Conditions for the restoration of the uterus after cleaning: possible complications and consequences. Curettage of the uterine cavity as an effective solution to gynecological problems

Often, with gynecological diseases, to confirm the diagnosis, it is required to examine the endometrium of the uterus. The most important processes occurring in the organs of the reproductive system depend on its condition and development. Cleansing is also prescribed for medicinal purposes. How the procedure goes, how painful it is, what the consequences may be, worries many women who are faced with the need for curettage of the uterine cavity. The risk of complications is minimal if the patient strictly follows the doctor's recommendations after the procedure.

Content:

What is scraping, what is it for

The uterus is lined from the inside with a membrane (endometrium), consisting of 2 layers. One of them borders directly on the muscles of the wall. On top of it is another layer, the thickness of which changes regularly in accordance with the functioning of the ovaries and the production of female sex hormones. Curettage is the complete removal of the functional layer. This procedure allows you to diagnose pathological neoplasms, as well as clean the organ cavity.

Types of procedure

There are several methods for such cleaning.

Regular cleaning consists in removing the mucous membrane only inside the cavity.

Separate differs in that the mucosa is first removed from the cervix, and then from its cavity. The selected materials are collected in different containers and examined separately. This allows you to clarify the nature of the pathology in each of the parts of the body.

An improved method is curettage simultaneously with hysteroscopy. Using a special optical device (hysteroscope), the uterus is illuminated from the inside, and the image of its surface is enlarged. Thus, the doctor does not act blindly, but purposefully. Hysteroscopy allows you to make a preliminary examination of the cavity, to act more accurately. This significantly reduces the risk of endometrial particles remaining in the uterus, complications after the operation.

Indications for cleaning for diagnostic purposes

It is used as an independent procedure, as well as an auxiliary one, which allows assessing the nature of neoplasms and the volume of the forthcoming abdominal surgery to remove tumors.

For diagnostic purposes, curettage is performed in the presence of the following pathologies:

endometrial hyperplasia - a condition in which it thickens excessively, neoplasms appear in it, and their nature needs to be clarified (the anomaly is first detected using ultrasound);
endometriosis (spread of the endometrium outside the uterus);
cervical dysplasia (a separate diagnostic procedure is performed if there is doubt about the benign nature of the pathology);
menstrual irregularities.

Therapeutic Purposes of Cleansing

Indications for curettage for therapeutic purposes are:

The presence of polyps. It is possible to get rid of them only by complete rejection and removal of the entire layer of the mucous membrane. Most often, after such a procedure, there are no relapses.
Severe bleeding during or between periods. Emergency cleaning helps prevent large blood loss. It is carried out regardless of the day of the cycle.
Infertility in the absence of obvious hormonal disorders and gynecological pathologies.
Uterine bleeding in postmenopausal women.
The presence of adhesions in the uterine cavity.

obstetric curettage

Carried out in the following cases:

during an abortion (artificial termination of pregnancy is performed in this way for a period of not more than 12 weeks);
after a miscarriage, when it becomes necessary to remove the remnants of the fetal egg and placenta;
with a frozen pregnancy (it is necessary to remove the dead fetus and completely clean the uterus to prevent inflammatory processes);
if there is heavy bleeding in the postpartum period, which indicates incomplete removal of the placenta.

Video: Indications for separate diagnostic curettage of the uterus

Contraindications for cleaning

Planned curettage is not carried out if a woman has infectious diseases or acute inflammatory processes in the genitals. In emergency cases (if, for example, bleeding occurs after childbirth), the procedure is carried out in any case, since it is necessary to save the patient's life.

Cleaning is not carried out if there are cuts or tears in the wall of the uterus. This method is not used to remove malignant tumors.

Carrying out the procedure

Curettage is usually performed in the last days of the cycle before the onset of menstruation. During this period, the cervix is the most elastic, it is easier to expand it.

Training

Before the procedure, a woman needs to pass a general blood and urine test for the presence of inflammatory processes. Blood clotting is tested. They are tested for syphilis, HIV and hepatitis.

Before the procedure, a microscopic analysis of a smear from the vagina and cervix is performed to determine the composition of the microflora.

3 days before the cleaning, the patient must stop using vaginal medicines, as well as refuse douching and refrain from sexual intercourse. The procedure is carried out on an empty stomach.

How is the operation performed

Curettage of the uterine cavity is carried out exclusively in a hospital, under conditions of maximum sterility. Anesthesia is carried out by using a mask with nitrogen dioxide or intravenous administration of novocaine. Sometimes general anesthesia is used.

During the procedure, the uterus is expanded with special devices, and its internal size is measured. The upper mucous membrane of the organ is scraped off with the help of a curette. If diagnostics is necessary, the material is sent for histological examination.

When carrying out an abortion or cleansing after a miscarriage, missed pregnancy, childbirth, the aspiration method is used. Removal of the contents of the uterine cavity is performed using a vacuum. In the same way, blood is removed from it in case of dysfunctional uterine bleeding or stagnation inside the uterus. This method is more gentle than curettage, since there is no risk of damage to the cervix or uterine wall.

