If deviations are observed in the functioning of a woman’s reproductive organs and suspicions arise about the development of pathological processes, then doctors conduct a comprehensive examination. One common type of examination is taking an aspirate from the uterine cavity. As you know, aspirate is taken for cytological analysis of the endometrial mucosa.
Taking samples through vacuum aspiration is considered a more gentle method when compared with traditional curettage for taking a biopsy, since during this procedure there is no trauma to the mucous membrane of the uterine cavity. It should also be noted that the consequences of aspiration are minor, and complications of various types occur quite rarely.
When is aspiration of the uterine body cavity prescribed?
Biopsy analysis by taking an aspirate is prescribed in the following cases:
- If there are serious disturbances in the menstrual cycle;
- In case of bleeding from the uterine cavity;
- For primary and secondary infertility;
- In the case of the development of diseases of the reproductive organs, such as: endometriosis, endometrial hyperplasia, neoplasms on the ovaries, etc.;
- With vaginal discharge of an atypical nature;
- If there is a suspicion of the development of malignant processes in the genital internal organs.
Additional information about a disease such as hyperplasia can be found in this video:
Aspirate collection can be prescribed based on the results of an ultrasound examination and as a control analysis after long-term use hormonal pharmacological substances. The analysis is also carried out in cases where a woman wears a contraceptive device installed inside the uterine cavity for longer than the prescribed period.
In what cases is vacuum aspiration contraindicated?
Despite large number indications for taking an aspirate from the uterine cavity and the relative safety of the procedure, there are still certain contraindications to its use. Thus, sampling of epithelial areas is not carried out in the following cases:
- In the presence of urological and gynecological diseases that are in acute stage;
- If inflammatory processes of any type are detected in the uterine body or in the vaginal cavity;
- For colpitis and cervicitis.
It is important to note that for women who are pregnant, an aspirate test is strictly prohibited.
Carrying out a uterine biopsy using a vacuum method
How is uterine cavity aspiration performed?
Of course, any surgical intervention, even the most gentle one, still involves the occurrence of painful spasms. When taking samples from the cavity of the uterine body, painful sensations also occur. The degree of pain depends on the level pain threshold patients. In any case, an hour before the procedure, the treating gynecologist prescribes an anesthetic, so you should not be afraid of this manipulation. To obtain a more reliable result, the aspirate is taken from the 6th to the 9th, as well as within 20-25 days from the beginning of the menstrual cycle.
The procedure itself, as a rule, is carried out in a antenatal clinic and does not imply registration for an inpatient stay in a hospital. The aspirate is taken according to the following steps:
- External genital organs are treated with iodonate;
- Using speculums (gynecological) provides access to the cervical section of the uterine organ;
- The cervix of the uterine cavity is grasped using bullet forceps;
- The material is taken with a vacuum-type syringe.
Possible complications from the procedure
As already mentioned, taking samples using the vacuum method is an easily tolerated procedure that practically does not cause serious complications. However, there is still the possibility of some complicated consequences. So, if during collection of material for analysis the blood vessels of the uterine cavity are damaged, then severe internal bleeding may occur. Moreover, it is often accompanied by dizziness, severe pain in the abdominal area, nausea, decreased blood pressure.
One more is enough serious complication there may be the development of inflammation in the uterine cavity. The first signs of development inflammatory process a significant increase in general temperature, a feeling of weakness and the occurrence of abdominal pain are considered. It is worth noting that the threat of inflammation will not arise if all the instruments used to collect the aspirate are sterile. Therefore, in order to avoid complications of various kinds, you need to carefully choose a gynecological clinic and not ignore the recommendations of the treating gynecologist regarding lifestyle during the recovery period.
The collected aspirate from the uterine cavity allows you to quickly determine the presence of gynecological ailments that have just begun to develop. In what cases is uterine aspirate necessary? Are there any contraindications to it?
When a patient has pathological intrauterine processes, the gynecologist may prescribe taking an aspirate from the uterine cavity. Cytological examination is a method of obtaining important data about the pathological processes of the uterine endometrium, cellular atypia, or even the presence of cancer cells.
