Pain after scraping

Curettage is a fairly common procedure that gynecologists prescribe to women after examinations. Due to the lack of information on this topic and the fact that gynecologists often do not explain to their patients in detail what the essence of this process is, women often have unfounded fears about pain after curettage.

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Causes of pain after curettage

Curettage is a safe procedure when performed by an experienced specialist. Complications after it are rare. Let's list the most common ones.

• Uterine perforation – the uterus is usually perforated using any instrument designed for this purpose, usually a probe or dilators. There are several reasons for this. Firstly, one of the main properties of the uterus is the difficulty of dilation, so due to excess pressure it can be pierced by a dilator or probe. Secondly, due to changes in the uterus, its walls become loose, so the slightest pressure on them can cause a puncture. If the perforations are not very large, they usually resolve themselves (under the supervision of a doctor and with the implementation of a treatment complex). In the case of major damage, an operation is performed, during which the perforation is sutured.
• Cervical rupture – this happens when the bullet forceps fly off. Flabby cervix can lead to weak fixation of the bullet forceps: when pulled, they can fly off and cause a cervical rupture. Treatment of cervical rupture is similar to the previous case: a small rupture will heal itself, in case of a large one, stitches are applied.
• Inflammation of the uterus - occurs when the curettage already had inflammation and septic and antiseptic conditions were violated, the doctor did not prescribe a preventive course of antibiotics. Pain after curettage occurs due to the inflammatory process. If sterility was violated during the operation or curettage was performed too intensively, infection could occur. Since the mucous tissue of the uterus is weakened, an infection could penetrate there and cause damage to the ovaries and tubes. With inflammation of the appendages, the patient feels severe pain after curettage in the lower abdomen. These are cutting and pulling pains after curettage, mainly the ovaries are felt. It is also accompanied by severe weakness, dizziness, nausea. The menstrual cycle is disrupted: the presence of heavy or, conversely, scanty menstruation, no ovulation, the lower abdomen constantly hurts after curettage. Antibacterial therapy is used as treatment.
• Hematometra – when blood accumulates in the uterine cavity. This happens if the cervix spasms – then blood accumulates, which in a normal case should flow out of the uterine cavity. The accumulated blood becomes infected and causes pain to the patient. Hematometra is treated with medication, the cervical canal is probed (thus relieving spasms).
• Damage to the mucous membrane (excessive curettage) - when curettage is performed by an inexperienced doctor, it could happen that his curettage actions were too strong and aggressive, which led to damage to the germinal layer of the mucous membrane, so the growth of a new mucous membrane is no longer possible. When a curettage operation is performed, the mucous layer of the uterus - the endometrium - is removed. Not the entire endometrium is removed, but only part of the functional layer. The essence is to leave a thin germinal layer, from which a new mucous membrane will then grow. Pain after curettage may occur if the structure of the endometrium is damaged due to excessive curettage or inflammatory processes where the mucous tissues are damaged. If the entire endometrium or most of it was removed during the operation, then the germinal layer of thin tissues was damaged, which can lead to a violation of their development. Adenomyosis is when the tissue no longer grows or, on the contrary, actively grows and grows into the muscles of the uterus.

Unfortunately, there are virtually no ways to cure this complication.

If all actions during the curettage operation were careful and correct, then the above complications will most likely not arise. Other possible situations are incomplete cleaning of the pathological formation (for example, a polyp). This happens when hysteroscopy is not used during the operation, and therefore the results are not checked on the spot. In such situations, curettage is repeated to prevent further development of the pathological formation in the uterine cavity.

A normal situation is when there is spotting bloody discharge for three to ten days. If the discharge stops abnormally early and abdominal pain occurs, you should immediately contact your doctor. The fact is that such symptoms may indicate a spasm of the cervical canal and the formation of a hematometra. Spasms can be detected using an ultrasound examination (ultrasound), and then specialists will prescribe the appropriate treatment for you.

Symptoms of pain after curettage

In addition to the complications described above, pain after curettage may be caused by an infection that began to develop in a favorable environment, still inflamed some time after the operation. The main symptoms accompanying pain after curettage are uterine bleeding, pain in the ovaries, fever, spasms, general weakness.

