What do you have to consider after the operation?
If the uterus is removed on an outpatient basis, the patient usually remains on the ward for a few hours after the procedure for monitoring. If she feels well and if no complications have occurred, she can be discharged home the same day. It is important to note that you are not allowed to drive yourself after an anaesthetic.
After the scraping it is important, as after every operation, to take it easy for a few days. Sport should be avoided for the next one to two weeks. You should also watch out for warning symptoms such as fever, severe pain, heavy bleeding or purulent discharge.
If these symptoms occur, you should consult a gynaecologist as soon as possible. A slight bleeding, which can last up to several days, and a delay in the next menstruation is normal. Due to the ablation of the uterine lining, it can take up to eight weeks until the lining has completely rebuilt itself and wound healing is complete. Therefore this should not be a reason for uncertainty.
Possible complications are, as with any surgical procedure, blood loss, up to the necessary transfer of foreign blood, with the associated risk of intolerance reactions and the transmission of HIV and hepatitis. Furthermore, infections, wound healing disorders, allergic reactions (with skin rash, itching, dizziness, vomiting, swelling…) as well as injuries and perforations of neighbouring structures and organs can occur. Particularly noteworthy are injuries to the wall of the uterus and the fallopian tubes, which can lead to adhesions and adhesions of the structures, which can cause changes in menstruation, as well as infertility and conception difficulties.
It is also possible to injure the intestines and bladder, which can lead to problems with urination or bowel movements, although this is very rare. Another complication to be emphasized, especially in young women, is the injury to the cervix. This can lead to a weakness of the cervix, which carries the risk of premature birth and miscarriage in subsequent births.
To counteract this, it is important that all women who wish to have children have their cervix softened with medication to prevent injuries. After the cervix is removed, there may also be some bleeding, which lasts for a few hours or days, but is perfectly normal and should not be a cause for concern. If fever, severe persistent pain or heavy bleeding occurs, a specialist should definitely be consulted!
Pregnancy and abortion
During pregnancy, cervical abortion is only indicated in the case of miscarriage. In most cases, a spontaneous discharge of the fruit is awaited and supported with medication, with substances that have an effect on the cervix (for example prostaglandins). If there is no spontaneous discharge (abortion), the uterus is scraped out.
It is important that the cervix is soft, which can be achieved, for example, by administering prostaglandins (body-like substances that soften the cervix and promote contractions). The cervix is then dilated under general anaesthetic and the embryo is scraped out with the help of a sharp spoon (curette). The procedure takes about half an hour and is performed on an outpatient basis, so that the patient can be discharged home the same day.
Another indication for a uterus scrape is if placental remains remain in the uterine cavity. They can lead to heavy and persistent bleeding, which can be life-threatening under certain circumstances. For this purpose, the placenta is checked for completeness after birth.
If it is torn open and not complete, a uterus scraping is performed immediately after birth under general anaesthetic and the uterine cavity is completely scraped out with the help of the curette. A uterus abortion can also be performed as part of an abortion. An abortion is permitted in Germany until the 12th week if the pregnant woman has had counselling at least three days before and decides to have the operation.
An abortion after the 12th week is only possible in special cases, for example after a rape, but only until the 22nd week. The most common abortion method in Germany is the suction method, with which about 80% of all abortions are performed. It is used during the 6th-12th week and is performed under general anaesthesia.
First the cervix is dilated with special pins (Hegar pins) and then a thin, flexible plastic tube is inserted into the uterine cavity. A strong suction is then used to suck out and remove the unborn child together with the placenta. In most cases, the remaining remains are then scraped out again with a curette.
Another abortion method is curettage (scraping). It can be performed on an outpatient basis during the 7th-12th week and is also performed under general anaesthesia. Here too, the cervix is first dilated with the Hegar pins and then the instruments are inserted to remove the unborn child from the uterine cavity. Finally, the remains are scraped out with a curette.