Scraping for endometrial hyperplasia: features, indications and consequences

Women due to the peculiarities of their body structure often face diseases. Pathological processes can have different character. Some of them are quite difficult to detect. In order not to bite your elbows, you need to visit a doctor on time. The gynecologist will conduct an examination, listen to your complaints and, if necessary, send for additional diagnostics.

Approximately half of the representatives of the weaker sex in menopause and after it show endometrial hyperplasia. Without scraping the uterus, it is possible to defeat pathology only under special conditions. Today's article will tell you about the origin of this disease and will present you its kinds. Also, you will find out whether it is necessary to do scraping with hyperplasia of the endometrium and what is fraught with it.

What it is?

Not every woman has to endure such manipulation as gynecologic curettage. With endometrial hyperplasia, it is often prescribed, but not always. Before you learn about the peculiarities of manipulation, you need to acquire an idea of the disease itself. Hyperplasia of the endometrium develops as a result of the growth of the inner surface of the muscular genital organ. Each cycle in the body of a woman there is a change in the hormonal background. During menstruation, the endometrium is torn away and comes out together with the blood. After this comes the time of estrogens. They promote the growth of the follicles and the restoration of the mucous layer of the uterus. Further, after ovulation, progesterone promotes proper secretion of the endometrium, it prepares the genital organ for pregnancy (attachment of the fetal egg). If conception does not occur, then the level of progesterone goes to decline, which causes another bleeding. Everything is extremely simple.

But if for some reason a woman has hormonal failure, then the endometrium does not tear away or is not at all exposed to the action of progesterone. Because of this, uncontrolled division of cells begins, their proliferation. Then the 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, removal of the uterus is indicated . What is endometrial hyperplasia?

• The glandular . It is considered one of the easiest, it is often amenable to drug treatment. The mucous surface grows evenly, not forming stromal cells between each other.
• Cystic . This form is similar to glandular, but with it the surface of the inner shell grows lumpy, forming bubbles, similar to cysts. It is treated by hormonal means.
• Focal or diffuse . The mucous surface grows evenly (when diffuse) or lumpy (with focal). Cysts and polyps are formed on the emerging sites. There are cases of overgrowth of such hyperplasia in cancer disease.
• Atypical . This form is considered the most dangerous. With it, the growth of the mucosa occurs not only on the surface of the inner layer. Cells actively divide, penetrating into the basal layer. Scraping with endometrial hyperplasia of this nature is often ineffective. For certain indications, it is necessary to remove the uterus.

Symptoms of the disease, indicating the need for curettage

The main signs of this disease are a variety of malfunctions of the menstrual cycle. A woman can complain about a delay, heavy bleeding, anointing before and after menstruation. Also during this period there are symptoms of malaise: abdominal pain, indigestion, poor health, fever and so on. Often, hypertrophy is accompanied by infertility. In which cases is scraping appointed? With endometrial hyperplasia, the indications should be as follows:

• Pain in the lower segment of the abdomen;
• Protracted bleeding;
• The duration of the cycle is more than 40 days;
• Infertility lasting more than half a year;
• Bloody discharge throughout the cycle;
• Laboratory confirmation of hyperplasia.

Preparation for manipulation: features

Scraping of the uterus with endometrial hyperplasia is performed only after preparation. Previously, the patient should be examined by such doctors as a neurologist, cardiologist, therapist. Experts conclude that there are no contraindications to manipulation. At the same time, such studies as a general and biochemical blood test, the determination of antibodies to hepatitis, HIV and syphilis are carried out. It is necessary to examine the heart through the ECG.

After this, the patient will have to visit the gynecologist. The doctor prescribes additional tests, which include ultrasound diagnosis, a smear to determine the purity of the vagina. It is forbidden to manipulate with poor results. If there is an inflammatory process, then it must be previously eliminated.

Procedure: the course of action

Scraping of the uterine cavity 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 the curettage the patient sleeps or is half asleep: she does not feel unpleasant sensations. With the help of dilators, the doctor opens the cervical canal, getting into the cavity of the genital organ. Curette removes the overgrown layer, which will be further investigated.

In the process of curettage, two positive actions are immediately performed: 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, then the woman can go home.

After scraping

If you have been cleansed due to the fact that endometrial hyperplasia is established, treatment after curettage will be prescribed necessarily. Always doctors recommend a course of antibiotic therapy. Anesthetics and anti-inflammatory drugs are also prescribed if necessary. Further actions are taken only after obtaining a histological transcript.

If the data come from the fact that there are no malignant findings in the study material, then the patient is prescribed standard hormone therapy. When the presence of malignant formations is confirmed, it is necessary to delete them by a separate operation. Let us consider the consequences of scraping.

Inflammatory process

If you have endometrial hyperplasia (no treatment after scraping), 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, an increase in body temperature. In all situations, urgent correction is indicated. Typically, doctors prescribe a long course of antibiotics for oral, intravenous and vaginal administration.

If the inflammation that has arisen due to curettage is not treated, then the pathology can spread to neighboring organs: the ovaries, the fallopian tubes and so on. All this is fraught with its consequences.

Perforation of the uterus or thinning of the walls of the organ

Treatment of endometrial hyperplasia without scraping is quite rare. If there is no improvement during the month of hormone therapy, then you should definitely clean it. During manipulation, complications such as perforation of the uterine wall may occur. This pathology requires urgent surgical intervention.

Also, the consequence of manipulation may be the thinning of the walls of the genital organ. In the future this leads to its complication. For example, during pregnancy, a uterine rupture can occur . Often, with thin walls, a planned cesarean section is prescribed .

Endometrial hyperplasia : scraping. Feedback on the consequences of the procedure

What is the opinion of patients about this procedure? Many people 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 relieve her from the ailment. Scraping does not eliminate the cause of hyperplasia, but only corrects its effects. Therefore, it is so important to listen to the appointments of the doctor and follow the prescribed therapy after the operation.

Summarize

From the article you could learn that the treatment of endometrial hyperplasia without scraping is possible, but only in exceptional cases. To really assess the patient's condition, you need to make a biopsy or curettage. Only in this way will it be possible to select an effective treatment that will save you from the existing problem.