With hysteroscopic curettage, a tube with a video camera is inserted into the uterus to inspect the surface. After removing the top layer of the endometrium, make sure that the mucosa is completely removed.

After the procedure, ice is placed on the lower abdomen. The patient remains in the hospital for several hours so that the doctors can fully verify that there is no risk of bleeding.

After operation

Immediately after the anesthesia wears off, a woman may feel quite severe abdominal pain for 2-4 hours. Then, for another 10 days, sensations of a weak pulling pain persist. Blood discharges in the first hours are strong, contain blood clots. Then they turn into spotting, they may appear for another 7-10 days after the operation. If they stop too quickly, and at the same time the woman's temperature rises, this indicates the occurrence of blood stasis (hematometers) and the inflammatory process. Treatment is with oxytocin, which increases uterine contractility.

To eliminate pain, painkillers and antispasmodics (no-shpa) are prescribed to help speed up the removal of blood residues. For several days, antibiotics are taken to prevent the occurrence of an inflammatory process in the uterus.

2 weeks after cleaning, a control ultrasound examination is performed to make sure that the procedure was successful. If the study shows that the endometrium is not completely removed, the cleaning must be repeated. The result of a histological examination of the cells of the removed material is ready in about 10 days, after which the doctor will be able to make a conclusion about the need for further treatment.

Menstruation after cleaning will begin in 4-5 weeks. The frequency of their occurrence is restored after about 3 months.

Warning: A doctor should be consulted immediately if blood impurities in the secretions do not disappear after 10 days, while the pain in the abdomen increases. The appearance of elevated temperature should be alerted a few days after scraping. It is imperative to visit a doctor if menstruation after cleaning the uterus has become too plentiful or very scarce, and their pain has also increased.

After the operation, until the complete disappearance of its consequences, it is necessary to refuse douching, inserting tampons into the vagina, drugs not prescribed by a doctor. You can not put a hot heating pad on your stomach, visit a sauna, take a bath, stay in a hot room for a long time or under the sun.

Do not take aspirin or other anticoagulants for 2 weeks after cleaning. Sexual relations can be resumed 3-4 weeks after curettage, when pain and the risk of infection disappear.

Pregnancy after scraping

Curettage, which passed without complications, usually does not affect the course of pregnancy and childbirth. The opportunity to become pregnant appears in a woman after a few weeks, but doctors recommend planning her onset no earlier than 3 months after cleaning.

Video: Is pregnancy possible after cleaning the uterus

Possible Complications

After a qualified curettage procedure, complications appear extremely rarely. Sometimes, due to a violation of muscle contractility, a condition such as hematometra occurs - stagnation of blood in the uterus. The inflammatory process begins.

During the procedure, a tear of the neck with instruments may occur. If it is small, then the wound heals quickly on its own. Sometimes you have to stitch.

During blind surgery, damage to the uterine wall can occur. In this case, the gap needs to be closed.

Possible damage to the basal (inner layer of the endometrium, from which the superficial functional layer is formed). Sometimes the restoration of the endometrium becomes impossible because of this, which leads to infertility.

If the polyps are not completely removed, they may grow again, and repeated curettage will be required.

Collapse

Curettage of the uterus is a traumatic procedure for removing the endometrial layer using a loop or other surgical instruments. There is such a procedure for treatment and diagnostics, the first is usually more extensive. But regardless of the type and purpose of the procedure, the recovery period after such an intervention is quite long, and it must be carried out correctly so that there are no consequences and complications. About how rehabilitation takes place after cleaning (curettage) of the uterus, will be described in this material.

Period duration

Strictly speaking, such an intervention is not considered a surgical operation, although in fact it is traumatic, and during it an extensive wound surface is formed. For example, after scraping to remove cysts or with endometriosis, almost the entire inner surface of the uterus becomes the wound surface, since the endometrium is removed from the entire surface.

Scraping

Recovery after curettage has a number of normal characteristics. In case of deviation from the norm, it is recommended to immediately consult a doctor. Normally, during this period, there may be:

Pain in the lower abdomen due to the fact that the uterus contracts after scraping;
minor bleeding;
Sensations of pulling, aching pain in the back.

Such symptoms may be present only in the first few days. If it persists after a week, then you need to see a doctor. You also need to act if there is severe bleeding and excessively intense pain, or a temperature appears after cleaning the uterus.

During this period, it is necessary to reduce physical activity, which will have a good effect on well-being. You can not bathe in the bathroom, hygiene must be observed with the help of a shower. In this case, it is better not to use chemicals for intimate hygiene, drugs administered vaginally, tampons and douches. Avoid overheating - do not visit saunas, baths, solariums, the beach, do not swim in open water and pools, carefully observe hygiene.

Preparations

Treatment after curettage of the uterine cavity involves taking medications. They are not aimed at directly promoting the growth of the endometrium, since this is not necessary - this is a natural process that occurs physiologically. Taking medications is carried out in order to improve the condition and well-being of the patient, avoid relapses of the disease, and also prevent the development of serious consequences and complications, for example, infection.

