Steps to harvesting the endometrium

Surgical treatment is a very common method in medicine. It is direct and simple, but surgical treatment generally has certain risks. Although surgery is a simple and straightforward treatment method, its significance is extraordinary. Especially if there are surgical errors or personal problems with the patient, it will have serious consequences. Next, let’s talk about the things you should pay attention to and the specific steps when removing the endometrium.

Endometrial biopsy is done for:

1. For the diagnosis of endometrial tuberculosis, samples should be obtained before menstruation.

2. To understand whether ovulation has occurred and whether the corpus luteum is healthy, the sample should be obtained within 6 to 8 hours of the onset of menstruation or 2 to 3 days before menstruation. If you are infertile, you must use contraception that month.

3. Understand the cyclical changes of the endometrium and obtain samples at different stages of the menstrual cycle. For those with incomplete endometrial exfoliation, samples should be obtained on the 5th day of the menstrual period.

4. Endometrial cancer can be sampled at any time.

5. Observe the therapeutic effect of endometrial hyperplasia.

Contraindications

1. Acute vaginitis and cervicitis caused by Trichomonas, fungi, sexually transmitted diseases or other reasons.

2. Acute and subacute pelvic inflammatory disease.

3. Those with body temperature exceeding 37.5℃.

4. Those who have had sexual intercourse within the last 3 days.

5. Pregnancy cannot be ruled out.

6. Those who have stopped taking sex hormone drugs for less than 1 to 2 cycles.

Preoperative preparation

1. Check blood routine, platelets, leucorrhea routine, and measure body temperature. For those over 45 years old, blood pressure and pulse should be measured. Patients suspected of having heart disease should undergo an electrocardiogram.

2. Sexual intercourse is prohibited for 3 days before surgery.

3. Understand the menstrual cycle carefully.

4. Patients with IUDs should undergo fluoroscopy or B-ultrasound examination before surgery.

5. For hydatidiform mole and choriocarcinoma, B-ultrasound examination and blood drawing and matching should be performed before surgery, and an infusion channel should be established to be ready for blood transfusion at any time. If necessary, the operation can be performed under B-ultrasound monitoring.

6. For patients with inflammation who require surgery, antibiotics should be used starting before surgery and continuing until 3 to 5 days after surgery.

Surgical procedures

1. Empty the bladder, take the lithotomy position, disinfect the vulva and vagina, and lay a sterile surgical towel.

2. Bimanual examination to understand the size, position, texture, mobility, shape of the uterus and its relationship with surrounding organs, and whether there are any abnormalities in the appendages on both sides.

3. Place the speculum, expose the cervix, disinfect the vagina and cervix, clamp the front lip with a cervical clamp, and pull it outward to make the uterus horizontal.

4. Use the uterine probe to gently probe the uterine fundus along the direction of the uterus, measure its depth and confirm whether the curvature and size are consistent with the examination. Do not force the probe if there is resistance. Change the direction to find a position of the uterine cavity without resistance and with variations. Determine whether there is any unevenness or adhesion of the inner wall of the cavity, or any obstruction of the probe caused by tumor compression.

5. Move the small endometrial scraper to the fundus of the uterus, close to the uterine wall, and scrape a small piece of tissue from the front and back walls and both sides of the uterus from top to bottom. For those suspected of tuberculosis, samples can be obtained from the uterine horns, or from the uterine fundus and lower uterine segment. If you plan to take cervical tissue at the same time, you should scrape the cervical canal first and then the uterine cavity.

6. The collected specimens are placed in fixative bottles according to the location and needs. After checking the name and number on the application form and the specimen label, they are sent for pathological examination.

The above is about some steps for removing the uterine membrane. Finally, we would like to remind everyone about the postoperative treatment. For example, if intestinal bleeding is found, antibiotics must be used. If the hair is tuberculous, take immediate measures to treat the disease. In addition, you should also pay attention to cleanliness and hygiene, especially within two weeks after the operation, you should not have sexual intercourse. It is best to eat a light diet.