Diagnostic curettage in Karaj is one of the methods used to diagnose the cause of bleeding and is used when an accurate diagnosis is desired. Its name clearly defines its nature and it is done in order to take a biopsy from the inner tissue of the uterus and the cervix.

The doctor's doubts about the existence of a serious injury can be resolved or confirmed by scraping the mucous membrane (endometrium and endocervix) and the removed sample is carefully examined by a pathologist and the result is reported within two to three weeks.

Women should not be afraid of shaving their uterus because it is not a difficult operation and only the inner layer of the uterus (endometrium) is removed under a short-term anesthesia or local anesthesia.

The endometrium is rapidly restored during the reproductive years by a preserved basal layer plus an appropriate hormone therapy.

Diagnostic curettage is planned when the ultrasound examination or Pap smear result shows the presence of unexplained and urgent pathological changes.

The main reason for diagnostic curettage is to investigate the cause of abnormal uterine bleeding in women over 35 years old. It is also done in postmenopausal bleeding. However, in younger women, there may be a need for this operation in case of abnormal bleeding and lack of response to medical treatment or based on ultrasound.

In polyps, endometrial hyperplasia (thickening of the inner layer of the uterus), incomplete abortion and severe bleeding, curettage is performed both for diagnostic and therapeutic purposes.

Endometrial hyperplasia and malignant tumors are among the things whose risk is low in women under 35 years old; But women who are in pre-menopausal age are at greater risk.

When people have bleeding 12 months after the permanent cessation of menstruation (menopause), diagnostic curettage in Karaj is necessary for diagnosis and treatment.

What measures are necessary before diagnostic curettage?

Before performing the diagnostic curettage, the doctor performs the following actions:

1_ Detailed history of disease symptoms and previous history of medical illness and drug use, drug sensitivity

2_pelvic examination

3_Pap smear

4_vaginal ultrasound of the uterus and ovaries

5_Laboratory examination such as anemia, coagulation tests, fasting blood sugar, pregnancy test, hormone tests, etc.

6_ Consultation with a cardiologist to allow the operation

When collecting the history, it pays special attention to the existence of women's diseases and allergic reactions to certain drugs. The description of the condition is of particular importance for choosing the anesthesia method. If the patient has already had such an experience, the doctor should familiarize himself with the results in order to carefully review them and determine additional research if necessary.

What problems can be identified with diagnostic curettage?

By performing diagnostic curettage, a number of diseases of the mucous membrane of the uterus and cervix can be diagnosed, which include:

• endometrial polyp;
• cervical polyp;
• endometrial hyperplasia (thickening of the inner layer of the uterus)
• endometrial cancer;
• Endometriosis
• Remnants of pregnancy.
• Molar pregnancy (baby eating)
• Myoma or mucosal fibroma (mucosal year)
• Endometritis (uterine infection)
• Disruption of hormonal balance

Diagnostic curettage is usually performed with anesthesia, but it can also be performed through local anesthesia (spinal anesthesia or epidural anesthesia).

side effects of diagnostic curettage

Diagnostic curettage, like any other surgical procedure, may have side effects, some of which are:

• Severe and prolonged bleeding:

It is a rare complication that occurs only when a surgical instrument damages the uterine wall or an undetected fibroid is cut.

• accumulation of blood clots in the uterine cavity (hematometer):

which gives due to cervical spasm.

• Infection:

The risk of contracting it is low, but symptoms such as fever, abdominal pain, vaginal secretions with a bad smell can be a sign of infection.

• slight spotting or bleeding

which is a natural phenomenon and there is spotting for a few days after curettage and it should be decreasing.

• Asherman syndrome:

Sometimes adhesions (scar tissue) may develop inside the uterus. This complication is called Asherman's syndrome, which can cause infertility and a sharp decrease in the volume of menstrual bleeding.

Perforation of the uterus:

In few cases, there is a possibility of perforation of the muscular wall of the uterus by a curt (a device for shaving the inner layer of the uterus) during the curettage operation. In cases where the uterus is deviated in the pelvic cavity (bent the uterus forward and back or sideways) or there is cervical stenosis (cervical stenosis) or the uterus has a severe infection, the possibility of uterine rupture during curettage increases. Depending on the size of the created hole, the next treatments are different and can range from monitoring without any action to hysterectomy surgery.

What things should be observed after this surgery

After the surgery, the patient is admitted to the hospital for at least a few hours and usually on the same day, the patient is discharged and stays in the hospital for a longer period of time only if there is a risk or complication.

Patients are informed by the doctor of the symptoms that may appear after curettage and which are normal and which are abnormal. In case of severe abdominal pain, severe bleeding, abdominal swelling, nausea and vomiting, or fever, you should see your doctor.

It is not recommended to use tampons after curettage.

Strenuous physical activity (e.g. sports) should be stopped for a while, as it may cause postoperative bleeding. At least one to two weeks after the operation, you can do sports, but this should be discussed with the doctor.

If you have nausea, eat low-fat foods.

Avoid having sex for a week.

After curettage, the patient must be under the control of a doctor for some time. And you must receive the answer of the pathology of the endometrial sample scraped during the operation from the hospital after about two to three weeks and go to your doctor with the answer. Sometimes, according to the pathology answer, drug treatment or hysterectomy surgery (uterus removal) may be needed.

Diagnostic curettage is a diagnostic method that is used to find the cause of abnormal uterine bleeding and some symptoms that indicate dysfunction of the female reproductive system.

In this method, only the uterine mucosa is sampled, because tissue examination cannot help in correct diagnosis.

For additional information and to raise your questions, you can contact Dr. Maryam Gholampour, a surgeon and gynecologist.