Separate diagnostic curettage

Separate diagnostic curettage is a procedure that is most often prescribed to women who have reached the age of forty as a prevention and treatment. But if some diseases are suspected, such as tumors, such a diagnosis of the state of the uterine cavity, along with the provision of related care, becomes a real salvation for young patients.

In short, doctors call such a relatively short manipulation of the RVD – by the first letters. It is prescribed for significant shifts in the menstrual cycle, when it was not possible to find the source of the problem in something else. But most often, a specific operation is necessary to correct the destabilization of the functionality of the reproductive organs.

Overview

For thorough cleaning of the cervical canal with the involvement of separate curettage, a surgical path is used. It allows you to capture biological material from the inside of the uterus. The collected epithelium is sent for laboratory study to determine the state of the material, further compiling a detailed program for subsequent recovery.

The control sample is then sent for histological testing. This will help to find out if the detected lesion is a neoplasm of an oncological nature. If the suspicion is confirmed, then the laboratory assistant will be able to determine at the same time whether the detected tumor belongs to the camp of benign or malignant, which has already metastasized.

An additional advantage is the fact that in one visit a specialist will be able to get hands on health indicators not only of the endocervix, but also of the endometrium. An integrated approach reduces time costs, and also significantly reduces trauma for a woman.

Many private clinics offer their patients to conduct a similar examination immediately after the initial appointment, recording the victim on any convenient date. At the same time, the price of the examination will vary depending on the party’s policy of doing business of a particular medical center, the classification of medical staff, and the equipment used.

The standard research instruments in each hospital remain identical. The patient will only need to grab a medical kit by asking for the appropriate package at the nearest pharmacy.

Depending on whether the procedure is a diagnostic measure, or it has a therapeutic value, the time of the manipulation will fluctuate, as well as the tools used. When the doctor sends the victim to the RVD to confirm the diagnosis, the woman often finds:

• myoma;
• polyposis;
• endometriosis;
• cervical cancer;
• endometrial hyperplasia.

But if the diagnosis was confirmed in some other way, such as computed tomography with contrast, then curettage can turn into a full-fledged operation. It is aimed at utilizing the neoplasm in the uterus itself and the cervical canal.

Preparatory marathon

Having figured out what separate scraping means, and how it happens, many begin to be interested in the correct approach to the preparatory stage. The most important point here is the reconciliation with the calendar of the menstrual cycle.

This is necessary in order to increase the chance of success with minimal trauma. It is best to have time to intervene a couple of days before the start of menstruation. Also, operations are prescribed during the period when menstruation has already begun, and the bleeding has become quite strong.

For doctors, even the second scenario is preferable, since the mucous membrane of the genital organs departs naturally. For the patient, this alignment will be less painful after the anesthesia stops working.

Before issuing a referral for manipulation, the gynecologist will definitely send his ward to take tests to exclude factors of possible contraindications. To protect a woman, she will have to pass the following tests:

• coagulogram;
• completed form No. 50;
• cardiogram;
• flora smear;
• ultrasound examination of the uterus.

Separately, you will have to check blood clotting to determine the duration of possible bleeding. It would also be useful to conduct a preliminary allergic test if the victim has never been subjected to anesthesia before. Such careful preparation will reduce the risks of possible anaphylactic shock.

Also, precautions relate to the ban on eating at least twelve hours before the appointed time. Because of such a strict restriction, doctors try to schedule such a delicate examination in the first half of the day.

The essence of the technique

In a favorable situation, manipulation rarely stretches over a period of more than twenty minutes. But separately it is necessary to take into account the sterilization of the surrounding surgical field, even if we are talking about standard diagnostics, and not a surgical intervention to remove the tumor.

A little more time will be needed for the standby mode, when the doctor is waiting for the anesthesia to begin. Only after the actions taken, it is allowed to place the probe into the cervical canal and the uterine cavity itself for further examination of the mucous walls.

All collected biological material is sent in a sufficient amount to a sterile container to be transferred later to the laboratory for subsequent clinical trials. It is important here that the nurse assisting in the diagnosis must enter all the necessary data into the form:

• patient’s personal information;
• date of material collection;
• the period of the menstrual cycle;
• epithelium sampling sites;
• preliminary diagnosis.

To facilitate the well-being of the victim, doctors insist on general anesthesia. Here it is important to provide data on the cardiogram, so that the gynecologist is convinced of the health of the cardiovascular system. If there are deviations, then the introduction of anesthesia can significantly disrupt the activity of the heart muscle. This is confirmed by the numerous reviews of former patients who were denied a diagnostic type operation due to diseases of the cardiovascular system.