A cytological examination of aspirate from the uterine cavity is usually performed on an outpatient basis. The material is collected as follows:
- When the uterine position and its size are determined, speculums are inserted and the cervix is treated with alcohol. Then the catheter is lightly inserted, an aspirate is taken using a syringe, the catheter is removed, and the resulting material is applied to a special fat-free and labeled glass for the purpose of examining the smear.
- Another method is carried out using a syringe, which already contains a couple of milliliters of sterile saline solution and 10% sodium nitrate in order to prevent blood clots in the material. First, the liquid is injected into the uterine cavity using a catheter, and then immediately aspirated into a syringe. Then the catheter is removed from the uterus, and the liquid is placed in a special tube for further centrifugation for 10 minutes. The sediment is left for cytological examination, and the liquid is washed off.
- The best way is considered to be the synchronous introduction and removal of fluid from the uterine cavity using 2 catheters. Prepare 2 syringes, 1 of which contains a sodium nitrate solution, and the second is used for collecting material (aspiration). The fluid washes the uterine cavity, but does not enter fallopian tubes or into the peritoneum. Next, the liquid is placed in a centrifuge tube, the resulting sediment from the liquid is examined and the results of the manipulation are recorded, in which the presence or absence of diseases is noted.
For what purpose are such tests prescribed? The main purpose of the this study— determination of the state of the endometrium of the uterus. The results obtained make it possible to determine how well the endometrium corresponds to the norms in a particular phase menstrual cycle. Along with this, this analysis allows you to quickly determine the presence of benign or malignant neoplasms.
Indications and contraindications for this procedure
Taking aspirate from the uterine cavity is currently considered the most gentle and informative way to study the endometrium. It does not injure the uterine mucosa as with curettage.
Inflammation and other complications occur extremely rarely. Just a couple of days after the manipulation, the woman can already collect the results. If cells of an atypical type are detected, the woman requires a biopsy and histological examination to determine the characteristics of the pathology and further treatment tactics.
Other indications for the study include: irregular menstrual cycle, infertility, diagnosis of endometriosis or hyperplasia, the presence of malignant neoplasms, negative ultrasound results, the presence of atypical vaginal discharge, monitoring the condition of the uterine mucosa during treatment hormonal drugs, long-term wearing of the IUD and use of contraceptives.
The spiral cannot be worn for more than the prescribed period, otherwise the uterine mucous membrane may become thinner. As a result, the reproductive organs become inflamed.
The aspiration procedure is contraindicated in the following cases:
- acute or chronic gynecological or urological ailments;
- inflammation of the cervix or vagina;
- colpitis and cervicitis;
- pregnancy.
What complications may arise after collecting an aspirate?
Rarely, but still sometimes injury to the uterus occurs. In this case, the patient experiences severe pain in the abdominal area. Sometimes the pain radiates upward, almost reaching the collarbone area.
Injury blood vessels may provoke the development of internal bleeding.
In this case, the patient experiences nausea, dizziness, decreased blood pressure, abdominal pain, and in some cases may experience spotting.
In rare cases, inflammatory processes may begin to develop in the uterus. This situation causes a woman to experience general weakness, abdominal pain and sometimes an increase in body temperature. Signs of this inflammation may occur several days later or immediately after aspirate collection.
According to numerous reviews from patients, aspiration is most often absolutely harmless. No special preparation is required for the procedure; hygienic actions are sufficient.
If the development of pathological processes in the uterine body is detected, collection of aspirate from the uterine cavity may be prescribed. As a rule, such a study is aimed at studying the endometrium in order to determine its condition. Based on the diagnostic results, the structure of the endometrium is analyzed and its compliance (or non-compliance) with the current phase of the menstrual cycle is determined.
Aspirate of the uterine cavity provides an opportunity to detect in advance the development of tumor formations of a malignant or benign type, and this allows timely, if necessary, treatment to begin and avoid the serious consequences of the disease.
