Curettage – What is it? How is it made and taken care of! ATTENTION!

Curettage is a simple intervention that is usually performed after a miscarriage , but is also used in other cases. We explain when it is indicated, what it consists of, and its possible complications.

Curettage is a technique used by gynecologists, which consist of scraping or curettage of the inner walls of the uterus in order to extract and collect the mucous layer called the endometrium .

When is  curettage performed?

Curettage has two main purposes: taking samples of the endometrium to analyze them, or emptying the inside of the uterus . More concretely, we can say that curettage is performed in the following situations:

1. Diagnosis of uterine cancer:

Endometrial cancer is not one of the most frequent cancers in women, but it is still not uncommon in mature women once they reach menopause. Curettage allows you to analyze the endometrium to see if there are signs of malignancy or not, but it does not constitute a treatment for cancer if it is detected.

2. Extract the contents of the uterus after a miscarriage:

Unfortunately, sometimes the embryo dies during the course of a pregnancy. If it’s completely expelled, it’s called a complete abortion , but if it’s left inside the uterus , it’s called a missed abortion . In these cases, the embryo and its attachments must be removed before an internal infection or other complications occur. Curettage is sufficient for interrupted pregnancies up to three months later, it may be necessary to use other more aggressive techniques.

3. Treatment of heavy menstruation:

There are cases of women whose periods are more abundant than normal. In this case, curettage can be performed to analyze the endometrium for abnormalities to explain this situation, but it can also be useful as a treatment in itself, because it can eliminate the cause (a fibroid, for example).

4. Treatment of irregular menstrual periods:

That is, curettage can be used to treat vaginal bleeding outside of the menstrual period. As the treatment of heavy menstruation , curettage would serve to analyze the endometrium and sometimes also resolve the cause of these hemorrhages. In addition, the curettage loop stops bleeding by cauterizing the vessels with heat.

5. Performing induced or therapeutic abortions:

One of the ways to terminate a pregnancy in the first trimester is to perform a curettage that allows the embryo to be extracted along with the rest of the endometrium . This curettage is performed either by the pregnant woman’s own will, because her health is in danger, or because the future fetus will not be able to develop.

6. IUD embedding:

One of the complications of intrauterine devices (IUDs) is that over time they remain embedded in the inner walls of the uterus , making it impossible to extract them directly. In these situations, a previous curettage is performed to remove the endometrium containing the IUD.

7. Treatment of endometrial fibroids and polyps:

Fibroids and polyps are abnormal endometrial or uterine muscle growths that develop inside the uterine cavity. Sometimes they give complications ( spontaneous abortions , sterility, heavy menstruation …) and must be eliminated by means of a curettage . Analysis to prevent endometrial cancer early :

This test is not recommended for all women (unlike mammography, for example), but in certain situations it is necessary to proceed to do the  curettage , because it can detect endometrial cancer , while it is still easy to resolve. The most typical situations occur after menopause and are abnormal bleeding in women taking hormone therapy, irregular bleeding and endometrial thickness growth detected by transvaginal ultrasound.

How is a curettage performed?

The curettage  procedure is performed under general anesthesia. Deep sedation is performed so that the patient does not move or feel pain, although at other times it can also be done by applying local anesthesia around the cervix . Then, to facilitate the entry of the instruments with which the curettage is performed, metal cylinders of different thicknesses are used. Once dilation is achieved, curettage is performed.

This can be done with a metal handle at the end of a long, thin handle, which is shaped like a “spoon”, or with a suction cannula. It should always be done under prophylactic antibiotic coverage. Once the curettage procedure is performed , it is verified that there is no excessive bleeding, that there is no injury to the cervix due to dilation and that the tissue sample is sent to the pathology unit.

Risks and complications of a curettage procedure:

  1. Risks associated with anesthesia, such as an adverse drug reaction and breathing problems;
  2. Bleeding or heavy bleeding;
  3. Infection in the uterus  or other pelvic organs;
  4. Perforation or perforation in the uterus ;
  5. Laceration or weakening of the cervix ;
  6. Scarring of the uterus  or cervix , which may require further treatment
  7. Incomplete procedure that requires another procedure to be performed.

What happens after curettage?

After curettage surgery , the patient is seen in a post-anesthesia care unit during recovery from anesthesia. Most patients who have had curettage  can return to normal activities within a few days. Non-steroidal anti-inflammatory medications may be recommended to relieve mild pain and cramping that may occur.

To lessen the chance of developing an infection after curettage , doctors advise patients not to use tampons or insert anything into the vagina for two weeks after surgery, and to refrain from sexual intercourse for the same period of time.

Follow-up office care depends on the surgeon. Most doctors return the patient to the office to make sure everything is ok and to discuss the results of the tissue samples that were removed after the curettage procedure . This is usually done 2 to 6 weeks after surgery. Sometimes the patient will simply be notified over a phone call with the results, and no direct contact with a healthcare professional is necessary.

When to contact your doctor:

Most women experience few complications after a curettage procedure , but you should be aware of symptoms that could indicate a possible problem after a curettage. Your doctor should give you specific instructions on what to expect, but contact them as soon as possible if you have any of the following after a curettage procedure if you feel:

  1. Dizziness or fainting;
  2. Prolonged bleeding (more than 2 weeks);
  3. Prolonged cramping (more than 2 weeks);
  4. Bleeding heavier than a menstrual period or filling more than one pad per hour
  5. Severe or increased pain;
  6. Fever above 100.4°F;
  7. Goosebumps;
  8. Smelly discharge.

Recommendations after a curettage:

Useful links: 

What recommendations are needed for curettage recovery ? After a curettage , the patient will usually get a list of instructions with the following suggestions:

  1. Avoid sexual intercourse for 2 weeks. The dilated cervix  needs a chance to get back to normal size. Until that time, bacteria can easily enter the uterus  and cause infection ;
  2. Only use sanitary napkins for bleeding. Avoid tampons for at least 2 weeks. Do not use douches;
  3. Be sure to come back for the follow-up appointment with the doctor. At this time, the doctor can discuss any lab reports on your tissue samples. The doctor will also want to examine you for signs of infection and make sure your cervix  has returned to its normal size.

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