What is scraping for?
Curettage is an invasive gynecological procedure, performed for diagnostic or operational purposes to remove a portion of the endometrium or an abnormal mass contained in the uterus. The curettage was renamed curettage in reference to the instrument (curette) used during the operation.
Diagnostic scraping is performed to trace the origin of some menstrual disorders (eg menorrhagia, metrorrhagia, hypermenorrhea, atrocious menstrual pain) or to confirm / deny a suspicion of cervical cancer. Operational scraping is instead indicated to sever tumors, fibroids or uterine polyps and to voluntarily remove the product of an unwanted pregnancy (no later than the 13th week of gestation).
But what happens after curettage? What are the risks and possible complications?
Let us try to clarify a little and give an exhaustive answer to the most recurring doubts that beset many women after a scraping operation.
What to do next
The duration of the procedure varies from 10 to 20 minutes. After curettage, the patient is returned to the hospital room, waiting for the anesthesia to vanish. Upon awakening, the patient must not get up for any reason, unless otherwise medically indicated. In the hours immediately following the curettage, the woman may complain of nausea, vomiting and drowsiness: these three symptoms are the most common side effects of general anesthesia.
Some women can go home the day of the surgery; others, however, must remain in the hospital for a few days, until complete recovery.
When she returns home, the woman must respect the rest. To prevent infections, your doctor may temporarily advise against the use of internal sanitary napkins and recommend abstaining from sexual intercourse for about two weeks.
In the days following the curettage, it is strongly recommended to seek medical attention immediately in the following cases:
- High fever
- Abnormal uterine bleeding
- Difficulty urinating
- Extreme weakness
- Stabbing stomach cramps
- Abdominal pain that gets progressively worse rather than better
- Smelly vaginal discharge
Pregnancy after curettage
Uterine scraping may temporarily affect fertility. Normally, if a child is desired, it is suggested to try conception after at least 3 months from the curettage. In fact, after surgery, the uterine mucosa of women of childbearing age requires a short period of time to fully rebuild.
risks
It is rare for curettage to cause injury to the uterus. However, it is still possible that, after the operation, the woman reports more or less serious complications.
Operative hysteroscopy involves fewer risks and complications than curettage. In fact, the aforementioned surgical procedure allows the interior of the uterine canal to be viewed by means of a micro-camera mounted on a hysteroscope, thus reproducing the anatomy of the uterus in a monitor.
The image reproduced on the screen acts as a guide for the doctor: by precisely identifying the abnormal mass to be removed, the risk of errors and of creating injuries to the uterus is less.
Curettage can cause complications such as:
- Hemorrhages in the abdominal cavity
- Perforation of the uterus: it is the most dangerous complication of curettage. Medical statistics show that only 1% of women experience uterine perforation after curettage.
- Formation of scar tissue on the uterine wall (or Asherman's Syndrome): constitutes a real complication after curettage. From what is reported in the scientific journal Human reproduction, it appears that the general risk of adhesions after curettage oscillates between 14 and 16%. Women who undergo this surgery to remove the fruit of an unwanted conception instead develop Asherman's syndrome in 30.9% of cases. Asherman syndrome should be treated with a specific hormone therapy, useful for promoting the growth of healthy uterine tissue.
- Allergic reaction: before undergoing any surgery, the woman must declare any allergies - presumed or ascertained - to minimize the risk of adverse reactions to materials (eg nickel allergy, latex allergy) or drugs.
- Damage to the cervix (injury, abrasion, bleeding)
- Infection: after curettage, the woman may develop an infection of the uterus or a salpingitis (infection of the fallopian tubes). This post-curing complication is however rare.