Indications and contraindications

Even if a woman has no problems with the work of other systems, this does not mean that she is allowed to carry out scraping with appropriate ailments. Many of the contraindications of the RVD are considered relative, which means that it is possible to bypass the ban under certain circumstances.

The main medical contraindications are:

• vulvovaginitis;
• gonorrhea;
• chlamydia;
• infected lesion of nearby organs.

Sometimes a kind of cleaning is the only way out for the fairer sex to become fertile again. To increase the chances of pregnancy, an experienced gynecologist will first recommend that she undergo treatment for the above diseases. In case of successful restoration of sexual health, she will be prescribed curettage.

With a successful outcome of the intervention, the diagnosis obtained with the help of RVD or the removal of the tumor immediately becomes the key to the possibility of conceiving already about a month after the completion of therapy.

Against the background of possible contraindications, the main indications cover a large category of diseases, including:

• polyps not only of the cervix, but also of the endometrium;
• myoma;
• adenomyosis and endometriosis;
• pathological abnormalities of the endometrium;
• disruptions in the menstrual cycle;
• Asherman’s syndrome, which is an adhesive process in the uterus at any stage of development;
• infertility;
• the inability to bear the fetus for the entire period;
• uterine bleeding that cannot be explained by other options;
• diagnosis of cancerous neoplasms at an early stage of development;
• prevention of uterine cancer.

Regardless of the initial verdict or medical suspicion, a delicate examination must be carried out only under the supervision of an experienced expert. To increase the chances of success, hysteroscopy is involved.

Step by step execution

Most gynecologists, before scraping, tell their wards in detail how material will be taken from the walls of the reproductive organ. This allows not only to navigate the essence of the manipulation, but also carries a psychological category for those who are too nervous, not knowing what awaits them.

Schematically, the whole process can be divided into several steps:

1. First, the woman is seated in a gynecological chair. Despite the simplicity of the diagnostic measure, it is allowed to carry it out only in the conditions of an inpatient department in a hospital. This guarantees the ability to provide emergency qualified assistance immediately.
2. Anesthesia is administered, and then the nurse uses an antibacterial agent to treat the external genitalia.
3. A speculum is inserted into the vagina so that the doctor can examine the cervix in detail.
4. The channel is fixed with a clamp, which is necessary to block any motor activity. Otherwise, even with involuntary contraction, the uterus can be seriously damaged on the surface of the probe.
5. Curettage is carried out first from the cervical canal, and then from the upper layer of the uterus. A special tool, a curette, helps to do this. Externally, the device resembles a spoon, which received a sharp side and a long handle.
6. The extracted material is transferred to sterile test tubes.

But then the algorithm will vary. Some doctors complete the examination at this stage, having finally treated the vagina and canal with an antiseptic again. But today, clinics with innovative equipment necessarily involve a hysteroscope to do a follow-up examination after the completion of the direct cleaning.

Such vigilance at times reduces the likelihood of side effects due to high trauma. The patient will only have to recover after anesthesia in the hospital ward. There, the hospital staff will observe her for about three hours. If all is well, the patient can be sent home on the same day.

You will have to wait about two weeks for the results of the tests, so you do not need to come to the hospital until that time. The only exceptions are sudden onset side effects or complications.

Complications and the norm

It is believed that in the postoperative period for about ten days it is quite normal when the victim continues to have minor bleeding. Such discharge should not cause significant trouble and discomfort. But if the standard time is up, and there is still no improvement, this is a reason to sign up for a second consultation.

A completely understandable reaction of the body to outside interference is a pulling pain in the lower abdomen, which feels like menstruation pain. To reduce the irritating feeling, as well as for the preventive purpose, the victim is prescribed a course of antibiotics for the entire period of rehabilitation therapy.

Their names, mode of administration, as well as the specific dosage should be told by the attending physician. It is strictly forbidden to independently prescribe anything beyond the boundaries of the drugs indicated in the prescription, as well as change the rules for taking it.

If everything goes according to plan, then spotting may have a brownish tint. But they must end no later than 10 days. When a woman is faced with bleeding, where clots are present, even if it is the first day, then this is an alarm signal. The problem lies in the fact that clots are not always able to come out naturally on their own. It often happens that they block the pathways, provoking extensive inflammation.

You should also not be afraid of the shift in the menstrual cycle, which sometimes deviates from the schedule up to three months, or even begins two weeks after the intervention.

To make it easier to transfer the recovery stage, it is worth abandoning active physical activity and lifting weights. It is also forbidden to use sanitary tampons, giving preference to pads, which should be changed more often.

Another prohibition is a hot bath, which can open bleeding. Because of this, gynecologists insist on replacing the hot hygiene procedure with the usual warm shower.