Uterine Curettage: Consequences, Diagnosis, Therapies And Advantages

It is thus known to a surgical intervention performed by gynecologists, in a hospital or clinic, with local anesthesia, usually resulting quite uncomplicated and elemental, where they perform a curettage or scraping of the uterus and its interior walls to remove the endometrium that is the mucous layer that covers it. It is usually done after a miscarriage.

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Is it known by other names?

Yes, uterine curettage may also be called surgery , curettage, curette, dilation and curettage (D and L), or uterine scraping.

What are your causes?

To perform this procedure there are several reasons, including that a uterus cancer has been diagnosed , remove the remaining tissue after a miscarriage, when there are abundant and unexplained menstrual bleeding , to perform tests on infertility, when there is presence of irregular bleeding, due to endometrial polyposis (protrusions of tissue), when the uterus thickens, due to intrauterine devices embedding, due to the presence of blood after menopause, bleeding during hormone replacement therapy, also if an induced or therapeutic abortion is performed .

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Diagnosis and therapies of uterine curettage

We will explain in depth why all the procedures mentioned above are performed and what each one consists of. Understanding that the uterine curettage has basically two important functions: one is to empty the entire interior of the uterus or to take samples from it to carry out analysis. Therefore, this technique is carried out for the following purposes:

• Diagnose uterine cancer : Although it is rare, this cancer may appear in older women who have already reached menopause. In this way, with curettage the endometrium is analyzed in search of malignant or negative alerts. However, it is not the definitive treatment in case of detecting the presence of cancer cells.
• Miscarriages : bad news for women, sometimes the embryo that is growing can die in pregnancy and there are two forms of expulsion: if the embryo remains inside it can be called a retained abortion, but if it is done completely it is called complete abortion. If the case of the woman is the first, then a curettage is carried out to eliminate the remains of the embryo that may cause some type of infection. This as long as the pregnancy is three months or less.
• Heavy periods: curettage is used to check if the endometrium has any type of abnormality that causes excessive and unusual periods.
• Irregular menstrual periods: like the previous point, this technique can be used if the woman has spotting or bleeding outside the regular menstruation time. Therefore, curettage could solve these abnormal bleeding.
• Provisional abortions : only possible in the third trimester of pregnancy, by decision of the woman, if her life is at risk or by examinations it is known that the fetus will come with some malformation or will not be able to develop. In this way the embryo is extracted in addition to the endometrium and its remains.
• Embedding of intrauterine devices (IUDs): sometimes it happens that these devices, the IUDs, are embedded in the uterus and its internal walls, which is why it is necessary to perform a curettage to be able to remove it.
• Fibroids or endometrial polyps : these growths in the uterus in an abnormal way are eliminated by a curettage as they can cause spontaneous abortions, excessive menstruation or sterility.

Uterine curettage procedure

With general anesthesia

Although it is not recommended, the patient should be completely asleep until the procedure is completed. It is recommended that 12 hours before doing it you can not ingest any food, drink or smoke. It will not cause any pain, since the woman will be asleep.

After placing anesthesia, the specialist must dilate the vagina using a speculum, then place a cannula and suction the fetus. This procedure lasts 15 minutes, then you must rest and rest for about an hour and then you will be discharged and you can go home.

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With local anesthesia

Quite the opposite to the previous one, the woman will be awake, but will not feel the procedure because previously she will have taken a muscle relaxant plus an analgesic. It is important that four hours before you should not eat, smoke or drink any liquids.

Since every body and every woman is different, some are likely to feel more sleepy than others.

Better choice

Between both techniques, the one that is less risky for the woman should be selected, but above all this will be defined by the gestation time of the fetus.

We will mention what are the recommended techniques according to the time of pregnancy:

• Week 10 to 12: It is recommended to use abortion pills, since its success rate is high and it has a low risk for the woman.
• Week 12-15: Suction curettage is the best technique.
• Week 15 to 26: the dilation and suction procedure is applied, although it is highly risky and can cause some complications.

In any case, after any of these procedures there may be the presence of bleeding during the following week, as well as dizziness, sleepiness and fatigue and other symptoms that will pass over the days.