Antispasmodics

Antispasmodics after curettage of the uterus should be administered with caution. This is due to the fact that after this procedure, the uterus contracts, pushing out excess endometrium and rejecting its remnants. This is a normal physiologically determined process in this situation, but it causes quite severe pain in the lower abdomen, which persists in the first days after the intervention.

It can cause quite severe discomfort to the patient, but it is undesirable to remove it with antispasmodics, because if the uterus does not contract, the healing process may be delayed. In severe conditions, No-shpu and other drugs are prescribed.

Diagnostic curettage

Antibiotics

Antibiotics after curettage of the uterine cavity are always prescribed. They are taken in a course of five to ten days, one or two tablets per day, depending on the selected drug. Depending on the condition of the patient, the course may begin on the day of the cleaning or a day or two earlier.

Why are antibiotics prescribed at all? Drinking them is necessary in order to avoid the addition of any concomitant infection. The fact is that with this intervention, not only a wound surface is formed, but local immunity is also greatly reduced. All this in combination significantly increases the likelihood of infection in the uterus. To prevent this, strong broad-spectrum antibiotics are prescribed, such as Tsiprolet, Ceftriaxone, Amoxiclav, etc.

Herbs

How to restore the uterus after curettage? In general, she is able to recover herself, this is a normal process, similar to the restoration of the endometrium after menstruation, when it is almost completely rejected and renewed. The growth of the mucous layer within the cycle and after curettage occurs under the action of the hormone estrogen produced by the ovaries. The more it is, the more actively the endometrium grows.

Estrogen preparations can cause hormonal imbalance, but the use of herbs rich in phytoestrogens (plant analogues of estrogen) works very well. You can drink decoctions and infusions from a boron uterus and a red brush. The upland uterus after scraping is especially indicated, as it contains more phytoestrogens than other herbs.

Anti-inflammatory drugs

Anti-inflammatory drugs are not always prescribed, but in most cases they are still indicated. They are needed for about the same thing that antibiotics are needed for - they prevent the development of an inflammatory process on the wound surface. Such drugs as Nurofen, Ibuprofen are prescribed, which are taken 2-3 tablets per day for a week, starting from the day of the procedure. For the same period, Diclofenac can be administered by injection. In addition to the direct anti-inflammatory action, they are also good pain relievers.

If a temperature appears after scraping, then this may indicate the beginning of the inflammatory process. Therefore, you must immediately consult a doctor.

intimate life

You can have sex within a week after the procedure, but it is better to coordinate this with your doctor. In addition, if during intercourse the patient feels pain, then you should immediately contact a specialist. It is important to carefully observe hygiene and use barrier methods of contraception to prevent various infections from entering the uterine cavity.

Sport

You can go in for sports as usual about a month after the intervention. At the same time, you can return to light loads, such as gymnastics or aerobics, earlier - after about a couple of weeks. The time to start playing sports should be discussed with a specialist, since a lot depends on the individual characteristics of the body and the speed of healing.

Example of daily routine

For a quick recovery, it is important to properly balance the modes of work and rest. Ideally, you need to sleep at least 8 hours a day, work no more than 8 hours, and rest at least 8 hours. At the same time, if the work is associated with physical exertion, then you need to take sick leave for at least a few days after the procedure. If the work is not hard physically, then, usually, you can return to it the very next day. But this must be agreed with the doctor.

Diet Example

You need to eat natural healthy foods, avoiding fried, fatty and smoked foods. An example diet might look like this:

Breakfast - yogurt or cottage cheese, egg, whole grain bread, weak coffee;
Second breakfast - fruit;
Lunch - vegetable or low-fat meat soup, a side dish of cereals and white low-fat fish, tea;
Snack - fruit fat, kefir, or yogurt;
Dinner - vegetable side dish and chicken breast, rosehip broth.

It is advisable to include in the diet foods rich in phytoestrogens - corn, soy, yams.

Pregnancy

Pregnancy after curettage is possible, and often even more likely, if the pathological endometrium was removed during it. Usually, menstruation begins around the third week after the procedure, since during this time the mucous layer of the uterus has time to recover. At the same time, the menstrual cycle is completely normalized and becomes regular after about 4 months. In general, it is possible to plan conception as early as six months after the procedure, but before starting attempts, it is better to consult a doctor.

Intervention progress

Conclusion

Curettage is a traumatic, but necessary procedure. It should not be avoided if it has been prescribed by a doctor, as this can have unpleasant health consequences. Provided that the recovery period is carried out correctly, complications after curettage are extremely unlikely, and this procedure affects health only on the good side.

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Scraping is, though small, but still the same operation. It is performed under general anesthesia (intravenous) and takes 15-25 minutes. Depending on the purpose of scraping, a woman can be discharged on the same day or after 1-2 days. In order to understand how it is necessary to restore the body after curettage, what to do after the procedure, it is necessary to dwell on the structure of a normally functioning uterus and understand what happens during curettage.

