If someone needs to have a uterine curettage, please ask the doctor whether they will use a curette or a plastic tube for suction.
Alright, let’s get started.
Question: Who needs to have a uterine curettage?
Answer: Women
Well, of course, men don’t have a uterus. Even if they undergo gender reassignment surgery to have a vagina, they still don’t have a uterus. Scraping or suctioning in the rectum is not a medical procedure.
We perform uterine curettage or suction for treatment or diagnosis only. For example, in cases of abnormal pregnancy, we perform an abortion. If the abortion is incomplete, we suction it out completely. This is treatment. For diagnosis, we do the same thing, which is to scrape or suction the uterine cavity to obtain tissue for examination to see if it is cancerous. That’s basically it.
So why did I title it Scrape or Suction?
That’s because in the past, we didn’t have much technology for this. We used sharp metal tools, resembling a spoon, inserted into the vagina, through the cervix, and once in the uterine cavity, we began scraping.
Imagine a young coconut being chopped at the top, leaving a hole to drink the cool coconut water to refresh your heart. Then we use a spoon to scrape the young coconut meat into our mouth, chew, and swallow.
That’s how it was scraped, really.
Women around the world have been having uterine curettage since my grandmother’s generation, perhaps even my great-grandmother’s, but I’m not sure because I wasn’t born yet.
This method was very painful because the tool was metal. Therefore, every patient had to be made pain-free, possibly through general anesthesia, injection to induce sleep, or spinal block to numb half the body, etc. The metal curette also posed a danger because it was metal.
Therefore, in the past, we encountered frightening complications such as uterine perforation, abdominal bleeding. Some cases were scraped so deeply that the metal cut into the uterine muscle layer, causing scarring, and that woman would never menstruate again in her life. In some cases, when perforation occurred, the metal curette even dragged out the intestines.
Horrifying
Wow, just imagining it is scary enough to make you shrink, right? (Um, I’m asking the male readers here.)
But that’s how it was because back then, the only tool available was the “metal curette.”
During my early years as a young doctor, I once scraped a patient’s uterus until it perforated. It was truly a sad story.
But times have changed.
Nowadays, we find that suctioning the uterine cavity can also remove tissue from the uterine cavity, and it does so better than scraping with metal. Plus, we use a plastic suction tube instead of metal, so it’s less painful, causes less injury, and results in fewer complications. In summary, it’s better. Therefore, we must urgently campaign to stop using metal curettes and switch to suction tubes. My team and I, or rather, the team and I, have been campaigning for this for about 16 years now.
Suction for miscarriage treatment
Suction to diagnose whether there is cancer in the uterine cavity
In summary, “Suction is better than scraping.”
Imagine a glass of bubble tea. We use a spoon to scoop the pearls or a straw to suck the pearls into our mouth. Slurp, slurp, slurp (Oops… got a bit carried away with the slurping). Which method will get the pearls at the bottom of the glass more conveniently and thoroughly? Think about it.
We teach new medical students to suction instead of scrape. My medical school has been teaching students to suction the uterine cavity for about ten years now.
Thanapan Chuboon
December 18, 2018
Songkhla Nakarin
Thanks to the story from Asst. Prof. Dr. Thanapan Chuboon