Overview
Dilation and curettage (D&C) is a minor surgical procedure that is done to remove tissue from the uterus (womb). This procedure is used to diagnose and treat uterine issues such as unexplained bleeding during menstrual periods, as well as to clear the uterine lining following a miscarriage or abortion. D&C is also performed if placental tissue from a previous pregnancy remains in the womb. A D&C can also help the doctor detect aberrant endometrial cells, which could indicate the presence of uterine cancer.
The D&C name comes from having the cervix dilated during the operation and from the doctor using a small instrument called a curette to scrape the uterine wall and remove the tissue.
D&C Procedure
A D&C procedure can be performed in the doctor’s office or the hospital, and you can usually go home the same day. You will receive anesthesia, and the choice of anesthesia will depend on the reason for the D&C and your medical history.
Before beginning the procedure, the doctor usually starts dilating the cervix using a laminaria stick by inserting a thin rod into the cervix and leaving it there for several hours; This stick absorbs fluids from the cervix, which enables the cervix to open and give access to the uterus.
During the procedure, you lie on an exam table with your feet supported by stirrups like during a gynecologic exam. Your doctor will insert an instrument called a speculum in your vagina to see your uterus then they will slowly dilate the cervix until it is open enough to insert the scraping instrument (curette), a suction tube, or other specialized instruments to remove tissue from inside the uterus.
Other procedures may be performed in addition to a D&C; for example, a slim instrument, called a hysteroscope, can be inserted by your doctor to observe the inside of your uterus and a polyp or fibroid may be removed.
Following a D&C, your doctor will send a sample of cells to the lab, where pathologists can determine whether you have normal or abnormal tissue, polyps, or cancer.
It usually takes around five to ten minutes to complete the procedure, after which you will have to stay in the recovery room for a few hours before you can go home.
Risks associated with a D&C
A D&C is a simple and painless operation. However, like with any surgery, there are potential risks. Some possible complications of a D&C may include, but are not limited to, the following:
- Heavy bleeding from the uterus
- Infection of the uterus
- Perforation of the uterine wall or bowel
- Adhesions (scar tissue) may develop inside the uterus
Patients who are pregnant or are allergic to or sensitive to medications should notify their doctor. There may be other risks depending on whether you have a medical condition. Before the procedure, make sure to discuss any concerns with your doctor.
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