In what cases is aspirate taken from the uterine cavity?
Aspirate from the uterine cavity is considered the most reliable and in a simple way extracting the contents of the uterine organ for research. Experts note that, unlike traditional curettage, this method is more gentle, since it does not cause injury to the mucous membrane of the uterine cavity. Also, this procedure quite rarely leads to various complications, for example, to the development of inflammatory processes.
You can learn more about inflammatory processes in the female genital organs from this video:
The results of the examination, during which aspirates are taken from the uterine cavity, are usually provided within two days. If presence is detected atypical cells in the body, then a histological and biopsy examination is prescribed to determine characteristic features pathology.
What may be the indications for the procedure?
Aspirate from the uterine cavity is prescribed in the following cases:
- If there are disturbances in the menstrual cycle;
- In case of primary and secondary infertility;
- If endometrial hyperplasia or endometriosis is suspected, as well as malignant processes (if these diseases are present, uterine cavity aspirate is re-prescribed);
- If the ultrasound shows unfavorable results;
- In case of atypical vaginal discharge;
- To monitor the condition of the endometrium when taking hormonal drugs.
Additionally, aspirates from the uterine cavity are taken in cases where a woman has been using an intrauterine device as a means of contraception for quite a long period. It is known that wearing the IUD for more than the prescribed period can lead to thinning of the uterine endometrium and, as a consequence, to the development of inflammation of the reproductive organs.
In this video you can learn more about this type of contraception as the intrauterine device:
Contraindications for vacuum aspiration
Despite the fact that the procedure is carried out in a gentle way, there are still some contraindications to its implementation. In practice, uterine cavity aspirate is contraindicated in these cases:
- For gynecological and urological diseases in the acute stage or exacerbation of chronic ones;
- In case of inflammation of the cervix of the uterine organ and vagina of any nature;
- Aspirates from the uterine cavity are especially contraindicated for colpitis and cervicitis.
It is important to note that uterine aspirate is not prescribed if the woman is pregnant.
How is aspirate collected from the uterine cavity?
Of course, every woman who is prescribed a uterine cavity aspirate is concerned about how painful the procedure is and how to prepare for it. Previously, the tissue sampling process was carried out using Brown syringes, which could result in pain for the patient. Today modern methods For this procedure, you can use either special vacuum syringes, which are produced in the States, or Italian cannulas. To minimize the degree of pain, an anesthetic pharmacological agent is used an hour before the procedure.
Aspirates from the uterine cavity are taken from days 20 to 25 of the menstrual cycle. During the procedure, the doctor performs the following manipulations:
- The external genital organs are disinfected with iodonate;
- The cervical section of the uterus is exposed using speculum;
- The cervix of the uterine organ is grasped with bullet forceps;
- An aspirate is taken from the uterine body using a syringe (vacuum);
- At the end of the procedure, the external genital organs are processed again.
An aspirate from the uterine cavity takes a few minutes and is usually carried out in a antenatal clinic. The patient does not need to register for a hospital stay. No special preparation is expected on the part of the woman, except for ordinary hygiene procedures.
Possible complications after the procedure
When uterine cavity aspirate is collected, there is a fairly small percentage that serious consequences may occur. In rare cases, injury to the mucous membrane of the uterine body may occur, which entails pain syndrome in the abdominal area, extending upward, closer to the collarbone. If blood vessels are injured during manipulation, there is a high probability of internal bleeding. And, as you know, as a result of blood loss, blood pressure drops, nausea appears, and dizziness occurs. Also, for some time the patient may notice small bloody discharge.
One more possible consequence after aspiration, there may be the onset of an inflammatory process in the uterine cavity. In this case, the woman experiences weakness, pain in the abdominal area, and the overall body temperature may rise significantly. Inflammatory symptoms may appear immediately after the procedure or several days later. However, many patient reviews indicate that such complications occur quite rarely.
An aspirate from the uterine cavity is taken to analyze the endometrial lining. Vacuum aspiration is a more gentle way of taking material for a biopsy compared to curettage; it does not injure the uterine mucosa and is much less likely to lead to various kinds of complications.