The uterus is a single hollow organ that is located in the pelvis and ends with the exit to the outside of the vagina. Between the vagina and the uterus there is a physiological narrowing called the cervix. The uterus consists of three layers: the outer (serous), which is in direct contact with the peritoneum; middle (muscular) and internal (endothelial) - endometrium. The structure of the endometrium is arranged in such a way that its functional layer is rejected with each cycle (menstruation), and the basal (deep) layer takes part in the renewal of the functional layer (contains germ cells). During a normal menstrual cycle, there is a maturation, thickening of the functional layer for the attachment of the fetal egg. If fertilization does not occur, then the functional layer is rejected, menstruation begins.

There are two types of scraping: diagnostic and therapeutic. Diagnostic curettage is carried out immediately before menstruation, in order for a functional renewal of the outer layer of the endometrium to occur. With diagnostic curettage, the doctor sends the selected material (scraping) for histological examination. Therapeutic curettage in case of detection of a neoplasm according to ultrasound data is performed after menstruation, when the endometrium is thin and it is possible to remove a sprouted tumor or polyp.

Scraping. Indications

Indications for diagnostic curettage:

Violation of the menstrual cycle;
Infertility;
history of miscarriages;
Uterine fibroids, adenomyosis, endometrial hyperplasia, uterine polyp, endometrial cancer, synechia and adhesions in the uterine cavity detected on ultrasound;
Before a planned gynecological operation.

Indications for therapeutic curettage (with removal):

Polyp of the uterus;
endometrial cancer;
uterine fibroids;
Hyperplasia of the endometrium;
Synechia and adhesions;
Uterine bleeding;
To remove the membranes (with complicated abortions, childbirth);
Miscarriage.

The success of the hysteroscopy operation (curettage) depends on the professionalism and delicacy of the gynecologist. It is in our clinic that highly specialized gynecologists work, who carefully carry out this manipulation.

Hysteroscopy can cause complications. Allocate early and late complications.

Early complications after curettage:

perforation of the uterus. It can occur with strong pressure on the probe or forceps, perforation is also possible if the uterine wall is changed and becomes loose. Small perforations are able to tighten on their own, larger doctors sew up on the spot;
Tearing of the cervix. Occurs when the bullet tongs slip off. Often occur with friability of the wall of the organ.

Late complications after curettage:

Inflammation of the uterus. Occurs if the operation was performed in the presence of an inflammatory process (smear III-IV purity), or if the rules of asepsis and antisepsis were violated;
Hematometra - accumulation of blood in the uterine cavity. After the curettage procedure, a spasm of the cervix may occur, then the blood secreted from the uterus accumulates in its cavity. To prevent this complication, gynecologists prescribe antispasmodics for several days;
Pyometra - occurs if the hematometra begins to suppurate. It is accompanied by pain in the lower abdomen and an increase in body temperature above 37.5. Doctors prescribe antibiotic therapy in prophylactic doses;
Damage to the endothelium of the uterus. If the procedure is carried out by a careful gynecologist, then this complication should not occur. If curettage is carried out, affecting the deeper, growth layers of the endometrium, then the restoration of the functional layer of the endometrium is disrupted. This is manifested by the non-occurrence of menstruation. Normally, after the scraping procedure, menstruation should occur 4-5 weeks after this manipulation. In the absence of menstruation in this period, you should immediately consult a doctor. Endometrial repair treatment is a long-term conservative treatment procedure;
When scraping after an abortion (miscarriage) - residual elements of the membranes. A month after the manipulation, the gynecologist prescribes a control ultrasound. If there are residual membranes of the fetal egg, then a second curettage is prescribed with their removal.

After scraping, what to do? A gynecologist prescribes antispasmodics and antibacterial therapy to a woman in prophylactic doses to prevent complications. Also, the doctor recommends to refrain from douching, using tampons and from sex for two weeks. It is necessary to immediately consult a doctor if a woman develops yellowish mucous discharge, or bloody discharge with an unpleasant odor, this indicates the development of an inflammatory process in the uterus. Bloody discharge for two to three days is a variant of the norm. If spotting lasts longer, you should consult a doctor, this indicates uterine bleeding. The non-occurrence of menstruation within 45 days after hysteroscopy is also a formidable sign - it indicates damage to the deeper layers of the endometrium.

A woman can plan pregnancy after hysteroscopy in 2-3 weeks. Non-appearing pregnancy within 6-9 months requires consultation and examination by a gynecologist.

The period after curettage of the uterine cavity requires a special approach on the part of the doctor and the responsible implementation of all recommendations on the part of the patient. The reproductive and physical capabilities of the female body are not unlimited, therefore, an important task of the gynecologist who performed the cleaning of the uterus is considered to be a full-fledged, careful observation and provision of a protective regime.

In the period after cleaning the uterus, experts identify three main areas of work for full rehabilitation:

Prevention of infections.
Restoration of the endometrium and the menstrual cycle.
Recovery of physical and mental health.

