A uterus cleaning, also called a dilation and cutterage, is a medical procedure in which tissues from the uterine wall are scraped or suctioned away. This most often happens by manually dialating the cervix, which is the opening to the uterus, then inserting one or more specially designed tools into the cavity to remove problematic tissues or growths. The procedure is usually only done when absolutely necessary since it is a minor surgery and there are risks attached. Medical experts often recommend dilation and cutterage in women who suffer from fibroids or uterine polyps, which are painful and sometimes harmful growths, as well as to remove tissues that should have detached on their own after the birth of a baby, a miscarriage, or an abortion. It can sometimes also be done as a way to gather tissue for testing, particularly when there isn’t any clear diagnosis for problems like pain or infertility.
When and Why It’s Done
Despite the “cleaning” part of the name, this isn’t usually something that’s done on a routine basis and isn’t considered a normal part of female hygiene. A uterine cleaning is a type of surgery that basically vacates all of the tissues and cellular matter attached to the uterine walls. In a sense this it what a menstrual period does, at least on a broad level, but in the case of a scheduled uterine cleaning the process is streamlined and much more controlled.
Dilation and cutterage is often used in order to make a diagnosis in a patient that has symptoms such as pelvic pain, irregular or very heavy bleeding, or vaginal bleeding after menopause. The tissue obtained from the procedure can be tested for things like uterine cancer, uterine polyps, or a pre-cancerous condition called endometrial hyperplasia. A uterus cleaning may stop heavy or irregular bleeding, but it is not uncommon for the bleeding to reoccur after two to six months if the underlying condition is not treated.
The surgery is also commonly performed when a doctor knows the source of the problem. It can be used to remove non-cancerous growths, for instance, such as uterine polyps or fibroids. Dilation and cutterage is also done when the placenta is not fully expelled after the delivery of a baby, or when tissue remains in the uterus after a miscarriage or abortion. When tissues like these are left attached, they can cause hemorrhage that can lead to many more complicated, and in some cases even life-threatening, conditions. Having the tissues removed under these circumstances isn’t always pleasant but it is almost always recommended to avoid problems later on.
This sort of surgery is usually done under local, regional, or general anesthesia, depending on the circumstances and the health of the patient. During the procedure, a speculum is used to open the vagina and allow the doctor access to the cervix, which is the narrow opening to the uterus. The doctor then uses a thin strip of metal to determine the angle and depth of the uterus. Metal rods, growing progressively thicker in size, are subsequently inserted into the cervix until it becomes properly dilated for the procedure.
After dilation, the doctor may insert an instrument called a hysteroscope to look at the inside of the uterus. This is typically followed by the use of a tool called a curette, which scrapes or suctions away the uterine tissue. It is common for any tissue retrieved from a uterus cleaning to be sent to a lab for testing.
What Patients Can Expect
Uterine cleanings are typically done as “outpatient” procedures, which means that patients can typically go home as soon as things are finished and an overnight stay isn’t usually required. Many of these operations are done in hospitals, but depending on the circumstances they may also be able to be performed in a doctor’s office or clinic. The whole thing usually takes about 20 minutes to complete, and a woman may experience cramping and light bleeding for several days after the procedure.
Risks and Precautions
Like any surgeries, cleanings carry a number of risks. They are typically performed only when medically necessary, and women who have a history of blood clotting problems or who are on blood thinning medication may not be good candidates. Any scraping that is done with too much force can scar the uterine walls as well, which can lead to its own set of problems. In most cases cleanings are only a good idea if the benefits outweigh the potential drawbacks.