Indications for aspirate collection
Vacuum aspiration of the uterine cavity is performed in the following cases:
- For menstrual irregularities;
- For infertility of unknown etiology;
- With uterine bleeding;
- For various gynecological diseases, in particular, endometrial hyperplasia and endometriosis, ovarian tumors;
- If you suspect malignant processes in the organs of the reproductive system;
- For atypical vaginal discharge;
- If the results of ultrasound of the pelvic organs are unfavorable;
- For control when taking hormonal drugs.
An additional indication is the long-term use of a contraceptive such as an intrauterine device. Exceeding the period of use intrauterine device leads to thinning of the endometrium of the uterus and the development of the inflammatory process. Therefore, after removing the spiral, aspiration is necessary, followed by cytological examination of the material.
Goals of cytological examination
Cytological examination of the aspirate allows one to analyze the structure of the endometrium, determine its compliance (or inconsistency) with a given phase of the menstrual cycle, as well as timely identify possible malignant formations at the earliest stage and differentiate them from others pathological conditions endometrium.
Other diagnostic studies, such as ultrasound, visual examination, blood test, do not provide such an accurate picture, since many gynecological diseases have similar symptoms.
The results of the cytological examination are prepared within 1-2 days. If, according to the results of the analysis, atypical cells were found in the uterine mucosa, then usually an additional histological examination of the uterine tissue and cervical canal, which helps to clarify the nature and extent of the pathological process.
The procedure for taking aspirate from the uterine cavity
Previously, so-called Brown syringes were used to take aspirate - plastic containers that were inserted into the uterine cavity. At the same time, women experienced some painful sensations. Currently, more advanced tools are used - vacuum syringes made in America and Italy. No special preparation is required for this procedure, but it is recommended that you take some kind of pain medication about an hour before the aspiration. The antispasmodic will relax the cervix, and this will make the procedure easier.
Typically, vacuum aspiration is prescribed on days 6-9 or 20-25 of the menstrual cycle. Douching should not be done during the day before the procedure.
The aspirate collection process includes:
- Disinfection of the external genitalia with iodonate solution;
- Exposure and fixation of the cervix using mirrors;
- Grasping the cervix with forceps;
- Probing the uterus to determine its size;
- Taking an aspirate with a vacuum syringe;
- Removal of instruments and re-treatment of organs with a disinfectant.
Since only uterine endometrial cells need to be taken for analysis, the movements of the syringe must be stopped before it is removed so that the cervical canal and vaginal cells do not get into the syringe.
In general, the procedure takes no more than 10 minutes, and taking the aspirate itself takes 10-15 seconds. After aspiration, some women experience nagging pain lower abdomen or bloody discharge, but these symptoms pass fairly quickly.
Contraindications for vacuum aspiration
- Acute gynecological or urological diseases or exacerbation chronic diseases;
- Any inflammatory processes of the cervix and vagina;
- Pregnancy.
In this case, damage to the uterine mucosa and relapse of existing diseases is possible.
Possible complications after aspiration
If the blood vessels of the uterus are damaged during the procedure, there is a risk of internal bleeding. In this case, there is a decrease in blood pressure, rapid heartbeat, dizziness, a feeling of nausea, dry mouth, and bloody vaginal discharge.
To others possible complication the development of an inflammatory process in the uterus may occur. In this case, the temperature rises, weakness and pain in the lower abdomen appear. These symptoms can appear either a few hours after the procedure or several days later. However, if the procedure is carried out correctly, using sterile instruments, this is excluded.
Since the uterine mucosa is slightly injured, minor painful sensations and discomfort in the lower abdomen.
In what cases can cytology results be incorrect?
- When taking an aspirate during menstruation;
- If vaginal antibacterial agents were used on the day of aspiration;
- If there is gel left on the internal genital organs after the ultrasound;
- If the procedure was performed during an exacerbation of a chronic infectious disease.
