous period for curettage, as the risk of bleeding and infection increases. It is best to carry out curettage of the cervical canal after the end of the discharge. In the future, under the influence of estrogens, the mucosa recovers faster than in the second phase of the cycle.
Women who receive curettage are wondering about its cost. If the patient has indications for the procedure, then it is performed free of charge. In private clinics, you will have to pay for such a manipulation, even if there are grounds for performing it. It should be noted that in a private medical institution, the examination that is carried out before the operation will also be paid.
Depending on the purpose and reason for the manipulation, an individual approach to the patient is chosen. The intervention is carried out only within the walls of a medical institution by a qualified gynecologist. Underground organizations should not be chosen to perform, since an incorrectly performed scraping can provoke complications and disrupt the function of the cervix.
For the comfort of the patient, anesthesia is administered before the intervention. If allergic reactions to any drugs have previously been observed, it is necessary to report this. The essence of the preparation of the procedure is simple: after an intravenous injection, the woman falls asleep. During the operation, the doctor uses only sterile instruments. Before the introduction of the expanding mirror, the external genital organs of the patient are treated with an antiseptic. Having captured the lip of the neck with bullet forceps, the specialist expands the entrance to the canal. With the help of small curettes, scraping of the mucous layer is performed. The resulting biological material is placed in an individual container and sent for an in-depth study.
Scraping can be performed not only from the walls of the cervix, but also from the uterus. In this case, the doctor chooses a larger curette and, having gained access to the mucous layer, cleans it off. The resulting material is also sent for a detailed study, but in a separate container.
You can get the result of diagnostic curettage of the mucosa within the next two weeks.
After the procedure
Immediately after the cleaning is completed and the instruments are removed, ice is applied to the lower abdomen of the patient. It helps stop capillary bleeding. The woman is transferred to the ward, where the next 2 hours is under the supervision of medical personnel. In the postoperative period, it is forbidden to get up until the effect of anesthesia has passed. In the future, care must be taken, because at the first active movements, the head may feel dizzy.
The doctor advises the woman:
- take antibacterial and anti-inflammatory drugs;
- exclude intimacy during the period of postoperative recovery – at least 2 months;
- avoid heavy physical exertion for 1 month;
- do not take a bath, do not go to the sauna and do not undergo thermal procedures – up to six months.
After curettage of the uterus, the patient is prescribed antispasmodics. Drugs can prevent the occurrence of hematomas – accumulation of blood. A week after the procedure, it is necessary to do a control ultrasound to evaluate the result of the intervention.
During the first two weeks after the manipulation, the patient may observe bloody or sanious discharge. They gradually become scarce and disappear completely. A few days after the intervention, there may be pain in the lower abdomen. If you take NSAIDs prescribed by a doctor, they will not be noticeable.
The negative consequences of the procedure occur quite rarely if all the rules were followed during the curettage.
- Perforation of the uterine wall – a puncture of the cavity with an inserted instrument. It usually happens if the manipulation is performed without ultrasound control. Requires emergency open surgery.
- Damage to the neck at the points of contact with the forceps. They are more common in chronic vaginal infections. Require suturing and may be accompanied by scarring.
- Hematometra – accumulation of bloody fluid in the uterine cavity. Usually the provoking factor is cervical spasm. Requires medical or surgical correction.
- Endometritis is an inflammation of the mucous layer. Most often, the causes are infection and non-compliance with asepsis rules.
A delayed complication is a violation of the function of the endocrine glands, inflammation of the neck, fusion of the canal walls.
The anatomical structure of the pelvic organs of a woman is such that she has to undergo various diagnostic and therapeutic interventions. Statistics show that most often curettage of the cervical canal is performed by women 25–35 and 50–55 years old. The technique of the procedure allows, if necessary, to switch from a diagnostic type of intervention to a therapeutic one.
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