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Endometrial hyperplasia

There is a mucous layer that covers the entire uterus from the inside, this is called the endometrium and its exaggerated growth is called endometrial hyperplasia and it produces rare and abnormal bleeding.

This is caused by the administration of exogenous estrogens or due to the ovaries producing excess estrogen.

Among its classification we can mention

• Simple hyperplasia : if cells are actively reproducing, but it can be stopped with proper treatment.
• Complex hyperplasia : when these cells continue to multiply, forming new glands and cells.
• Simple atypical hyperplasia and complex atypical hyperplasia: these are cells that predispose to endometrial cancer.

But it is important to know that if any of these are detected early, the progression of the cancer can be prevented.

Although it has almost no presence of major symptoms, there may be exaggerated menstruation, menorrhagia or bleeding between each period.

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For the treatment should take two important factors:

• If the woman wishes to conceive: it begins with hormone treatment through contraceptive pills or progesterone. Carrying out checks from time to time
• If you do not improve or do not want to conceive , a uterus is removed, called a hysterectomy.

By anembryonic egg

This problem may not be well known, but it is highly common in the first three months of pregnancy. It is said that it is practically a pregnancy, but without a baby since the ovum is fertilized, but only the gestational sac develops , without an embryo inside.

The cause of this is due to the fact that an egg or sperm has chromosomal problems with an information error in the so-called primitive egg, from here the empty egg is produced, producing only the layer or cover that will form the placenta in the future. From month two of pregnancy, an ultrasound can be performed to determine if the egg is empty. It can also be confirmed if the embryo’s heart cannot be heard.

In general, the body itself naturally expels the anembryonic egg and if this does not happen, the curettage will be carried out. To think about conceiving again, you must wait at least 30 days after the expulsion or curettage when the first normalized menstruation appears.

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By hysteroscopy

This technique consists of performing a minor surgery, to use a very thin endoscope that passes through the vagina and cervix and reaches the uterus and helps define or diagnose a uterine problem and also works for treatment and may or may not use anesthesia.

There are different reasons for performing this procedure, among which we can mention abnormal uterine bleeding, infertility, consequent abortions, adhesions, abnormal growths and displacement of the IUD.

You may feel a little nauseous or tired at the end, but these symptoms will pass quickly. When you go home, you should rest and then see your doctor only if you have symptoms such as fever, severe abdominal pain, or heavy vaginal bleeding.

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Consequences and side effects of uterine curettage

Generally, there will be no major aggravations after performing the curettage, but since every body acts and works differently, we mention some complications that may occur:

• Uterine puncture: occurs if the uterus is (unintentionally) punctured with the curettage rod.
• Uterus occlusion due to scarring : After curettage, the uterine surfaces make contact and heal together rather than separately. This can cause sterility.
• Cervical tear: can be resolved if the tear is sewn (if it is small) or with deep surgery.
• Infection: all the instruments used during curettage will be sterile and clean to perform the procedure, but if the microbes present in the vagina pass into the uterus, this can be negative, triggering an infection that can be treated with antibiotics or intravenously.
• Hemorrhage: this complication is common in any surgery, so special care will be taken to prevent it from occurring during curettage and once it is completed.
• Leaving tissue inside the uterus: occurs if part of the endometrial tissue is left inside the uterus, which can serve as a source of infection.

Recovery time for a uterine curettage

It is advisable to attend the hospital or clinic with a companion, although generally the departure is authorized the same day. Recovery after performing a curettage is fast , it will depend on each woman, but it is estimated that after a day of the procedure, it can be incorporated into your activities and daily routine. Taking into account that it can be normal to have pain in the pelvis, cramps or vaginal bleeding.

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Post-curettage care

As we discussed in our previous point, it is common for you to have dizziness, diarrhea or vomiting after the procedure. Try to carry sanitary pads in various quantities as the bleeding on day one is in large quantities.

Avoid using tampons, bathtubs, and douches for at least 15 days afterward, try not to exercise too hard, and leave intercourse until after the bleeding stops. If you feel sad, discouraged and depressed it is important that you seek external help because the emotional impact after having an abortion in many cases is usually high.

Some doctors recommend fasting between six and 24 hours later, placing intravenous drip as a substitute for food.

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Uterine curettage and a new pregnancy

It is recommended to wait a period of three months to go in search of a new pregnancy , but this will depend on the recovery of each woman after performing the curettage. Before this time, contraceptive methods such as condoms should be used to avoid internal infection if the uterus has not yet fully healed.

When the woman feels mentally ready to conceive again, due to the fear that may remain after suffering a miscarriage. However, there is a high possibility of a future new pregnancy without any risks . In the same way, it is important to maintain a relaxed life with low levels of stress to achieve the goal. Once pregnant again, you should stop fear and enjoy those months to the fullest.

We remind you that there are certain factors that can directly affect the production of an abortion and that is the consumption of alcohol, drugs, cigarettes and the indiscriminate use of analgesics and anti-inflammatories – such as ibuprofen – and aspirins, as well as the age at which you decide carry a baby.

It is advisable to take folic acid and iodine during the months of pregnancy.

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Uterine curettage and relationships

This procedure does not affect the sexual life of a couple at all, however the times indicated by the doctor must be respected to avoid unwanted complications. 15 days later it is likely that these practices can be reactivated , but with protection because the probability of getting pregnant at that time is quite high and it is possible that you have not healed completely.

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Advantages and disadvantages of uterine curettage

As everything has its positive and negative points, here we compare various aspects that will help you make the right decision about the application of this procedure:

Advantage

• If you have a complicated pregnancy in which the negative conditions of the fetus are known or the fetus is dead inside the uterus, curettage is a good option so that the emotional level is less affected under this procedure, since the woman does not you must wait until the moment of giving birth to be able to expel him.

However, the recommendation is to induce this expulsion with the use of drugs or medications and then as a last option to resort to curettage.

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Disadvantages

• High risk of perforating the uterus.
• Danger that an egg does not find a wall inside the uterus that is adequate to start gestation. This can happen if it does not heal properly, which could interfere with future attempts at pregnancy.
• Side effects after full or partial anesthesia.
• Risk of infection from surgical instruments.

Medical and natural treatments for uterine curettage

These are some foods and remedies that are recommended to consume to improve the mood of women:

• Oatmeal: helps against depression and stress, reducing fatigue and strengthening the nervous system. It allows the body to recover after the loss of abundant blood as it has high amounts of magnesium, iron, zinc and some vitamins.
• Wheat germ, nettle and brewer’s yeast : regulate the hormonal system and help against anemia.
• Garlic: prevents infections and has antibiotic power as long as it is consumed raw and peeled at the moment.
• Raspberry leaf : if you make an infusion of these leaves and take 3 cups a day for a maximum of two weeks, it will repair the uterus and tone it at the same time.
• Oregano: recommended if colic is present.
• Green tea: thanks to its antioxidants the uterus will be healthy and prevents fibroids in it.

For its part, to treat cramps it is advisable to ingest infusions of ginger, poppy, chamomile, paico, rue, linden, blackberry , among others. And for the nerves wallflower, lettuce, lavender, valerian and lemon balm.

Complement these treatments with a fiber-based diet and consumption of high amounts of water (minimum 10 glasses a day) to ensure intestinal movement. Consume green leafy vegetables such as cabbage, spinach, nettles and broccoli, since their phytoestrogens compete with the estrogen produced by the body and could stop the growth of tumors present in the uterus. They also have high amounts of calcium, potassium and magnesium.

These foods that stop the growth of so-called fibroids are fruits that contain vitamin C and bioflavonoids that prevent ovarian cancer. On the other hand, those dairy products rich in calcium and vitamin D are synonymous with strong and healthy bones, in addition to providing positive uterine health. That is why it is recommended to consume cheese, milk, yogurt or butter always in moderate quantities.

Other foods that can be consumed are cold water fish for having omega 3 , lemon since it protects the immune system of the body and the uterus by its vitamin C taking care of bacteria and infections, nuts help to produce hormones, they contain good cholesterol that allows the elimination of fibroma and uterine cancer and finally the castor oil gives resistance to the uterus.

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