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 with the suspicion of certain diseases such as tumors, such a diagnosis of the state of the uterine cavity along with the provision of concomitant care becomes a real salvation for young patients.
In short, doctors call such a relatively short manipulation of the WFD - the first letters. It is prescribed for significant displacements of 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.
To thoroughly clean the cervical canal using separate curettage, the surgical pathway 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 condition of the material, subsequently compiling a detailed program for subsequent recovery.
A control sample is then sent for histological testing. This will help to determine whether the detected lesion is a tumor of a cancerous nature. If the suspicion is confirmed, then the laboratory assistant will be able to determine at the same time whether the identified tumor belongs to the camp of benign or malignant, which has already managed to start metastases.
An additional advantage is the fact that in one visit a specialist will be able to get on his hands the health indicators of not only endocervix, but also endometrium. An integrated approach reduces time spent, and also significantly reduces the morbidity for women.
Many private clinics offer their patients to conduct a similar examination immediately after the initial appointment, recording the victim at any convenient date. At the same time, the price of the examination will vary depending on the policy of the party conducting business of a separate medical center, the classification of medical staff, and the equipment used.
The standard research tools for each hospital remain identical. The patient will only need to grab the medical kit by asking for the appropriate package at the nearest pharmacy.
Depending on whether the procedure is a diagnostic measure, or whether it has therapeutic value, the time of the manipulation, as well as the tools used, will fluctuate. When the doctor sends the victim to the RVD for the need to confirm the diagnosis, it is often found in a woman:
- 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 the disposal of neoplasms in the uterus and cervical canal.
Having figured out what separate curettage 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 injuries. It is best to have time to carry out the intervention a couple of days before the start of menstruation. Also, operations are prescribed at a time 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 genitals departs naturally. For the patient, this alignment will be less painful after the anesthesia ceases to act.
Before giving a direction for manipulation, the gynecologist will surely send his ward to take tests to exclude factors of possible contraindications. To protect a woman, she will have to pass the following tests:
- completed form No. 50;
- smear on the flora;
- ultrasound examination of the uterus.
Separately, you will have to check blood coagulability to determine the duration of possible bleeding. It will also be useful to conduct a preliminary allergy test if the previously injured person has never been anesthetized. Such careful preparation will reduce the risks of possible anaphylactic shock.
Also, precautions relate to the prohibition of food intake at least twelve hours before the appointed time. Due to such a strict restriction, doctors are trying to schedule such a delicate examination in the first half of the day.
The essence of the methodology
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 it comes to standard diagnostics, and not surgical intervention for the removal of the tumor.
A little more time will be needed for the standby mode, when the doctor waits for the start of the anesthesia. Only after the actions taken is it allowed to place the probe in the cervical canal and the uterine cavity itself for further examination of the mucous walls.
All collected biological material in sufficient quantities is sent to a sterile container to be transferred to a laboratory for subsequent clinical trials. It is important here that the nurse assisting in the diagnosis must enter all the necessary data in the form:
- personal information of the patient;
- date of collection of material;
- the period of the menstrual cycle;
- epithelium sampling sites;
- preliminary diagnosis.
To facilitate the well-being of the victim, doctors insist on carrying out general anesthesia. Here it is important to provide data on a 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 numerous reviews of former patients who were refused a diagnostic type of 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 perform curettage with appropriate ailments. Many contraindications of the WFD are considered relative, which means that it is possible to circumvent the ban under certain circumstances.
The main medical contraindications are:
- infected lesions of nearby organs.
Sometimes a kind of cleaning is the only way for the fairer sex to become able to conceive again. To increase the chances of pregnancy, an experienced gynecologist will first recommend that she undergo treatment for the above diseases. In the event of a successful restoration of sexual health, she will be prescribed curettage.
If the outcome of the intervention is successful, the diagnosis obtained or the removal of the tumor obtained with the help of the RVD immediately becomes the key to being able to conceive already about a month after completion of therapy.
Against the background of possible contraindications, the main indications cover a large category of diseases, among which:
- polyps of not only the cervix, but also the endometrium;
- adenomyosis and endometriosis;
- pathological abnormalities of the endometrium;
- disruptions in the menstrual cycle;
- Asherman's syndrome, which is a commissural process in the uterus at any stage of development;
- the inability to bear the fruit all the time;
- uterine bleeding that cannot be explained by other options;
- diagnosis of cancer in the early phase of development;
- prevention of uterine oncology.
Regardless of the initial verdict or medical suspicion, a delicate examination is required only under the supervision of an experienced expert. To increase the chances of success, hysteroscopy is used.
Most gynecologists before curettage tell the wards in detail how the material will be taken from the walls of the reproductive organ. This allows not only to orient in the essence of manipulation, but also carries a psychological category for those who are too nervous, not knowing what awaits them.
Schematically, the whole process will be divided into several steps:
- First, a woman is seated in a gynecological chair. Despite the simplicity of the diagnostic measure, it is allowed to carry out it only in a hospital unit. This ensures the ability to provide emergency qualified assistance immediately.
- Anesthesia is administered, and then the nurse treats the external genitalia with an antibacterial agent.
- A mirror is inserted into the vagina so that the doctor can examine the cervix in detail.
- The channel is fixed with a clamp, which is necessary to block any motor activity. Otherwise, even with an involuntary contraction, the uterus can be seriously damaged on the surface of the probe.
- Scraping 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 that received a sharp side and a long handle.
- The recovered material is transferred to sterile tubes.
But then the algorithm of the conduct will vary. Some doctors complete the examination at this stage, finally treating the vagina and canal once more with an antiseptic. But today, clinics with innovative equipment are sure to attract a hysteroscope to do a follow-up examination after direct cleaning is complete.
Such vigilance at times reduces the likelihood of side effects due to the high morbidity. The patient will only have to recover after anesthesia in the hospital ward. There, the hospital staff will watch her for about three hours. If all is well, then on the same day the patient can send home.
You will have to wait for the results of the tests for about two weeks, so until this time you do not need to come to the hospital. The only exceptions are sudden side effects or complications.
Complications and norm
It is believed that in the postoperative period about ten days is quite normal, when the patient continues minor bleeding. Such discharge should not cause significant troubles and discomfort. But if the standard time is up, but no improvement has come, this is an occasion to sign up for a second consultation.
An understandable reaction of the body to external intervention is listed as a pulling pain in the lower abdomen, which, according to sensations, resembles soreness of menstruation. To reduce the annoying feeling, as well as for the preventive purpose of the victim, a course of antibiotics is prescribed for the entire period of rehabilitation therapy.
Their names, regimen, as well as a specific dosage should tell the attending doctor. It is strictly forbidden to prescribe yourself something outside the boundaries of the drugs indicated in the prescription, as well as change the rules of admission.
If everything goes according to plan, then spotting may have a brownish tint. But they should end no later than in 10 days. When a woman is faced with bleeding, where clots are present, even if this is the first day, then this is an alarming signal. The problem lies in the fact that clots are not always able to independently emerge naturally. It often happens that they block pathways, causing extensive inflammation.
You should also not be afraid of a displacement of 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 phase, 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 ban is a hot bath, which can open bleeding. Because of this, gynecologists insist on replacing the hot hygiene procedure with the usual adoption of a warm shower.