The role and steps of segmental diagnostic curettage

Diagnostic curettage (DCT) is a procedure in which the endometrium is scraped for pathological examination to confirm the diagnosis. If cervical lesions need to be excluded, the cervical mucosa and endometrium need to be scraped separately, which is called segmental diagnostic curettage. This method can be used for abnormal uterine bleeding, amenorrhea, miscarriage, endometritis, etc. But let us take a look at the following article to understand the specific effects and steps of segmented diagnostic curettage.

Indications:

1. Abnormal uterine bleeding requires confirmation or exclusion of endometrial cancer, cervical cancer or other lesions such as miscarriage, endometritis, etc.

2. For dysfunctional uterine bleeding or incomplete abortion, diagnostic curettage can not only provide a clear diagnosis, but also play a therapeutic role.

3. Infertility: Endometrial sampling is used to determine whether ovulation has occurred and the development of the endometrium.

4. Amenorrhea may be caused by suspected endometrial tuberculosis, ovarian dysfunction, intrauterine adhesions, etc.

5. Auxiliary diagnosis of ectopic pregnancy.

Operation steps walkthrough:

1. Empty the bladder, take the lithotomy position, routinely disinfect the vulva, vagina, and drape

2. A bimanual examination is performed to determine the size, position, and parauterine tissue of the uterus.

3. Use a speculum to dilate the vagina to expose the cervix, and disinfect the vagina and cervix again with disinfectant.

4. The cervix is ​​fixed with a cervical clamp and the depth of the uterine cavity is detected with a probe. (If segmental curettage is required, the endocervix should be scraped first, and then the uterine cavity should be explored)

5. Use a special diagnostic curette to scrape the endometrium.

6. During curettage, the curette is used to scrape out the endometrium in order from the inside to the outside along the four walls, fundus and lateral corners of the uterine cavity, and pay attention to whether the uterine cavity is deformed or uneven.

7. All scraped endometrium was fixed in 10% formaldehyde or 95% alcohol and sent for pathological examination.

Correctly grasp the time and scope of diagnostic curettage.

(1) Understand ovarian function: It should be done 1-2 days before menstruation or within 24 hours of menstruation.

(2) Dysfunctional uterine bleeding: If endometrial hyperplasia is suspected, curettage should be performed 1-2 days before menstruation or within 24 hours of menstruation. If incomplete endometrial exfoliation is suspected, curettage should be performed on the 5th to 7th day of menstruation. If the bleeding is heavy or lasts for a long time, anti-inflammatory treatment and curettage should be performed at any time.

(3) Primary infertility: Curettage should be performed 1-2 days before the onset of menstruation. If the secretion is good, it indicates ovulation; if the endometrium still shows proliferative changes, it indicates anovulation.

(4) Endometrial tuberculosis: It should be diagnosed and cured one week before menstruation or within 12 hours of menstruation. During the curettage, special attention should be paid to the uterine cornua on both sides, because the positive rate is higher there (those suspected of tuberculosis before surgery should first take anti-tuberculosis drugs).

What are the functions and steps of segmental diagnostic curettage? After reading the above, I believe you already know the answer. Some people may ask whether curettage will be painful and what side effects there will be. In fact, diagnostic curettage is just a gentle scraping with a scraper, which does not cause much harm. Just pay attention to hygiene and avoid infection.