Diagnostic curettage of the uterus - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | In Gynecology

meaning operation is curettage (scraping or) endometrium, more precisely, its functional layer.Scraping may be diagnostic when remote mucosa subjected to histological (or other) research, and therapeutic when therapeutic purposes remove the diseased lining of the uterus, or delayed in its spongy layer remains of the ovum.

should empty the bladder and rectum before surgery endometrial curettage.

skin of the perineum and external genital organs before surgery treated with 70% ethyl alcohol and 0.5-1% alcohol solution of iodine.With a very gentle, clear and correct performance of the operation can not do, especially for women with increased pain sensitivity.

To facilitate the expansion of the cervical canal is rational for 20-30 minutes before the start of the operation to enter the patient one of antispasmodics.The injection can be done directly in the cervical tissue.

vagina open mirrors and fix the neck of the uterus with forceps.It is best to grab the front lip of the cervix with forceps.After proc

essing the mucosa of the vagina and cervix with 70% alcohol and 0.5% ethyl alcohol solution of iodine to start anesthesia.For this purpose, as already indicated, is introduced into the cervix 1-2% lidocaine with epinephrine, injection can be done in two or four points: at the sides, front and rear (left).After anesthesia, you must wait at least 10-15 minutes.To analgesia lidocaine may be administered parauterine fiber.

After anesthesia produce uterine cavity sensing and proceed to the expansion of the cervical canal expanders Gegara diameter reamer each subsequent numbers increase by 0.5-1 mm.The maximum diameter of the reamer №29 equal to 2.4 cm. Start the expansion should be small diameter dilators consistently introducing dilators increasing diameter until the desired number extender will be found.Enter the tool by the same rules as the mother probe (right figure), it must conform to the curvature of the curve of the uterus.For diagnostic curettage of the mucous membrane of the uterus is sufficient to expand the cervical canal dilator №7-8, if necessary, the use of a large curette larger diameter dilators used, respectively (№10-12).Expansion of the cervical canal can be done with a special tip attached to the apparatus for vibrating massage.

curette Scraping produce, which also come in different sizes.Prior to introduction into the uterine cavity curette should be compared with its width the width of the handle extender if it is equal to or slightly less than the width of the handle, which is significantly better curette can be introduced smoothly into the uterus and will not injure the tissue.Gently curette having advanced to the uterine fundus, it is pressed against the acute part of the front wall of the uterus and boldly but gently withdrawn to the inner zevu and again carefully return to the bottom.Curette backward movement from the bottom to the inner zevu must be done on the mucous membrane, which has not been scraped and scraped located next to the uterine wall.So gradually, starting in the midline, scraped off the front wall of the uterus endometrium.Then turn sharp curette part backwards and systematically scraped mucous membrane of the posterior wall of the uterus.Rounding out the operation by scraping the mucosa from the bottom and the uterine horns.Only then did the same curette, turned backwards, remove the scraped mucosa from the uterus.During the entire operation the curette should not be greatly compress in hand.When rough strong pridavlivaniya curette to scrape the uterine wall may be the basal layer of the endometrium and even the muscle of the uterus.During the operation, you should never in anything at any cost to achieve audibility of the so-called "royal crunch".The mucous membrane scraped off, if the uterine wall is smooth, has no soft tissue, which resembles the movement of traffic on the curette wool.

Scraping is collected in the tray, and after the shift operation in the cheesecloth is washed with water from the blood, the vial is lowered (e.g., from under penicillin) and poured formaldehyde solution 10.5% or better 96% ethyl alcohol.In this form, scraping sent to the laboratory for histological examination indicating the date of the transaction, the names of the patient, her age, the day of the menstrual cycle, clinical diagnosis and the place where tissue is taken.

Contraindications for the procedure are:

· common infectious diseases

· heart disease, liver, kidney decompensated

· genitals diseases