What is the difference between hysteroscopy and curettage?

Hysteroscopy is a common gynecological surgery and is also one of the most advanced and visual surgeries. Both are actually means to end abortion. In fact, compared with curettage, the harm of curettage is greater. Let us introduce their differences below.

Hysteroscopic curettage is a relatively advanced surgery and the only visual surgery so far. It does not require curettage, so it is definitely less harmful to the human body than traditional abortion surgery and will not cause unbearable pain like traditional curettage. But after all, it is an operation, so you should pay attention to diet adjustment after the operation. Eat some liquid food first, and then you can eat normally the next day. Eat more protein-containing foods such as lean meat and eggs, which are conducive to wound recovery. Avoid spicy and irritating foods. Female friends who like to drink coffee should note that they should not drink coffee after surgery. Therefore, the harm of hysteroscopic curettage is less than that of blind curettage.

Risks of hysteroscopy:

1. Injury: It is mostly related to rough operation and can cause cervical tear, uterine perforation, fallopian tube false passage, fallopian tube rupture, etc. 2. Bleeding: Hysteroscopy will not cause severe bleeding. If there is excessive bleeding, the primary disease should be treated. 3. Infection: rare, mostly with a history of chronic pelvic inflammatory disease, the indications should be strictly controlled. 4. Complications of CO2 uterine distension: Prolonged operation time and excessive uterine cavity perfusion may cause CO2 gas embolism. The operation should be stopped immediately, oxygen should be inhaled, and dexamethasone should be injected intravenously. 5. Cardiocerebral syndrome: Dilation of the cervix and expansion of the uterine cavity can lead to increased vagus nerve tension, which is similar to what occurs during vacuum extraction during artificial abortion.

Dangers of curettage:

1. Cervical laceration: Common in infertile women, usually occurs on both sides of the cervix. For such patients, the operation should be gentle. Small lacerations can be blocked with iodoform gauze to stop bleeding; for larger lacerations, they should be sutured under direct vision to stop bleeding. If vaginal hemostasis is ineffective, laparotomy is required to find the bleeding blood vessels and ligate the bleeding, and occasionally a hysterectomy is required.

2. Uterine perforation: Pregnancy and tumors (such as hydatidiform mole) can make the uterine wall fragile, which can easily cause uterine perforation during curettage. For uterine perforation with less bleeding, conservative treatment such as anti-inflammatory and hemostasis can be performed; if the perforation is large and complicated by heavy bleeding, laparotomy is required to stop bleeding, repair the perforation wound, or perform hysterectomy.

3. Infection: Adequate preoperative preparation, strict aseptic operation, and preventive antibiotic treatment after surgery can reduce the occurrence of infection.

4. Uterine cavity adhesion: If the scraping is excessive during uterine cleaning, uterine cavity adhesion will occur, and the consequences are infertility, miscarriage, amenorrhea, dysmenorrhea, etc. Adhesions can be separated under hysteroscopy.