A scraping is used to clean or obtain examination material from the affected organ. Most often, this refers to a scraping of the uterus after a miscarriage. Although the risks are low, injury to the uterus may occur during the procedure and infection may occur after the procedure, but these are easily treated.
What is a curettage?
Although curettage is used in other medical specialties, it usually refers to a scraping of the uterus used in gynecology. The term curettage refers to the surgical removal of tissue through a curette, an instrument made for this very purpose. A curette comes in a variety of designs, usually with a cutting or blunt spoon. Although curettage is also used in other medical specialties, it usually refers to a curettage of the uterus used in gynecology. Curettage may also be used in dermatology, such as for wart removal, or in dentistry for the treatment of periodontal disease. Scraping out the lining of the uterus is also called “abrasio uteri” and is necessary, for example, after a miscarriage.
Function, effect and goals
During a curettage, the treating gynecologist first scrapes out the cervix and then, after dilating the cervix slightly, the uterine cavity with a curette. It is possible to suction the removed tissue directly, but this is only done under general anesthesia and is called suction curettage. If curettage is performed for diagnostic purposes, for example in the case of menstrual cramps, only a very small amount of mucosa is removed with a probe; this is referred to as aspiration curettage. In this case, no anesthesia or only local anesthesia of the patient is necessary. After the sample has been taken, the tissue is examined in order to detect possible malignant changes. In the case of menstrual problems, a sample is usually taken from the cervix and then from the uterus itself. This procedure is called fractional abrasion and is also used for women who get a menstrual period after the menopause. During curettage, a hysteroscopy, or endoscopy of the uterus, may also be performed at the same time. In most cases, menstrual cramps or menopausal symptoms are harmless and hormonal, but in rare cases it can be uterine cancer. Therefore, curettage is performed if there are suspicious ultrasound or cancer smear findings. If a woman suffers a miscarriage, scraping of the uterine cavity is necessary to completely remove embryo and placental tissue. Failure to scrap the uterus after a miscarriage can lead to serious infections. Curettage can also be used for abortion. In this case, a suction curettage is usually performed. Thus, the goal of a curettage is either to obtain examination material or to clean the uterine cavity. Genetic examination of the material obtained during curettage is possible if a woman suffers several miscarriages. In this case, possible severe genetic diseases can be clarified.
Risks, side effects, and hazards
Mild bleeding after curettage is completely normal. Sometimes a curettage also leads to fever, abdominal pain and heavy bleeding similar to menstruation. In these cases, the attending physician should be consulted, as there may be an infection that requires treatment. In case of heavy bleeding shortly after the procedure, there is also a risk that there is an injury to blood vessels that needs immediate treatment. In exceptional cases, the wall of the uterus is injured during curettage. In general, however, this can be treated well or heals on its own. If the doctor punctures the uterine wall with the tip of his instrument, bleeding into the abdomen and severe infections of the uterus or ovaries may occur. Curettage after a miscarriage or for abortion means a strong psychological burden for the affected woman and possibly also for her partner. If the woman is unable to cope with her grief alone after the procedure, professional help should definitely be sought. Many gynecologists recommend contact persons after a curettage.All in all, however, curettage is a routine procedure that is very rarely associated with complications.
