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Bougienage of the cervical canal is an operation that is performed in case of narrowing or complete overgrowth of this lumen. In medical terminology, this phenomenon is called atresia.
Women develop pathology due to various reasons, but most often the primary source of problems is a classic complication after curettage, or a response to age-related atrophy. To return the patency to the previous level, a special procedure is prescribed, which is not too long in time. Its recovery stage lasts much longer, which can be shortened if you seek help from a qualified specialist and follow his recommendations.
Especially bougienage
Manipulation aimed at expanding the cervical canal by force is the expansion of the cervix using a special tool. Its name, bougie, served as the name for the procedure itself. A referral for such an appointment is received by patients who have been diagnosed with a narrowing, partial overgrowth, or complete obstruction of the indicated channel.
Sometimes it is bougienage that is the only way out in case of detection of serious pathologies associated with the inability to use the reproductive function of the body. The method is consistently in high demand among doctors who examine women at the time of menopause. If they are found to have a serometer, then they can be sent to do this minor surgery.
Despite the fact that some reviews describe the procedure for the operation as rather scary, in reality everything happens almost painlessly. This is explained by a prerequisite in the form of anesthesia. To get a good effect, you will need to find not only a good doctor, but also go to a medical center that uses innovative, less traumatic equipment.
Why pathology makes itself felt
In medical practice, there are cases when the primary source of atresia was problems that were not related to the list of standard causes. As a result, they blocked reproductive activity, although outwardly deviations may not make themselves felt for a long period.
Among the main reasons that provoke an anomaly, the development of endocervicitis is especially distinguished. If we omit the point about poor-quality diagnostic or therapeutic curettage, then there is still a classic medical abortion. The risks of complications of this kind are also high if the victim previously used the services of cauterization of the mucous membrane of the cervical canal with electric current. The final common cause is conization.
The consequences of the formed obstruction of the cervix are often called false amenorrhea. Moreover, health problems do not affect the frequency of the menstrual cycle. Instead, the girl is pursued by endometrial detachment, which provokes further bleeding.
But due to the fact that the lumen is partially blocked, or completely closed tightly, the mechanism for throwing the contents of the uterus into the fallopian tubes is triggered. In the most neglected state, it is even possible to throw the contents into the abdominal cavity. Further, the victim develops endometriosis, which is characterized by a strong pain syndrome and an extensive inflammatory process.
Separately, cervical stenosis is isolated, which is also a side effect of curettage. Many women then complain of feeling unwell, which is explained by the hematometer. The so-called accumulation of blood in the uterine cavity. If at this stage you try to endure, then you can reach a serious inflammation localized in the uterus. The picture ends with traditional peritonitis.
Against this background, doctors recommend immediately making an appointment at the first suspicion, otherwise the patient will be hospitalized in intensive care and followed by long-term rehabilitation therapy.
The basics of proper preparation
Usually the price of bougienage in one city, but in different clinics is not much different. Because of this, experts advise focusing in their choice on the reputation of the medical institution and the qualifications of the gynecologist, and not the final cost. You can find out how much the procedure itself costs from the administrator on duty. He should also be asked whether the announced amount is a figure for payment without anesthesia or with it.
The operation is performed with two formats of anesthesia:
- local;
- general.
Pricing policy will vary depending on the type of anesthesia and anesthesia. But the final decision on which option to give preference to will be made by the expert on the spot. This is due to the fact that only the attending physician knows the characteristics of a particular patient, as well as the degree of obstruction of her cervical canal. But often the gynecological maneuver is carried out under general anesthesia, since the forced expansion of the cervix is an unpleasant and painful procedure that cannot be tolerated without medication.
In order for everything to go according to plan, first the young lady will be sent to take a whole bunch of auxiliary tests. This is necessary not only to confirm a previously established diagnosis, but also to check the current state of health. A comprehensive package of analyzes includes:
- general blood analysis;
- biochemistry;
- test for sexual infections;
- testing for AIDS, syphilis, hepatitis B, C;
- coagulogram, which helps to determine the rate of blood clotting.
An auxiliary assistant is colposcopy, which means the need to study the reproductive organ through a special medical device.
Also, sometimes doctors require the results of microscopy of the vaginal smear and the material that was obtained from the entrance area of the channel under study.
For the successful application of anesthesia, you will need to provide the results of the electrocardiogram. This is necessary for a detailed assessment of the activity of the cardiovascular system, since with some serious pathologies in the operation of this system, anesthesia poses a mortal threat.
It is not possible to make a decision on the need for bougienage without three standard checkpoints:
- fluorography;
- bacterial culture from the vagina and CC;
- ultrasound examination of the pelvic organs.
