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Why do you need scraping from the uterine cavity for histology?
Why do you need scraping from the uterine cavity for histology?
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Diagnostic - and sometimes therapeutic - procedure in gynecology has different names: curettage, scraping, cleaning. During it, the inner layer of the endometrium of the uterus is removed, and a tissue sample is transferred for histological examination.

During it, the degree of organ damage, the presence of atypical cells and some other pathological changes are determined.

Scraping from the uterine cavity for histological examination is one of the types of surgical intervention, therefore, they are prepared for it in the same way as for any operation. Preliminarily eliminate infections and pass the necessary tests.

Examination of scrapings

To make a scraping for histology, several types of manipulations are carried out.

RDV - separate diagnostic curettage. First, the epithelium of the cervix is scraped out, and then its cavity.

There are 2 types of epithelial cells on the neck. From the side of the cervical canal, the epithelium is cylindrical, unilamellar, and flat, multilayer from the side of the vagina. These cells are constantly exfoliated, fall into the lumen of the cervix and vagina.

In a cytological examination of the cervical scraping, the presence of infection is determined, tissue studies are carried out, during which it is possible to distinguish healthy cells from altered - atypical ones - but this diagnostic procedure does not give a complete picture of the change, as it is not therapeutic

Cytological examination is carried out during a routine gynecological examination, the epithelium is exfoliated with a special brush, the manipulation is painless. There is no need to prepare for it. During the scraping of the neck, polyps or cervical hyperplasia, an overgrown endometrium, are simultaneously removed.

RFE can be performed under the control of hysteroscopy. In this case, a tube is inserted into the uterine cavity, connected to an optical device - a hysteroscope. This procedure allows you to conduct a preliminary examination, identify the existing pathology, check the quality of the manipulations performed.

With uterine fibroids, large tissue samples are transferred for examination during the diagnostic procedure. Hysteroscopy allows you to identify - and, very importantly, remove immediately - submucous fibroids, neoplasms on the legs, which are very difficult to identify. Scraping of the uterus with myoma also allows you to determine how pathologically the structure of the organ tissue has changed, if the intramural neoplasm is located in the inner muscle layer

Curettage is performed very carefully if an oncological process is suspected, so as not to cause perforation of the wall damaged by the tumor. An experienced gynecologist can make a conclusion even before receiving a scraping.

He analyzes the sample taken - if it does not crumble, in most cases it turns out that the neoplasm was benign and in order to eliminate the symptoms that made one suspect a terrible disease, you will have to look for a different treatment regimen.

The mucous membrane of the uterus with benign formations is separated by stripes, with malignant ones - it crumbles into small pieces.

With a frozen pregnancy, a scraping from the cervix and uterine cavity must be sent for histological examination to determine the cause of the pathology. In this case, the mucous layer is removed in full, so that there is no tissue of the embryo or its membrane left in the cavity. Curettage is performed in the same way as for curettage for diagnostic purposes

Tissue samples for research

The uterus is a hollow organ of muscle tissue that looks like an inverted pear. The narrow side connects to the cervix, which extends into the vagina. The cavity is lined with the endometrium, which consists of two layers:

  1. basal, consisting of stem cells;
  2. functional, which is rejected during menstruation, if pregnancy has not occurred.

For histological examination, the functional layer is separated in the uterine cavity. The superficial layer of the endometrium is also separated from the cervical canal - the place where the cervix connects to the body of the uterus.

How is uterine scraping done?

After the tests are collected and the gynecological infections, if any, have been treated, the patient is given a referral for diagnostic manipulation.

  • You cannot eat or drink 8 hours before the procedure - all actions are carried out under anesthesia, therefore certain rules should be followed. A cleansing enema is not done, but before surgery, it is imperative to empty the bladder.
  • The genitals are treated externally with an antiseptic - more often with iodine, then mirrors are installed, and the patient is administered anesthesia. The patient no longer feels the withdrawal of the uterus and its fixation with the help of bullet forceps.
  • In some cases, it is necessary to resort to the use of Gegar's dilators, with the help of which the cervical canal expands. You should not be afraid that surgeons can injure gynecological organs - they carry out manipulations taking into account their position. The dilators are inserted gradually, starting at the smallest diameter.
  • After carrying out the diagnostic procedure, nothing interferes, a sharp curette spoon is introduced into the uterus, with which the endometrial layer is separated. The neck is scraped out first, then the front wall, back, corners. Tissue samples from different parts of the uterus are placed in separate tubes.
  • If a gitroscopy is performed, then an examination is required to assess the quality of the work done.
  • The procedure takes from 15 minutes to an hour, depending on the nature of the pathological changes and the number of procedures required. 15 minutes is enough for curettage for frozen in early pregnancy, for hysteroscopic surgery for submucous myoma or cancer of the uterine body, it takes 1-1.5 hours, since the bumpy surface has to be processed very carefully.

The patient's condition can be maintained with a dropper with saline, but sometimes they do without it.

In case of force majeure, they always have time to take the necessary measures - a doctor, an operating nurse and an anesthesiologist are in the manipulation room. Do not worry - this is one of the most mastered and safest medical operations.

Consequences of diagnostic curettage

After curettage, bleeding ends on average by 21 days. The anointing is not profuse and resembles days 4-5 of the normal menstrual cycle.

Menstruation comes after scraping the uterus, usually after 28-33 days, depending on the individual cyclical interval. They can be more abundant and liquid, since the wound surface has not yet completely healed.

There is a likelihood of complications after curettage, which most often manifest themselves against the background of an increase in temperature.

This should already be a signal that everything did not go as planned, and it is necessary to contact a gynecologist.

  1. Infection. It is detected by the appearance of purulent discharge and pain in the lower abdomen. It appears with violations of hygienic requirements, early onset of sexual activity, violations of the rules of asepsis by doctors, with the introduction of an infection through the bloodstream or due to undetected genital infections. Treatment with antibacterial drugs;
  2. Hematometer - after curettage, blood accumulates in the uterine cavity and does not come out. The patient feels bursting pains in the lower abdomen. Treatment is carried out in a hospital - medications are administered that eliminate the spasm, or additional manipulations have to be carried out to dilate the cervix;
  3. Perforation is a violation of the integrity of the walls of the uterus. Small lesions heal on their own, with large ones sometimes the uterus must be removed. Symptoms of the condition are profuse bleeding;
  4. Violation of the growth layer of the endometrium. Sign - profuse bleeding, consequence - the endometrium is no longer renewed, reproductive function is impaired;
  5. Asherman's syndrome - in a woman, after curettage in the uterine cavity, adhesions begin to grow, fertility is impaired, although menstruation comes regularly.

Before carrying out the diagnostic curettage procedure, you should find out in detail how the rehabilitation period proceeds.

For any deviations, you must contact a gynecologist. Postoperative complications such as perforation of the uterus or hematometer pose a serious health hazard.

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