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Dilation and Curettage (D&C)

About Dilation and Curettage, Menopause Center Los AngelesDilation and curettage (pronounced “dye-LAY-shun” and “KYUR-uh-tedge”) is a surgical procedure to scrape the uterine lining, either to remove tissue or take a sample for testing. The procedure involves dilating the cervix and scraping the inside of the uterus with a surgical tool. A D&C can be used for several different reasons:

  • Remove tissue following a miscarriage
  • Extract residual pieces of the placenta following childbirth
  • Terminate an early pregnancy

It also is used to diagnose and treat conditions such as:

  • Abnormal bleeding
  • Uterine polyps
  • Uterine fibroids
  • Uterine cancer
  • Imbalances of hormones

Preparation for a D&C

Your doctor will want to take a complete medical history before your surgery. You will want to let her know if:

  • You are or may be pregnant
  • You are on any blood thinners or have any known blood disorders
  • You have any allergies to medication or latex

How is a D&C Performed?

Dilation and curettage can be performed in a hospital setting, but they are also routinely performed at your gynecologist’s office as an outpatient procedure. The procedure usually only takes about 10-15 minutes, but you may need to remain in recovery for a few hours before going home.

Depending on your medical history and the extent of the D&C, your doctor may choose one of three types of anesthesia for your procedure:

  • Local anesthesia – Your cervix will be numbed to minimize your discomfort.
  • Nitrious Oxide (laughing gas) – This is often used  for many procedure that are performed in-office to minimize pain.
  • General anesthesia – You will be asleep during the procedure and won’t feel any pain.

During the procedure, you will be positioned on your back with your feet in stirrups. The doctor will place an instrument called a speculum into your vagina, so that the other instruments can access the cervix and uterus.

Dilation

Next, your doctor will need to dilate your cervix. This can be done with a dilation rod or with medication.

Curettage

Once the cervix is dilated, the doctor can scrape the lining of the uterus with an instrument called a curette. The curette looks like a small spoon or loop at the end of a long, thin handle. In some cases, the doctor may need to use a suction device to remove all of the tissue.

Hysteroscopy

If your doctor needs to take a look inside your uterus, she may insert a slender instrument equipped with a lens at this time. The lens allows your doctor to view the inner walls of the uterus and may help in making a diagnosis. This is not required in all D&C procedures.

Risks of Dilation and Curettage

Surgeries, Dilation and Curettage, Menopause Center Los AngelesDilation and curettage is a very safe procedure, but all medical interventions carry some risk. Many women experience minor side effects after a D&C, such as:

  • Light vaginal bleeding
  • Cramping
  • Grogginess
  • Nausea

You can manage these effects with a pain reliever (Tylenol) and sanitary pads. Refrain from using tampons for at least one week following a D&C.

Complications are rare, but you should call your doctor if you experience any serious symptoms, such as:

  • Fever, chills
  • Nausea or vomiting that lasts longer than 24 hours
  • Heavy bleeding or clotting
  • Severe pain
  • Swelling and tenderness in the abdomen
  • A change in color, texture, or odor of vaginal discharge

These symptoms may be a sign of infection or damaged tissue.

Asherman’s Syndrome

Rarely, a D&C may cause scarring. Scar tissue of the pelvic organs is known as adhesions, and they can cause pain and hinder fertility in some cases. Adhesions can be treated. Your doctor can evaluate you for adhesions at a follow-up appointment.

Recovery from D&C

You will need someone to drive you home following your D&C and you may need to take a day or two off work. Most women experience some light cramping and bleeding. This is normal, and you can take medication or use a heating pad to manage the pain.

To reduce the risk of infection, avoid inserting anything into your vagina for at least one week, including tampons and having sex.

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