To achieve the set goals, gynecologists give recommendations in terms of taking antibacterial drugs, oral contraceptives, limiting physical activity, maintaining sexual rest and performing general strengthening measures.

Not everyone is able to quickly enter the usual rhythm of life, resume sports and physical activity. Recovery time largely depends on the individual characteristics of the body.

After curettage, mild abdominal pain, mild anesthesia-related dizziness, and moderate bleeding are usually noted.

Recovery of the uterus after curettage, both therapeutic and diagnostic, lasts one menstrual cycle, the whole body - from 2 to 6 months.

General well-being after scraping:

Body temperature up to 37.2-37.3 is considered normal in the first 2-3 days.

Moderate abdominal pain lasts up to 7 days.

Mild dizziness is allowed.

Allocations after the cleaning procedure:

The first few days marked discharge from the genital tract in the form of fresh blood, as during menstruation.
A week later from the moment of curettage, the discharge takes on a bloody character: they become mucous and have a brown color due to the admixture of altered blood.
The restoration is completed with secretions that have a yellow color, which gradually take on a classic look: a scanty, mucous discharge, which, when dried, takes on a yellowish tint.
The duration of discharge is normal in the recovery period is 10-12 days.

Following curettage, menstruation should begin after 25-45 days.

Normally, the first day of menstruation should come after a period of time equal to the length of the cycle before cleaning (provided that it is regular).

What you should pay attention to, and when you need to seek help from medical professionals if a woman has undergone curettage:

Prolonged (more than 20 days) bloody discharge.
Scanty or heavy menstruation, spotting, not associated with menstruation in the long term after curettage. These symptoms may indicate the development of endometriosis of the cervix, hormonal failure.
Unpleasant smell of discharge.
Type of discharge, like "meat slops."
Increased secretions during light physical exertion.
Pain in the lower abdomen lasting more than a week after scraping.
A sharp cessation of discharge after uterine curettage, which may indicate the accumulation of clots in the cavity of the organ (hematometer).
Profuse bleeding.
Increase in body temperature.
Loss of consciousness.

The above symptoms may indicate the development of endometritis.

The severity of some purulent-inflammatory diseases of the internal genital organs after curettage may not correspond to the clinical picture and laboratory parameters.

That is why it is extremely important to be under the supervision of a doctor in the presence of even minimal signs of infectious complications.

What is the dangerous period after the procedure

The uterine cavity after cleaning is an extensive wound surface. The lion's share of recommendations after curettage will be aimed at preventing microorganisms from entering the cavity of the operated organ. Gynecologists are aimed at preventing the development of inflammation of the reproductive organs and its chronicity.

Specialists distinguish two groups of risk factors for the development of infectious complications after uterine curettage:

Main group. This category includes women with a history of endometritis, chronic recurrent chlamydia, urea- and mycoplasmosis, candidiasis, human papillomavirus infection, persistent vaginal dysbacteriosis. In such patients, the likelihood of developing purulent-inflammatory diseases in the gynecological area during curettage is most likely. Patients are subject to the closest attention from physicians. This also includes emergency cases of scraping.

Additional group. Patients who underwent uterine cleaning due to bleeding (endometrial hyperplasia), abortion, curettage of placental or ovum remnants have a lower risk of infectious complications compared to the main group.

Women who have undergone diagnostic curettage have the lowest risk of developing complications of an infectious nature. Typically, this type of study is carried out with infertility of unknown origin, in preparation for IVF, suspected polyps and subserous fibroids, and menstrual irregularities.

Factors indirectly affecting the period after curettage:

Obesity.
Diabetes.
Anemia.
Hypothyroidism.

The above diseases have an indirect effect on the course of the recovery period of curettage, but their presence significantly reduces physical strength, the body's resistance to infections and slows down the healing process of the wound surface in the uterus after curettage.

The most common complication of an infectious nature after curettage is endometritis - inflammation of the inner layer of the uterus.

The causative factor of the disease is the conditionally pathogenic flora of the vagina (staphylococci, streptococci, E. coli), as well as representatives of the pathogenic flora, if the patient before the operation had untreated sexually transmitted infections - chlamydia, ureaplasmosis, mycoplasmosis, gardnerellez and others. That is why, in the period after therapeutic curettage, gynecologists recommend taking antibacterial drugs without fail, regardless of the infectious history. After diagnostic cleaning, you can limit yourself to taking sulfonamides.

According to statistics, the frequency of endometritis after uterine cleansing is 20%.

Not always purulent-inflammatory diseases of the genital area after curettage appear due to non-compliance with the doctor's recommendations. Nosocomial infection is relevant in our time. A woman should opt for modern clinics with rich obstetric and gynecological experience.

Poor cleaning can be the result of the penetration of endometrial cells into the tissues of the neck, which leads to endometriosis.

Sexual life is excluded for 3 weeks after cleaning. The goal is to prevent infectious complications and bleeding. In addition to bacteria, semen contains prostaglandins that relax the uterus.
Within 6 months after curettage, it is recommended to use a condom to prevent pregnancy.
For a month, you should not take a bath and visit the pool.
It is not recommended to use swabs to absorb blood after curettage. This can provoke the development of inflammatory processes in the uterine cavity.
After scraping, physical activity should be limited as much as possible.

