Dilation and Curettage (D&C)

Dilation and Curettage (D&C) is a brief surgical procedure in which the cervix is dilated and a special instrument is used to scrape the uterine lining.

You may need a D&C for one of several reasons. It’s done to:

Remove tissue in the uterus during or after a miscarriage or abortion or to remove small pieces of placenta after childbirth. This helps prevent infection or heavy bleeding.

Diagnose or treat abnormal uterine bleeding. A D&C may help diagnose or treat growths such as fibroids, polyps, or endometriosis, hormonal imbalances, or uterine cancer. A sample of uterine tissue is viewed under a microscope to check for abnormal cells.

Before the Procedure

Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your health care provider which drugs you should still take on the day of your surgery.

On the day of your surgery:

• You very often will be asked not to drink or eat anything for 6 – 12 hours before the surgery.
• Take the drugs your health care provider told you to take with a small sip of water.

Your health care provider or nurse will tell you when to arrive at the hospital 

Dilation and Curettage (D&C) Procedure

You can have a D&C in your doctor’s office, an outpatient clinic, or the hospital. It usually takes only 10 to 15 minutes but you may stay in the office,

During a Dilation and Currettage (D&C), you lie on your back and place your legs in stirrups like during a pelvic exam. Then the doctor inserts a speculum into the vagina and holds the cervix in place with a clamp. Although the D&C involves no stitches or cuts, the doctor cleanses the cervix with an antiseptic solution.

• What to Expect When Having a D&C
• Recovery After a D&C

A Dilation and Curettage D&C involves two main steps:

Dilation: involves widening the opening of the lower part of the uterus (the cervix) to allow insertion of an instrument. The doctor may insert a slender rod (laminaria) into the opening to gradually cause it to widen. Or medication may soften the cervix to help it widen.

Curettage: involves scraping the lining and removing uterine contents with a long, spoon-shaped instrument (a curette). The doctor may also use a cannula to suction any remaining contents from the uterus. This can cause some cramping. In many cases, a tissue sample goes to a lab for examination.

Recovery after a Dilation and Curettage (D&C)

After a D&C, you will need someone to take you home. If you had general anesthesia, you may feel groggy for a while and have some brief nausea and vomiting. You can return to regular activities within one or two days. In the meantime, ask your doctor about any needed restrictions. You may also have mild cramping and light spotting for a few days. This is normal. You may want to wear a sanitary pad for spotting and take pain relievers for pain.

You can expect a change in the timing of your next menstrual period. It may come either early or late. To prevent bacteria from entering your uterus, delay sex and the use of tampons until your doctor says it’s OK.

See your doctor for a follow-up visit and schedule any further treatment that’s needed. If any tissue was sent for a biopsy, ask your doctor when to expect results. They are usually available within several days. 

Risks

As with any surgery there are risks, however Dilation and Curettage (D&C) carries the lowest risks of complications:

• Heavy Bleeding, Blood Clots
• Infection
• Damaged Cervix
• Perforated Uterus, or Bowel is extremely rare

Complications from anesthesia, some other temporary side effects include brief bouts of nausea and vomiting, cramping, spotting or mild to heavy discharge.

Talk with your doctor to understand possible risks and benefits of surgery.