Pain in the lower abdomen after curettage

Many women experience pain after curettage. Surgical intervention leads to menstrual irregularities and the development of algomenorrhea. In situations where the endometrium has been removed too much, in addition to the above processes, the vaginal microflora is disrupted. Therefore, in addition to inflammatory processes in the uterine tissues, infectious diseases of the ovaries and cervix develop. The consequences are painful periods, severe abdominal pain after curettage, dizziness and general weakness.

Pain and discharge after curettage

If severe pain and leucorrhoea are observed after curettage, this is a signal that something is wrong. If an excessive amount of the germ layer was removed, small wounds and cracks could remain on the mucous membrane. This became the impetus for the development of inflammatory processes and bleeding. After the operation, there may be profuse bloody discharge, over time, it can transform into uterine bleeding. Pain in the pelvis after curettage is accompanied by severe tingling and contractions-spasms. The discharge-leucorrhoea after curettage is usually dark brown or bloody in color, profuse, sometimes with clots. At the same time, the abdomen hurts very much in the lower part. Over time, the leucorrhoea decreases in abundance and becomes smearing and periodic, released before and after menstruation.

Menstruation after curettage

After the curettage operation, menstruation may be slightly delayed (the delay will not be more than 4-5 weeks). This is a normal situation, but if the delay lasts more than three months, then you should contact a doctor.

Pain during sex after curettage

Vaginal sex is not recommended for seven to fourteen days after curettage. The fact is that the cervix will remain open for some time. The mucous membrane at this point remains damaged and compromised due to curettage. Sexual intercourse can introduce an infection and cause undesirable consequences.

The first period after curettage, painful sensations are possible during sex. This is quite normal, unless it continues for several months. In this case, consult your doctor.

Types of curettage

Curettage is the name of the process itself, but the essence of the operation can vary.

Separate diagnostic curettage of the uterine cavity (SDC). First, the cervical canal is scraped, then the uterine cavity. After that, the scraping is sent to specialists for histological examination to establish a diagnosis. In addition, during curettage, the formation (polyp, hyperplasia) is removed, because of which this operation was prescribed.

Separate diagnostic curettage under hysteroscopy control (SDC + HS) is a modern type of such an operation as curettage. With other types of curettage, the doctor performs it "blindly". When hysteroscopy is used, a special device is inserted into the uterine cavity, which allows examining the uterus, identifying pathological formations, after which the curettage process is performed, and then a final check of the work performed. With the help of hysteroscopy, the doctor evaluates how carefully he performed the procedure, whether pathological formations remain in the cavity.

Indications for curettage

Most often, curettage is performed for diagnostics or to eliminate bleeding in the uterus. The operation is performed in cases where there is abnormal bleeding that is not typical for the natural course of events: between periods, if menstruation is too heavy, when bleeding occurs during menopause, etc. Also, curettage is used to remove polyps, small formations in the lining of the uterus. In addition, abnormal bleeding can signal the development of cancerous tumors in the uterus, so curettage can prevent cancer.

Doctors also prescribe a curettage operation if there has been an incomplete spontaneous abortion to remove the remaining placental fragments. This is done in a hospital setting, using general anesthesia, or less commonly, local anesthesia for outpatient treatment.

Carrying out a curettage operation

Most women experience the curettage procedure as a very painful procedure, so they perform general anesthesia: when the cervix dilates, these sensations are similar to labor pain. The cervix is a tiny opening in the vagina at the back, which is very sensitive, so to prevent painful sensations, anesthesia is used.

At the time of dilation of the cervix, the doctor, using a curette in the shape of a spoon, scrapes the walls of the uterus. The tissue that was removed is collected for examination under a microscope. Sex is not recommended for fourteen days after scraping. It will take a couple of days to recover from the operation.

Complications for this procedure are rare, but sometimes occur with infection or severe bleeding when the uterine wall is damaged or punctured during curettage. Signs include chills, constant abdominal pain or cramps, heavy bleeding, weakness, dizziness, unusual or foul-smelling vaginal discharge. If any of these are detected, you should immediately contact a doctor.

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Treatment of pain after curettage

After completion of the curettage operation, patients may experience pain in the lower abdomen even without complications. Pain after curettage can last from several days to a week until the tissues and mucous membrane are fully restored. If only pain is observed, without other symptoms, it can be relieved with a regular painkiller tablet.

Prevention of pain after curettage

To prevent the formation of a hematometra and to prevent pain after curettage, take No-shpa one tablet two to three times a day.

To prevent complications such as inflammation, antibiotics are prescribed for use in the postoperative period.