Understand This First Before Undergoing a Curette

Curette is best known as a process that a woman needs to go through when having a miscarriage. However, there are actually other curette functions. Knowing the curette process is expected to help patients and their companions prepare themselves and live it more calmly. Curette is actually the name of a surgical tool to remove tissue from the uterus. The procedure is called curettage. This procedure is performed by an obstetrician, and generally takes about 10-15 minutes. Before the curette is performed, the patient is anesthetized first.

Curette Function

Curette is not only done to clean the uterus after a miscarriage, but can also be done to diagnose certain conditions in the uterus, such as when there is suspicious vaginal bleeding.

• Curette for Examination

To help with the diagnosis, curettes are generally done if the patient experiences the conditions as below.
• Having bleeding after menopause.
• Having bleeding outside the menstrual cycle, or with excessive amounts
• As a step further examination if the doctor finds abnormal cells from the results of the examination, for example to detect cervical cancer in the results of abnormal pap smears.
When the curette procedure is made as part of the diagnosis process, the doctor will collect tissue samples from the uterus to be examined in the laboratory. The results of the examination can be used to diagnose various conditions, such as uterine cancer, uterine polyps, or endometrial hyperplasia (a precancerous condition characterized by thickening of the uterine wall). As an examination procedure, a curette is often combined with hysteroscopy, which is done by inserting a thin flexible tube with a camera and a beam, to check if there is anything abnormal in the uterus. In the middle of the hysteroscopy process, the doctor may be able to remove fibroid tumors and small polyps in the uterus. However, as an examination procedure, curette is no longer widely used and is more often replaced with ultrasonography (USG).

• Curette as Therapy

If a curette for examination is only done by taking a sample, a curette carried out to treat certain conditions is done by removing almost all the tissue in the uterus. This step is generally carried out in the following situations:
• Clean the remaining tissue in the uterus to prevent heavy bleeding or for example after a miscarriage or after an abortion procedure.
• Remove polyps from the uterus or cervix.
• Removing clots in the uterus caused by molar pregnancy (pregnant with wine).
• Cleansing the remaining placenta and sticking it in the uterus, to treat excessive bleeding after delivery.
• Removing benign fibroid tumors that form in the uterine wall.
The lining of the inner wall of the uterus, called the endometrium, will re-form, but your next period may be late. If the curette is performed because you have a miscarriage, consult your doctor to plan your next pregnancy.

Curette Process

Before undergoing a curette, your doctor or nurse will ask about your condition and medical history. Make sure your doctor knows if you:

• Allergy to certain drugs or ingredients.
• May be pregnant.
• Are taking blood thinners or have a history of blood disorders.

In addition to this, the doctor will usually ask you to fast for 6-8 hours before the curette is performed. You will be asked to lie down with both feet open, during the curette. Generally before the curette process begins, patients will be sedated so that they do not feel pain. The type of anesthesia to be administered depends on the type of curette to be passed. Local anesthesia will make the area around the cervix numb or not feel anything. Epidural anesthesia will make the body from the waist down to numb. Meanwhile, general anesthesia will make you unconscious throughout the procedure. After being sedated, the doctor will insert a speculum into the vagina, and clean the cervix using antiseptics. Then, the following stages will be undertaken by curette patients:

• Dilated

The first step that will be done is dilation. This is the process of widening the cervix using drugs, or by placing an instrument called laminaria that will absorb fluid in the cervix and expand, so that it can dilate the cervix to simplify the process of curettage.

• Curettage

Remove the lining and fill the uterus with a spoon-like thin tool called a curette. A device called a cannula can also be used to suck out the remaining tissue in the uterus. However, if the curette is done for examination purposes, the doctor will only take a small amount of tissue as a sample, to be tested in the laboratory.

After the procedure, the patient's condition will be monitored for several hours to ensure the patient has fully recovered from the anesthesia and to detect whether complications occur, such as heavy bleeding. Drowsiness, nausea, and vomiting are effects that may be felt when the patient is undergoing general anesthesia. Generally patients can go home within a few hours after the procedure, but it is recommended to be accompanied and delivered by the family. Normally, patients can resume normal activities after 24 hours. Some patients can feel nausea and cramps for at least one day. Some can even experience vaginal bleeding for approximately 1-2 weeks. Therefore, it is recommended to use pads or pantyliners after undergoing a curette.

Curette Risk

Although it is relatively safe, every operating procedure certainly has risks. Curette contains the following risks:

• Heavy bleeding.
• Infection in the womb.
• Scarring of the uterine lining, or called Asherman's syndrome, can cause miscarriage in the future, pain or menstrual disorders, even infertility.

In addition, the risk of curettage that occurs less frequently includes damage or formation of holes in the cervix, uterus, bladder, or blood vessels. Holes can form due to injury due to surgery. The formation of a hole in the uterus due to injury is more at risk for women who have entered menopause or have just given birth. Although these holes can generally close by themselves, sometimes it is necessary to take further action in the form of drug administration or surgery if there is damage to an organ or blood vessel. Immediately see a doctor if after undergoing a curette, you have a fever, severe bleeding that can make you need to replace the pads every hour, more severe pain, discharge that smells of odor from the vagina, and stomach cramps for more than two days.