What is curettage?
Scraping is a surgical procedure during which the gynecologist removes all or part of the uterine lining. To do this, he uses a special instrument, a kind of spoon with a blunt or sharp (cutting) edge – the curette. The procedure is also called abrasion or curettage.
In suction curettage (aspiration), the tissue is sucked out of the uterine cavity with the help of a device that generates negative pressure. This technique is often used in abortions and is usually gentler than curettage.
When is a curettage performed?
A curettage can be performed for diagnostic or therapeutic reasons (e.g., miscarriage or abortion).
Scrapping for diagnostic purposes
Fractional abrasion, in which the mucous membranes of the individual uterine segments are examined separately, allows conclusions to be drawn about the exact location of a cell change – for example, in the case of cervical cancer. Abrasion is then often combined with hysteroscopy to further increase the significance of the scraping.
Scrape in miscarriage and premature birth
Scrape after birth
After a birth, very often parts of the placenta or the membranes remain in the uterus. If the uterus cannot contract properly, these tissue remnants bleed. As a rule, certain medications help the uterus to contract again. However, if these do not work sufficiently, only a curettage of the mucous membrane can help. In severe cases, the gynecologist must remove the uterus completely (hysterectomy).
Increased, heavier or irregular menstrual bleeding are also possible reasons for a curettage. Menopause is a common time for the occurrence of such bleeding disorders. The cause may be hormonal disturbances or benign cell changes in the endometrium (for example polyps). Intermittent bleeding may also necessitate abrasion. These are often due to inflammation of the endometrium (endometritis).
An operative (instrumental, surgical) termination of pregnancy can in principle be performed by means of curettage. As a rule, however, the usually gentler method of suction (suction curettage) is chosen.
You can read more about the methods, the procedure and the risks of an abortion in the article Abortion.
What is done during an abortion?
Whether a curettage can be performed on an outpatient basis depends on the doctor’s assessment and possible concomitant diseases of the woman as well as the type of curettage. Generally, gynecologists choose to perform a curettage on an outpatient basis whenever possible in order to minimize the stress for the patient.
The curettage: procedure and preparation
During the abrasion, the patient lies on a gynecological chair, as it is also used during preventive examinations.
He then uses the curette to carefully remove the mucous membrane in the uterine body and cervix. The tissue removed is collected so that it can be examined in more detail as needed.
What are the risks of curettage?
Bleeding, infection, and/or pain are common after a curettage. Treatment for these complications depends on their severity.
Heavy bleeding after scraping
How long bleeding after uterine curettage lasts also depends on possible concomitant diseases, for example, blood clotting disorders.
Infection and perforation of organs
As with other procedures, the risk of infection of the wound increases after an abrasion. This in turn can lead to blood poisoning (sepsis), which the doctor then treats with antibiotics and drugs to support the circulation.
Cervical weakness
In the course of a curettage, the connective tissue of the cervix can be damaged to such an extent that it can no longer adequately support the weight of the child during a subsequent pregnancy (cervical weakness). This can cause premature birth or damage the child during birth.
Altered menstruation after curettage
Pain after curettage
Especially in the first days, pulling abdominal pain may occur after scraping the uterus. These are usually similar to the familiar menstrual cramps. The doctor can administer painkillers to support recovery after curettage.
What do I need to keep in mind after a curettage?
Behave carefully after a curettage of the uterus – take it easy for a few days. This can prevent complications and support recovery after curettage.
You should wait one to two weeks before exercising after uterine abruption to reduce the risk of bleeding. Discuss this with your gynecologist.