Antibacterial drugs should be taken strictly at regular intervals.
The minimum duration of taking antimicrobials: 3 days for Azithromycin and 5 days for other drugs.
The dosage of the drug should correspond to the weight of the patient.
Drinking alcohol while taking antibiotics is not recommended.
To relieve pain, you should take Ibuklin or Diclofenac.
To prevent the formation of adhesions, as a rule, enzyme preparations are prescribed (Wobenzym, Longidase).

Restoration of menstrual function is an important part of the rehabilitation period after curettage. The cyclic work of the female body is very sensitive to various fluctuations and outside interference. "Artificial" disposal of the endometrium sends the wrong signals to the main regulators of the menstrual cycle - the hypothalamus and pituitary gland. The ovaries, as performers, will also respond to this type of impact.

The drugs must be taken from 2 to 6 months, depending on the diagnosis that served as the reason for cleaning the uterus.

Oral contraceptives after the procedure for cleaning the uterus:

Jess.
Logest.
Belara.
Janine.
Silhouette.
Newsletter and others.

The first tablet is taken on the day of scraping. The selection of the drug is carried out only by a gynecologist and based on the results of a blood test for hormones.

After curettage, physical activity is recommended to be resumed no earlier than after 2 months. With a visit to the gym, you should wait, and lifting weights (more than 3 kg) and running are also excluded. Any physical activity is stressful for the body, which, of course, reduces immune activity and will prevent healing.

EHF-therapy. The therapeutic effect is achieved by irradiation with electromagnetic waves of the EHF range, which increases the nonspecific resistance of the body, increasing resistance. It is recommended to use EHF-therapy after cleansing to prevent endometritis.
ultrasound therapy. The method is recommended for the prevention of the formation of adhesions in the uterus and small pelvis, resulting from curettage.
Phototherapy. Infrared rays have an anti-inflammatory effect.

After manipulation of curettage, many experts recommend using sorption therapy as part of a preventive focus, the essence of which is the introduction of a special solution into the uterine cavity that has the properties of a sorbent and an antiseptic. Usually a mixture of Enterosgel and Dioxidin is used. The composite solution is inserted into the uterus using a thin catheter. Due to its thick consistency, the mixture does not flow out, therefore, special restrictive recommendations for physical activity are not required. An aspiration biopsy is used to monitor healing. The aspirate is examined under a microscope and the condition of the obtained cells is assessed.

After the procedure for cleaning the uterus, doctors monitor the healing process using the method of aspiration biopsy. It is carried out on the 23-25th day of the cycle after 2 months after all types of curettage.

Artificial termination of pregnancy by curettage for medical reasons is a strong stress factor that negatively affects the adaptive-compensatory capabilities of the body.

An equally important task facing the gynecologist is to provide comprehensive rehabilitation using funds aimed at restoring psychovegetative disorders.

As a rule, after curettage, the patient is recommended the following therapeutic measures and drugs:

Acupuncture.
Psychotherapy.
Herbal soothing preparations for 2 weeks after cleansing (Phytosedan, soothing teas with lemon balm, sedative preparations).
Antidepressants (Coaxil, Gelarium, Azafen) for 10-20 days.

The problem of purulent-inflammatory diseases in gynecological practice after curettage continues to be one of the leading ones. Full, adequate appointments and compliance with them by the patient in the recovery period guarantee the complete absence of consequences and complications in terms of reproductive function.

Endometritis after curettage is a common complication that occurs in women after an abortion, removal of uterine polyps, missed pregnancy, or remnants of a fetal egg during spontaneous miscarriage. This disease carries a great danger to women's health and therefore requires an early visit to a doctor and mandatory medical treatment.

Causes of illness after abortion

Curettage (curettage) is a complex gynecological procedure during which the endometrium, the upper mucous layer that lines the uterine cavity, is removed.

When a pregnancy is terminated, a thorough cleaning of the organ is carried out, removing not only the mucous membrane, but also the fetal egg. During the operation, the integrity of the upper layer of the uterine cavity is violated, as a result of which, during the rehabilitation period, an inflammatory process may occur on the walls of the uterus, which characterizes the development of endometritis.

This disease is caused by the addition of a secondary bacterial infection, provoked by improper procedure, non-compliance with the rules of asepsis during curettage, and refusal to use antibiotics in the postoperative period.

If the cleaning was not done thoroughly enough, there are blood clots, remnants of the fetal egg and placenta in the uterine cavity, which are a favorable environment for the reproduction of microbes that cause inflammation. Infection can also be introduced with non-sterile instruments directly during curettage.

Other factors contribute to the occurrence of endometritis after scraping. Among them:

decreased immunity;
the presence of sexually transmitted diseases;
stress;
non-compliance with intimate hygiene;
hormonal disbalance.

