Dilation and Curettage (D&C)
What is a dilation and curettage?
Dilation and curettage (D&C) is a minor surgical procedure used to remove tissue from the uterus (womb). The uterus is the organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus.
Dilatation opens and widens the cervix (the opening of the uterus). Curettage (scraping) is used to remove tissue from the uterus.
When is it used?
D&C may be done to:
· Try to find the cause of abnormal bleeding from the uterus
· Treat abnormal bleeding from the uterus.
· Remove polyps from the uterus.
· Remove an IUD.
· Remove pieces of placenta after childbirth.
· Remove tissue remaining after a miscarriage.
· Perform a termination of pregnancy (also called an abortion).
Examples of alternative procedures are:
· Endometrial biopsy: Your primary care provider takes a sample of tissue from the inside of the uterus with a thin, strawlike tube put through the vagina and cervix into the uterus. The tissue is examined under a microscope in the lab.
· Hysteroscopy: Your primary care provider looks at the inside of the uterus with a thin lighted tube with a camera put into the vagina, through the cervix, and into the uterus. Tissue may be removed during the procedure and sent to the lab for examination.
Another alternative is to choose not to have any procedure. Be aware of the possible risks of your condition if you choose to not have a procedure. You should ask your primary care provider about these choices.
How do I prepare for a D&C?
Plan for your care and recovery after the procedure, especially if you are to have general anesthesia. Arrange to have someone take you home and stay with you for a while after the procedure. Allow for time to rest. Try to find people to help you with your daily duties for 24 hours after the procedure.
Follow your primary care provider’s instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery
Follow any other instructions provided by your primary care provider. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.
What happens during the procedure?
You will be given a sedative or a regional or general anesthetic. A sedative helps you relax. A regional anesthetic numbs part of your body, keeping you from feeling pain while you stay awake. A general anesthetic relaxes your muscles and puts you to sleep. It will keep you from feeling pain during the procedure.
Your primary care provider stretches open (dilates) your cervix and guides a scooplike instrument called a curette into the uterus. Your primary care provider uses the curette to scrape all around the lining of the uterus and remove tissue. This tissue is usually sent to the lab for tests.
What happens after the procedure?
You can usually go home a few hours after the procedure if there are no complications. Expect some bleeding and menstrual-type cramps for the first day or so. Your primary care provider may suggest a pain medicine to relieve the discomfort. Women who are still having periods usually have their next period on schedule after the D&C.
Follow your primary care provider’s instructions about when you can have sexual intercourse. Do not put anything inside the vagina until your primary care provider says it’s safe. Don’t use tampons for a few weeks after the D&C.
Your primary care provider will tell you what other steps you should take and when you should return for a follow-up visit.
What are the benefits of this procedure?
Removing and testing tissue from the uterus may help diagnose or treat your problem.
What are the risks associated with this procedure?
· There are some risks when you have general anesthesia. Discuss these risks with your primary care provider.
· A regional anesthetic may not numb the area quite enough and you may feel some discomfort. In rare cases, you may have an allergic reaction to the drug used in regional anesthesia. In most cases regional anesthesia is considered safer than general anesthesia.
· The uterus may be punctured (perforated) by the curette. You might then need more surgery.
· The uterus may bleed more after the procedure than before the procedure.
· There is a small chance the uterus will get infected.
· Scar tissue (adhesions) may form inside the uterus, requiring more surgery and treatment.
You should ask your primary care provider how these risks might apply to you.
When should I see my primary care provider?
See your primary care provider right away if:
· You have heavy bleeding from your uterus (you need more than 1 pad per hour or the bleeding is heavier than your menstrual flow).
· You develop a fever over 38.6 C (101.5 F).
· You have severe abdominal pain.
· You keep having abdominal pain even after you take pain medicine.
· You have discharge from the vagina the smells bad.
See during office hours if:
· You have questions about the procedure or its result.
· You want to make another appointment.