Uterine Curettage - Gynecology

What is Uterine Curettage?

Uterine curettage, also known as dilation and curettage (D&C), is a gynecological procedure where the lining of the uterus is scraped to remove tissue. This can be done for diagnostic or therapeutic reasons. The procedure often involves dilating the cervix to allow the insertion of a curette, a surgical instrument designed for scraping.

Indications for Uterine Curettage

Uterine curettage is performed for multiple reasons. Some of the common indications include:

Abnormal Uterine Bleeding: To diagnose the cause of irregular or heavy menstrual bleeding.
Miscarriage Management: To remove retained products of conception after a miscarriage.
Endometrial Hyperplasia: To treat or diagnose thickening of the uterine lining.
Polyp Removal: To remove uterine polyps that could be causing symptoms.
Cancer Screening: To obtain a tissue sample for biopsy when endometrial cancer is suspected.

How is the Procedure Performed?

The procedure typically involves several steps:

Anesthesia: Local or general anesthesia is administered to minimize discomfort.
Cervical Dilation: The cervix is gradually dilated using a series of rods.
Curettage: A curette is inserted to scrape the uterine lining. The collected tissue is then sent for histopathological analysis if needed.
Recovery: The patient is monitored for a short period before being discharged home.

Risks and Complications

Although uterine curettage is generally safe, it carries some risks and complications:

Infection: There is a small risk of uterine or pelvic infection.
Bleeding: Some bleeding is normal, but excessive bleeding could occur.
Perforation: Rarely, the uterine wall may be perforated, requiring further intervention.
Adhesions: Scar tissue, also known as Asherman’s syndrome, can form in the uterus.

Post-Procedure Care

After the procedure, patients are advised to rest and avoid strenuous activities for a few days. Specific post-procedure care instructions may include:

Avoid using tampons or douches for at least two weeks.
Refrain from sexual intercourse for a specified period.
Monitor for signs of infection, such as fever or foul-smelling discharge.
Follow up with the healthcare provider to discuss pathology results and further management.

Alternatives to Uterine Curettage

In some cases, other alternatives might be considered depending on the underlying condition:

Hysteroscopy: A minimally invasive procedure to diagnose and treat intrauterine conditions.
Endometrial Ablation: A procedure to destroy the lining of the uterus to treat heavy bleeding.
Medical Management: Medications to manage conditions like heavy menstrual bleeding or endometrial hyperplasia.