(Dilatation and Curettage, D&C)
A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the cervical canal and uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues in the uterus. A suction D&C uses suction to remove uterine contents. This is sometimes called a dilation and evacuation (D&E).
Other related procedures used for diagnosing and treating the endometrium include endometrial ablation, hysteroscopy, and hysterectomy. Please see these procedures for additional information.
The organs and structures of the female pelvis are:
With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone help to thicken its walls. If fertilization does not occur, the endometrium, coupled with blood and mucus from the vagina and cervix (the lower, narrow part of the uterus located between the bladder and the rectum), make up the menstrual flow (also called menses) that leaves the body through the vagina. After menopause, menstruation stops and a woman should not have any bleeding.
A D&C may be used as a diagnostic or therapeutic procedure for abnormal bleeding. A D&C may determine the cause of abnormal or excessive uterine bleeding, to detect cancer, or as part of infertility (inability to become pregnant) investigation.
Causes of abnormal bleeding include the presence of abnormal tissues such as fibroid tumors (benign tumors that develop in the uterus, also called myomas) polyps, or cancer of the endometrium or uterus. Tissues obtained from the D&C can be examined under a microscope. Abnormal uterine bleeding may also be due a hormone imbalance or disorder (particularly estrogen and progesterone) especially in women approaching menopause or after menopause.
A D&C may be used following a miscarriage to remove the fetus and other tissues if they have not all been naturally passed. Infection or heavy bleeding can occur if these tissues are not completely removed. This type of D&C may also be called a surgical evacuation of the uterus or a D&E.
Occasionally following childbirth, small pieces of the placenta (afterbirth) remain adhered to the endometrium and are not passed. This can cause bleeding or infection. A D&C may be used to remove these fragments so that the endometrium can heal properly.
There may be other reasons for your physician to recommend a D&C.
As with any surgical procedure, complications may occur. Some possible complications of a D&C may include, but are not limited to, the following:
Patients who are allergic to or sensitive to medications, iodine, or latex should notify their physician.
If you are pregnant or suspect that you may be pregnant, you should notify your physician.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
A vaginal, cervical, or pelvic infection may interfere with a D&C.
A D&C may be performed in a physician’s office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician’s practices.
The type of anesthesia will depend upon the specific procedure being performed. Some D&C procedures may be performed while you are asleep under general anesthesia, or while you are awake under spinal or epidural anesthesia. If spinal or epidural anesthesia is used, you will have no feeling from your waist down. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
Generally, a D&C follows this process:
The recovery process will vary depending upon the type of procedure performed and type of anesthesia that was administered.
If you received regional or general anesthesia, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed on an outpatient basis, you should plan to have another person drive you home.
After a D&C using local anesthesia, you may rest for about two hours before going home.
You may want to wear a sanitary pad for bleeding. It is normal to have some spotting or light vaginal bleeding for a few days after the procedure.
You may experience cramping for the first few days after a D&C.
You may be instructed not to douche, use tampons, or have intercourse for two to three days after a D&C, or for a period of time recommended by your physician.
You may also have other restrictions on your activity, including no strenuous activity or heavy lifting.
Because a D&C removes the lining of the uterus, the lining must build back up. Your next menstrual period may begin earlier or later than usual.
You may resume your normal diet unless your physician advises you differently.
Take a pain reliever for cramping or soreness as recommended by your physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Your physician will advise you on when to return for further treatment or care.
Notify your physician if you have any of the following:
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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