Uterine curettage, also known as diagnostic or therapeutic curettage, is a gynecological surgical procedure in which tissue is removed from the endometrial cavity. The procedure can be performed for diagnostic or therapeutic reasons and is usually performed under general anesthesia or sedation.

When is Uterine Curettage Indicated?

Curettage may be recommended by the gynecologist in cases such as:

➤ Diagnostic use:

• Investigation of abnormal vaginal bleeding, particularly in perimenopausal or postmenopausal women.
• Check for endometrial hyperplasia, polyps or neoplastic lesions.
• Obtaining sufficient histological material when endometrial biopsy with pipelle is not sufficient

➤ Therapeutic use:

• Removal of residual tissue after miscarriage or childbirth.
• Management of uterine bleeding that does not respond to medication.
• Removal of hyperplastic endometrium, in cases of hyperplasia with or without atypical cells, mainly for immediate hemostasis and histological evaluation.
• Complementary treatment of chronic or complicated endometritis, especially when there are tissue remnants or persistent inflammation despite antibiotic treatment.

How the Procedure Is Performed

• The patient is placed in a gynecological position and appropriate anesthesia is administered.
• The cervix is progressively dilated with dilators.
• A special tool (curette or suction cannula) is inserted to remove the endometrial tissue.
• The duration of the procedure usually ranges from 15 to 30 minutes.

Benefits and Risks

Benefits:

• Immediate relief from uterine bleeding.
• Diagnosis of pathological conditions such as hyperplasia, polyps or cancer.
• Removal of tissues that cause inflammation or bleeding.

Risks:

• Injury to the cervix or perforation of the uterus.
• Infection or inflammation.
• Asherman's syndrome (endometrial adhesions), especially in repeated or aggressive curettage.

Aftercare After Scraping

• It is recommended to avoid physical exertion for a few days.
• Tampons should not be used or sexual intercourse should be performed until the endometrium has fully healed.
• Light bleeding or cramping is expected and will gradually subside.
• Any severe symptom (fever, severe pain, foul-smelling discharge) requires immediate medical evaluation.

Alternative Methods

• Hysteroscopy: It allows immediate overview and targeted removal of pathological lesions with less trauma.
• Drug treatment: In cases of hyperplasia or uterine bleeding, progestogens or other hormonal regimens may be administered as a first choice, mainly in women who wish to avoid invasive treatment.

Conclusion

Uterine curettage is a useful and safe procedure, when applied with appropriate indications and under specialized medical guidance. It is an important tool for both the diagnosis and treatment of gynecological diseases such as hyperplasia, persistent bleeding and complicated endometritis. With proper monitoring and care, it contributes substantially to the restoration of gynecological health.