Suction and evacuation is a surgical procedure to remove or empty the contents of a uterus. It is a common surgery with high success rates and low risks. If you are scheduled for a suction and evacuation procedure, here is everything you need to know.
Suction evacuation is a surgical procedure to clean the uterus. The doctor will access the uterus via the cervix, use a suction or vacuum pump, and evacuate the contents of the uterus. It is a simple and pain-free procedure that may cause cramping or spotting soon after the procedure. The patient is under anaesthesia throughout the procedure, and the cervix is dilated with the use of pills. So, there are no surgical cuts or incisions to cause any pain or marks.
A suction evacuation procedure may be necessary in the following situations:
1. Miscarriage – After a miscarriage, the body will get rid of the uterine contents on its own. In some cases, you may need a medical procedure to remove the remaining contents from the uterus, as leaving anything in the uterus can turn dangerous very quickly.
2. Elective Abortion – When a woman decides to abort her pregnancy for personal or medical reasons within the first twelve weeks of pregnancy, the suction and evacuation method is one of the most commonly used methods of abortion.
3. Vaginal Delivery – After a vaginal delivery, a suction and evacuation may be necessary to empty the uterus.
4. Endometrial Biopsy – In the case of endometriosis, the suction evacuation procedure is used to obtain a sample of the uterine lining for further analysis.
The suction and evacuation procedure is done in the following way:
1. Softenig the Cervix – A tablet is inserted into the vagina to soften the cervix – the vaginal opening.
2. Preparation – The patient is made to lie on her back with her feet up in stirrups. This gives better access for the doctor to perform the procedure smoothly.
3. Anaesthesia – the doctor may choose to sedate the patient completely or use local anaesthesia to numb the abdominal region. General anaesthesia or spinal anaesthesia can also be used.
4. Preparing the Cervix – Next, they will insert a speculum into the vaginal opening and gently open the cervix for better access. Thin rods, known as dilators, are inserted into the cervix to stretch the opening of the cervix further.
5. Cannula Insertion – A thin tube known as the cannula, attached to the source of suction on one end, is slowly inserted into the uterus through the stretched cervix.
6. Aspiration – With the help of a syringe or an electric pump for suction, the contents (fetus, placenta, endometrial lining) of the uterus are removed through the cannula.
7. Checking Uterus – Once the evacuation is done, the uterus is thoroughly checked for any remaining contents using a curette – a surgical tool used for scraping the uterus.
8. Procedure Complete—Once satisfied, the doctor will gently remove the tube, rods, and speculum. The entire procedure takes about 15 minutes to complete.
The suction and evacuation procedure is a very common and safe procedure. However, like any other medical procedure, this method has its own set of risks:
● Vaginal Bleeding – One of the most common complications is excess vaginal bleeding in the first few hours following the procedure. The bleeding will decrease, and mild bleeding may continue for about 2 weeks. In some cases, the bleeding could be in excess, accompanied by clots.
● Cramps – Mild cramping for the next two weeks is common. Routine painkillers after the procedure can help control these cramps.
● Retention in Uterus – If the uterine contents are not cleaned properly, it can become dangerous. If the procedure is performed before 6 weeks of pregnancy, there are chances of leaving behind some pregnancy tissue in the uterus.
● Infection – If the uterus is not cleaned properly, the retained product, which is nothing but dead tissues, can cause infection. Bacteria entering the uterus during the procedure can also cause infections.
● Injury – Use of medical instruments can cause perforation in the uterine wall or injury to the cervix or vaginal opening.
While the suction and evacuation procedure may not have any major medical side effects, if you have opted for suction and evacuation during pregnancy, you may need to consider the impact on your mental health.
Whether the reason to abort the pregnancy is medical or personal, it is a big decision that can take a toll on your mental health. Most hospitals offer counselling before the procedure to help the patient or the couple cope with the emotional aspect of the procedure.
If you require support, do not hesitate to seek professional help. Joining support groups and meeting other women who can empathise with your situation can help to a great extent.
The suction evacuation procedure is a quick procedure with little risk and a high success rate. Ensure you choose a well-reputed doctor and facility to get your procedure. The facility’s hygiene and the doctor’s expertise in performing the procedure without causing any damage to the organs or leaving anything behind in the uterus are very important for a safe and successful outcome.
The cervix is first dilated, and the patient is given local or general anaesthesia. Next, the cervix is opened wider with the help of dilators, and a tube attached to a suction device is inserted into the uterus. After evacuating the uterine contents using the suction, the dilators and the tube are pulled out. The entire procedure takes less than 30 minutes.
Suction and evacuation is a fairly simple procedure free of any complications. You may experience mild cramping and bleeding soon after the procedure. Some women can experience heavy vaginal bleeding in the first few hours after the procedure and light bleeding that lasts up to 2 weeks. The anaesthesia can cause nausea and vomiting and make you feel faint.
In a dilation and evacuation procedure, the cervix is gradually dilated using medical instruments. After the anaesthesia takes effect, a tube attached to a suction device is entered into the uterus, and the contents are gently evacuated. The patient is kept under close observation for a few hours after the procedure before they are sent home.
The typical suction evacuation pressure to clean out the uterus is 60–80 mmHg of negative pressure. Increasing the pressure further can damage the uterus and cause other complications.