A study of aspirate from the uterine cavity is carried out to diagnose pathological processes occurring in the endometrium. The prerequisites for carrying out such a procedure are the presence of multiple disorders occurring in the uterus and ovaries in order to assess the effectiveness of the treatment with hormonal hormones. medicinal drugs, to identify the reasons, causing infertility, and in the formation of malignant tumors in the endometrium.
The need for
The use of this technique makes it possible to detect the atypical component of aspirate cells from the uterine cavity on initial stages illness, which facilitates timely treatment and guarantees a successful recovery. The need to use the method of aspiration from the uterine cavity appears in cases of bleeding during menopause, in the case of long-term use of the IUD, in cases of suspected hyperplasia of the mucous membrane, and much more.
If problems are detected in the condition of the genital organs, the woman must be examined by a specialist with necessary tests. This is due to the fact that a successful outcome in the treatment of progressive pathology in cases of oncological formations is possible only with early stages, which can only be diagnosed using a procedure for examining aspirate from the uterine cavity. Carrying out an analysis of aspirate in this way provides a detailed picture of the state of the endometrium and makes it possible to select effective methods treatment based on individual characteristics patients.
The current level of medicine allows a graduate student to conduct an analysis of the uterine cavity during a visit to the antenatal clinic and, based on the study, determine the nature of changes in the endometrium for the presence of malignant formations in the shortest possible time. The results of the examinations, during which aspirate is collected from the uterine cavity, are usually ready within 2 days. If the presence of atypical cells is detected in the analysis results, additional biopsy and histological tests are prescribed to determine the nature of the pathological changes.
Contraindications for aspirate collection
The aspiration procedure is a gentle way of conducting an examination, however, there are some contraindications for its implementation. Aspirate is not recommended in case of exacerbation of chronic diseases of the reproductive organs, as well as their condition in an acute complicated form. Inflammation in the uterine cavity and the presence of pathological foci in the vagina are also an obstacle to analyzing aspirate from the uterine cavity. The use of such a procedure in cases of colpitis or cervicitis is strictly prohibited. Pregnant women are never given an aspirate.
Features of the method
The procedure for collecting aspirate from the uterine cavity is carried out on the twenty-fifth day from the start of menstruation. If there is menopause, patients can undergo this examination at any convenient time. Removing material from the uterine cavity for further research occurs in two ways, using a syringe and a catheter inserted into the uterine cavity. The second method uses a flushing method using a sterile sodium chloride solution injected through a syringe and then drawn back in. The resulting liquid, after a series of procedures using rotation, provides material for further study.
Modern medicine offers improved medical instruments for use to obtain material for research. For example, aspirate from the uterine cavity using the vacuum method differs in many ways from previously used options. Through the slightly open cervix, the depth of the fundus of the uterine cavity is measured, then the required amount of material is taken for further research using vacuum syringe and cannulas. The resulting sample is sent for final analysis.
Possible complications after examining an aspirate
Carrying out the aspirate procedure does not require special preliminary preparation; it is enough to take ordinary hygienic actions. The use of the aspirate method rarely causes complications in the form of severe consequences. Sometimes injury to the mucous membrane occurs during the insertion of a catheter or careless use of a syringe when introducing and suctioning a solution from the uterine cavity. This may result in minor pain in the genital area. If blood vessels are damaged during the test, there is a risk of internal bleeding. The result of such a disorder can be a drop in heart pressure, dizziness and nausea. After some time, discharge mixed with blood may appear from the vaginal cavity.
If inflammatory complications occur as a result of the aspiration procedure, the temperature may rise, loss of strength, fever, and abdominal pain may occur. The manifestation of the listed symptoms is possible immediately after the end of the aspirate procedure, or they may manifest themselves within several days. However, the occurrence of such complications is rare and is the exception rather than the rule.
Aspirate from the uterine cavity is currently considered the most reliable method for obtaining high-quality material for research. With the help of this analysis, it became possible to apply more gentle examination methods to a woman without the use of traditional curettage. This procedure protects female organs from unnecessary injury and very rarely causes subsequent complications.