Women often experience diseases due to the structural features of their bodies. Pathological processes can have a different character. Some of them are quite difficult to find. In order not to bite your elbows later, you need to visit a doctor in a timely manner. The gynecologist will conduct an examination, listen to your complaints and, if necessary, refer you for additional diagnostics.
Approximately half of the representatives of the weaker sex in menopause and after it, endometrial hyperplasia is found. Without curettage of the uterus, pathology can be defeated only under special conditions. Today's article will tell you about the origin of this disease and introduce you to its types. You will also find out whether it is necessary to do curettage for endometrial hyperplasia and what it is fraught with.
What is this?
Not every woman has to endure such manipulation asgynecological curettage. With endometrial hyperplasia, it is often prescribed, but not always. Before you learn about the features of manipulation, you need to gain an understanding of the disease itself. Hyperplasia of the endometrium develops due to the growth of the inner surface of the muscular reproductive organ. Every cycle in the body of a woman there is a change in the hormonal background. During menstruation, the endometrium is shed and comes out with the blood. After that, it's time for estrogen. They contribute to the growth of follicles and the restoration of the mucous layer of the uterus. Further, after ovulation, progesterone contributes to the proper secretion of the endometrium, it prepares the reproductive organ for pregnancy (attachment of the fetal egg). If conception does not occur, then the level of progesterone declines, which causes another bleeding. Everything is extremely simple.
But if for some reason a woman has a hormonal failure, the endometrium is not rejected or not exposed to progesterone at all. Because of this, uncontrolled cell division begins, their growth. That's when doctors diagnose "endometrial hyperplasia."
Types of hyperplasia and features of its correction
There are several varieties of this pathology. Some of them are not so dangerous and can be amenable to hormonal correction. Others call for surgical interventions. In some situations, the removal of the uterus is indicated. What can be endometrial hyperplasia?
- Glandrous. Countsone of the easiest, often amenable to drug treatment. The mucous surface grows evenly, without forming stroma cells between them.
- Cystic. This form is similar to the glandular one, but with it the surface of the inner shell grows in a lumpy manner, forming vesicles that look like cysts. It is treated with hormonal agents.
- Focal or diffuse. The mucous surface grows evenly (with diffuse) or lumpy (with focal). In the emerging areas, cysts and polyps are formed. There are cases of such hyperplasia developing into an oncological disease.
- Atypical. This form is considered the most dangerous. With it, the growth of the mucous membrane occurs not only on the surface of the inner layer. Cells are actively dividing, penetrating into the basal layer. Curettage with endometrial hyperplasia of this nature is often ineffective. According to certain indications, the uterus has to be removed.
Symptoms of the disease, indicating the need for curettage
The main signs of this disease are a variety of menstrual irregularities. A woman may complain of delay, heavy bleeding, spotting before and after menstruation. Also during this period, there are symptoms of malaise: abdominal pain, indigestion, poor he alth, fever, and so on. Often hypertrophy is accompanied by infertility. In what cases is curettage prescribed? With endometrial hyperplasia, the indications should be as follows:
- pain in the lower abdomen;
- prolonged bleeding;
- cycle duration over 40 days;
- infertility lasting more than six months;
- bleeding throughout the cycle;
- laboratory confirmation of hyperplasia.
Preparation for manipulation: features
Uterine curettage with endometrial hyperplasia is performed only after preparation. Previously, the patient should be examined by such doctors as a neurologist, cardiologist, therapist. Experts give the conclusion that there are no contraindications to manipulation. At the same time, such studies are carried out as a general and biochemical blood test, the determination of antibodies to hepatitis, HIV and syphilis. Be sure to examine the heart through an ECG.
After that, the patient will have to visit a gynecologist. The doctor prescribes additional examinations, which include ultrasound diagnostics, a smear to determine the purity of the vagina. It is forbidden to carry out manipulation with poor results. If there is an inflammatory process, then it must first be eliminated.
Carrying out the procedure: course of action
Uterine cavity curettage with endometrial hyperplasia is performed only within the walls of a medical institution. The procedure itself lasts no more than 20 minutes. Manipulation requires intravenous anesthesia. During curettage, the patient sleeps or is half asleep: she does not feel any discomfort. With the help of dilators, the doctor opens the cervical canal, gettinginto the cavity of the reproductive organ. The curette removes the overgrown layer, which will be examined later.
In the process of scraping, two positive actions are carried out at once: the doctor cleans the accumulated layer and can later determine its composition and danger (using histology). After cleaning, the patient is under the supervision of medical personnel for another 2-4 hours. If there are no complications, the woman can go home.
After Scraping
If you have had a cleaning due to the fact that endometrial hyperplasia has been established, treatment after curettage will be prescribed. Doctors always recommend a course of antibiotic therapy. Also, if necessary, painkillers and anti-inflammatory drugs are prescribed. Further actions are taken only after receiving a histological transcript.
If the received data indicate that there are no malignant findings in the test material, then the patient is prescribed standard hormonal therapy. When the presence of malignant tumors is confirmed, it is necessary to remove them by a separate operation. Consider the consequences of scraping.
Inflammatory process
If you have endometrial hyperplasia (treatment after curettage was not carried out), then there is a high probability of an inflammatory process. It manifests itself with the following symptoms: abdominal pain, unusual discharge with an unpleasant odor,increase in body temperature. In all situations, urgent correction is indicated. Usually doctors prescribe a long course of oral, intravenous and vaginal antibiotics.
If the inflammation that arose as a result of curettage is not treated, then the pathology can spread to neighboring organs: ovaries, fallopian tubes, and so on. All this is fraught with consequences.
Perforation of the uterus or thinning of the walls of the organ
Treatment of endometrial hyperplasia without curettage is rare. If within a month of hormonal therapy there is no improvement, then it is necessary to carry out cleaning. During manipulation, a complication such as perforation of the uterine wall may occur. This pathology requires emergency surgical intervention.
Also, the consequence of manipulation may be thinning of the walls of the reproductive organ. In the future, this leads to its own complication. For example, uterine rupture can occur during pregnancy. Often, with thin walls, a planned caesarean section is prescribed.
Endometrial hyperplasia: curettage. Feedback on the consequences of the procedure
What is the opinion of patients about this procedure? Many say that endometrial hyperplasia does not disappear after scraping. After a few cycles, the mucous membrane begins to thicken again, forming cysts, polyps. Indeed, if the patient is not prescribed appropriate therapy, then the surgical intervention itself will not save her from the disease. Scrapingdoes not eliminate the cause of hyperplasia, but only corrects its consequences. Therefore, it is so important to listen to the doctor's prescriptions and follow the prescribed therapy after the operation.
Summarize
From the article you could find out that the treatment of endometrial hyperplasia without curettage is possible, but only in exceptional cases. To really assess the patient's condition, it is necessary to perform a biopsy or curettage. This is the only way to find an effective treatment that will save you from the existing problem.