The greatest risk of developing an inflammatory process in the postoperative period occurs with surgical curettage, which is considered the most traumatic, and with vacuum aspiration. With a pharmacist, such a complication practically does not occur if, after taking the appropriate medications, the uterine cavity is completely cleared.

Characteristic symptoms of the disease

After curettage, acute endometritis most often develops, which has strongly pronounced symptoms and causes a deterioration in the woman's well-being. The first manifestations of the disease occur 3-4 days after the cleaning.

Symptoms of acute endometritis include:

pressing pains in the abdomen;
temperature rise to 38°C or more;
vaginal discharge with an unpleasant odor;
increased heart rate;
weakness, lethargy;
chills;
painful urination.

If a woman was not given timely assistance, endometritis quickly becomes chronic, which is characterized by a sluggish inflammatory process in the uterus, accompanied by frequent aching pains in the lower abdomen, serous vaginal discharge, and uterine bleeding. In the future, a woman experiences disruptions in the menstrual cycle, menstruation becomes plentiful or too scarce, there is severe discomfort during intercourse.

Acute post-abortion endometritis is the basis for hospitalization in a hospital, where the patient is provided with complete rest, bed rest, and medication is prescribed. In a medical institution, an ultrasound of the uterus is mandatory.

If during the study it is established that there are remnants of the fetal egg or blood clots in the organ, the woman is sent for re-cleaning, after which therapy begins immediately.

The basis of treatment is antibacterial drugs, selected taking into account the sensitivity of the infectious agent to antimicrobial substances. The following medicines are used:

Gentamicin.
Clindamycin.
Amoxicillin.
Levomycetin.
Ceftazidime.
Lincomycin.

Perhaps the simultaneous appointment of several drugs belonging to different groups of antibiotics. Also, along with antibacterial agents, antiprotozoal drugs are often used to eliminate the anaerobic flora in the uterus (Metronidazole).

For symptomatic therapy, anti-inflammatory, antipyretic and analgesic drugs (No-shpa, Indomethacin, Ibuprofen, Baralgin) are prescribed. In order to prevent the development of candidal infection provoked by antibiotics, antifungal drugs are used, probiotics are used to restore the microflora of the body, and immunomodulators and multivitamin supplements are used to increase immune protection.

If endometritis is accompanied by severe intoxication, droppers with protein and saline solutions are prescribed.

At the final stage of treatment, in order to accelerate the processes of regeneration of the mucous layer, it is recommended to undergo a course of physiotherapy (UHF, electrophoresis, magnetotherapy).

Similar treatment regimens are used for chronic endometritis. First of all, infectious agents are eliminated with antibiotics, then a course of restorative treatment is carried out aimed at regenerating the uterine mucosa. During this period, hormonal drugs and agents with a metabolic effect are used, which improve metabolism and accelerate the healing of the endometrium. It is strongly recommended to undergo physiotherapy, mud and hydrotherapy.

What could be the consequences

In the absence of adequate timely treatment of endometritis, pus begins to accumulate in the uterine space, which can then penetrate into the ovaries, fallopian tubes and abdominal cavity, which endangers not only the functioning of the reproductive system, but also the life of a woman, increasing the risk of developing sepsis. The disease can cause the formation of cysts and polyps in the uterus, contribute to the appearance of adhesions in the pelvic organs, disrupting their functioning.

Endometritis, which develops after curettage, often causes partial or complete infertility, prevents normal pregnancy and provokes miscarriages. Due to the disease, the processes of renewal of the mucous layer of the uterus are disturbed, thinning or hyperplasia of the endometrium can be observed. These disorders prevent the attachment of the fetal egg to the wall of the organ and the onset of pregnancy.

Prevention

To prevent the development of endometritis after curettage, doctors carefully follow the rules of asepsis and antisepsis during the operation. After the procedure, the patient is prescribed antibacterial drugs that prevent the development of pathogenic flora in the uterus. To make sure there are no blood clots and fetal debris in the organ, an ultrasound examination is performed.

The woman herself during the entire rehabilitation period must carefully monitor intimate hygiene and refrain from sexual intercourse. When the first signs of endometritis appear, you should immediately seek medical help.

Period duration

Scraping

Recovery after curettage has a number of normal characteristics. In case of deviation from the norm, it is recommended to immediately consult a doctor. Normally, during this period, there may be:

Pain in the lower abdomen due to the fact that the uterus contracts after scraping;
minor bleeding;
Sensations of pulling, aching pain in the back.

Diagnostic curettage

If a temperature appears after scraping, then this may indicate the beginning of the inflammatory process. Therefore, you must immediately consult a doctor.

You need to eat natural healthy foods, avoiding fried, fatty and smoked foods. An example diet might look like this:

Breakfast - yogurt or cottage cheese, egg, whole grain bread, weak coffee;
Second breakfast - fruit;
Lunch - vegetable or low-fat meat soup, a side dish of cereals and white low-fat fish, tea;
Snack - fruit fat, kefir, or yogurt;
Dinner - vegetable side dish and chicken breast, rosehip broth.

It is advisable to include in the diet foods rich in phytoestrogens - corn, soy, yams.