Clinics with a high level of service also provide a consultation with an anesthesiologist before the scheduled day of the operation. During such a meeting, he is obliged to select the optimal drugs for anesthesia.
Phased execution
Having determined how much the canal was narrowed, and what kind of anesthesia the victim needs in connection with this, the doctor appoints the day of the operation. It is carried out strictly in a hospital setting. Typically, surgery is not stretched for more than half an hour.
The algorithm for performing actions during bougienage is as follows:
- The patient is placed in a gynecological chair and anesthesia is administered intravenously.
- The gynecologist processes the external genitalia to maintain maximum sterility.
- The doctor inserts a gynecological speculum into the vagina, which is designed to expand visible access to the specified organ.
- The narrowest bougie pattern is introduced first to produce the primary expansion.
- After the successful completion of the first stage, the specialist takes a larger instrument. The fixtures change, growing exponentially in diameter until a bougie of the desired size can enter normally.
The gradual increase in the size of the instruments is aimed at reducing the load on the cervix, which will return to its natural size in a gentle manner.
The reception is completed by repeated sanitation with a solution of an antiseptic spectrum of action.
If everything went well, then the patient can go home after she comes to her senses after the end of the anesthesia. But with a deterioration in well-being, a woman is left in a hospital for at least one more day. Since no one can answer the question with XNUMX% accuracy: how much blood bleeds after the intervention, there is simply no single right period for recovery.
Postoperative treatment
Two weeks are considered the average norm for returning to normal life after bougienage, but this does not mean that the dates cannot be shifted. If, after half a month, the uterus does not dare to heal, then it is worth re-going to an appointment with a gynecologist.
Many young ladies are interested in whether the pain passes during the specified period, but even here there is no definitively accurate answer. It is better if you find any feeling of discomfort in yourself, immediately consult a doctor. It is especially important to sound the alarm in time if the victim often has relapses of atresia. In such a situation, it would be more efficient to use the installation of an artificial alloplastic channel.
During the outpatient postoperative period, the patient should take anti-inflammatory drugs, as well as wound healing suppositories. Only a doctor can prescribe them, focusing on the general dynamics of recovery, as well as individual intolerance to certain medicinal components.
But from the very beginning, you will have to prepare for the fact that after the end of the anesthesia, pain will “wake up”. If, along with bougienage, the usual curettage was performed – the endometrium, then bleeding is normal. It flows like menstruation.
In order to catch possible deviations in time, a woman should carefully monitor her health immediately after the operation and, in case of detection of dangerous signs, immediately seek medical help. Alarm bells can be:
- increased bleeding;
- pain in the lower abdomen that does not go away;
- elevated body temperature.
If everything is fine, then the victim simply has to take antibiotics in the form of tablets or intramuscular injections according to a pre-approved program. Also, to prevent possible side effects, antifungal agents are prescribed, which is necessary to block the risk of developing thrush. Not without conventional anti-inflammatory drugs.
Some ladies believe that bougienage will completely ruin their plans for family replenishment planning. But the procedure for expanding the cervical canal does not affect pregnancy at the planning stage. If the cause of infertility is atresia, then fertilization can be expected already at the onset of the next cycle.
Medical Contraindications
Doctors agree that it is better to carry out the prevention of infection in time than to go to the gynecological chair to correct the diameter of the canal. In order not to become a victim of blockage of the cervix, it is necessary to treat any inflammation associated with the reproductive system in a timely manner.
An equally important point is the careful conduct of labor activities. If a woman is already sent for cleaning, then it should be done under the supervision of a true professional with experience who will perform scraping accurately and efficiently.
Another productive option for prevention is the rejection of the uncontrolled use of chemicals that allow protection. Even vaginal irrigations involving aggressive solutions can cause such a deviation.
To minimize the risks of primary infection, the fairer sex should adhere to the principles of a healthy lifestyle. It is especially important to use the recommendation during gestation. This means that you will need to avoid infection with infectious diseases that adversely affect the condition of the endocervix.
All of the above is important, since when the channel is narrowing, bougienage can not always help, which makes it easier to prevent the development of such a sad scenario. The warning is explained by the presence of several serious contraindications in the popular procedure.
The first point provides for the inflammatory process at the acute stage of the course of the disease. The threat is the pathology of the coagulation system. And the final weighty prohibition for manipulation is the decompressed state of the cardiovascular system. These include high blood pressure, chest pain, and headaches.
In all other clinical cases, bougienage is perhaps the only way out of an almost impasse with the possibility of restoring reproductive functions.