Intervention progress

Many women in their lives have come across a uterine cleansing procedure, which is performed to treat and diagnose many female diseases. Cleaning is a surgical operation, and after it is carried out, the woman's body needs a certain amount of time to recover. It is impossible to say unequivocally how long it will take to restore health after cleaning the uterus, since this process depends on the characteristics of the patient's body.

Is it possible to get pregnant after the cleansing procedure?

Planning for conception after cleaning will largely depend on what caused such an operation. You can usually get pregnant within a couple of weeks after cleansing. Childbirth, as a rule, takes place absolutely normally.

In this video you can learn more about cleaning the uterus:

However, according to experts, you should not try to get pregnant immediately in the first month after the procedure. Although menstruation resumes within a month, it will take a longer period of time for the body to recover. After such an operation, a woman needs rest, a full and balanced diet, positive emotions that will help the body return to normal as soon as possible.

If the cause of the cleansing was a missed pregnancy or miscarriage, then in the next six months (or at least three to four months) you should not even think about getting pregnant. The fact is that a woman's body will need time to get stronger enough to restore hormonal balance, emotional state. And if you manage to conceive a child in the first month after a miscarriage, then sad consequences are possible. It is very likely that such a pregnancy will also end in an interruption, and again it will be necessary to do the cleaning.

Recovery after cleaning the abortion will be much faster, and if the patient does not plan to become pregnant in the near future, then you can start using contraception in the first weeks after the procedure.

But if, after six months after the gynecological cleaning, you still cannot get pregnant, then in this case you need to consult a doctor who will prescribe adequate treatment. Sometimes, as a result of curettage, a woman's ability to conceive a child is impaired, but such cases are quite rare. In any case, planning for the conception of a child can be discussed with your doctor. After all, only a specialist can correctly assess the state of health of a woman, suggest the right treatment.

What complications should be feared after cleaning?

After the transferred procedure of curettage, the following complications are possible:

An infectious process of an inflammatory nature in the uterine cavity (endometritis), which occurs when microbes enter it, it is accompanied by a high temperature;
Bleeding, which is noted, as a rule, in women who have problems with blood clotting. Unlike normal discharge, bleeding after cleansing is a fairly serious threat to women's health;
Hematometra (accumulation of blood clots in the uterine cavity), which is dangerous for the subsequent development of infection. The rapid cessation of discharge, fever are the first signs of such a complication;
Remains of particles of the fetus, tissues after the cleaning procedure. Curettage is carried out blindly, and sometimes tissue fragments may remain in the most inaccessible places. They can provoke the development of an inflammatory process in the uterine cavity;
The formation of adhesions in the uterine cavity, which can sometimes threaten infertility;
Infertility. Such a complication, as noted earlier, is extremely rare.

What can be done to avoid such complications? For the speedy recovery of the woman's body after cleansing and in order to avoid complications, you should immediately contact the treating specialist who will prescribe the treatment. You need to contact in such cases:

In the presence of severe bleeding;
If the temperature has risen to 38 degrees;
When there is severe pain in the abdomen.

It is important not to forget that self-treatment or its delay can have disastrous consequences for the health and life of a woman.

What is done after the cleansing operation for the speedy recovery of the body?

The regimen after the scraping operation and treatment is prescribed by the doctor. If the operation was successful, then, subject to all the instructions of the specialist, in the next day or two, the woman will be able to fully recover.

In order for the recovery of the body not to be delayed, it is necessary to follow the recommendations of doctors unconditionally. What are the restrictions in the postoperative period? So, after cleaning it is impossible:

Take a bath (shower only);
Do douching;
Visit baths or saunas;
Lift heavy objects;
Start a sexual life;
Use vaginal tampons.

Sex after cleaning the uterus

Many women are worried about whether it is possible to start having sex after cleaning? For two weeks it is undesirable to live sexually. Why? The fact is that after cleaning the neck of the uterine organ remains open for a certain time, small erosions are observed on it (a consequence of scraping). For this reason, infections can enter the uterine cavity during intercourse, which, in turn, will lead to undesirable consequences.

There is a possibility that during the first time after cleaning, during sex, pain will occur, different in strength. This happens after cleaning, but if the pain does not go away after two months, you need to make an appointment with a doctor.

Menstruation after cleansing

The first menstruation should pass a month and a half after the procedure, but much will depend on the state of health of the woman herself. A delay in menstruation is possible if a woman had an abortion, but in a few months the cycle should improve. If the period of normalization of the cycle is delayed, there is an increased temperature, then you should immediately go to the treating specialist.

In cases where the removal of a frozen pregnancy, miscarriage, polyps was carried out, menstruation can be quite long and plentiful. There is no need to be afraid here. But the complete absence of menstruation after the allotted time is a serious reason for seeking advice from a gynecologist.

For more information about menstruation, watch this video:

How long does the recovery process take after cleaning?

In general, cleaning is an operation that is quite safe to do, and its effectiveness has been proven over the years. But, as with any other operation, for a complete and quick recovery after it, you need to follow two rules: