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Dilation & Curettage (D & C)

Overview

Dilation and curettage, usually called a D&C, is a procedure in which a doctor removes tissue from the uterus. It is used as a treatment for a variety of conditions and can also help a doctor diagnose problems in the reproductive system. The procedure includes two parts: the dilation of the cervix and the use of a tool called a curette to remove tissue from inside of the uterus.

Preparation and Procedure

Dilation and curettage is an outpatient procedure that takes a few hours. Patients are asked to not eat or drink prior to the procedure. Anesthesia is administered prior to the procedure, which can cause drowsiness in the hours after the procedure is complete. Most patients are able to return to their normal routine within a day or two.

There are instances when the dilation of the cervix is started hours or a full day prior to the procedure, especially if the dilation needed is excessive. In most cases, dilation begins shortly before the procedure. Patients might receive a general, regional, or local anesthetic, depending on the severity of the procedure. Once the anesthetic is working and dilation is complete, the process takes about 15 to 30 minutes.

During the procedure, patients lie on their back with their legs in stirrups. A speculum is inserted into the vagina, which is then dilated, usually with rods. There might be medication administered in advance to soften the cervix and making dilation easier. Once the cervix is between six and nine millimeters wide, the curette is inserted and the tissue is removed. Patients usually feel no discomfort during the process because of the anesthesia. Following the procedure, patients will spend a few hours in recovery. During this time, they are monitored for bleeding and other side effects or complications.

Once the procedure is complete, your doctor will give you information about resuming sexual activity and using tampons. It is important to follow these instructions carefully. While your cervix is dilated, you can introduce bacteria into the uterus if you put anything into your vagina. Your doctor will also have recommendations about pregnancy for women who needed a D&C due to a miscarriage.

Many women find their period is delayed following the D&C procedure because it takes time for the uterine lining to build up again. Usually a menstrual period will occur within six to eight weeks. If you do not experience a period within this time, contact your doctor.

A D&C is a safe, relatively painless procedure for restoring health to the uterus and other reproductive organs. If you are interested in learning more about dilation and curettage, speak with your doctor at Women’s Heath Care of Georgia.

How Do You Know You Need Dilation & Curettage?

A D&C is sometimes used to diagnose the cause of abnormal bleeding, menstrual pain, or abnormal endometrial cells following a pap smear. Cells are collected from the uterus and tested for polyps, cancer, or endometrial hyperplasia. A D&C might also be used to treat conditions, such as excessive bleeding following a pregnancy, the removal of polyps in the cervix or uterus, the removal of fibroid tumors, and the removal of tissue remaining after an abortion or miscarriage. In order to make future pregnancy possible, it is important to remove the tissue that might remain following an abortion or miscarriage. Speak with your doctor concerning the procedure and its relation to future pregnancies if you have any concerns.

Risks

There are very few risks involved with a D&C, but problems do occur. These include:

Perforation of the uterus: occurs when the curette punctures the uterus. Tears and punctures typically heal on their own, but your doctor must ensure there was no damage done to any organs or blood vessels.

Cervical damage: occurs when the cervix is torn, scraped, or cut. Your doctor can repair the damage with medicine, pressure, or sutures.

Infection: occurs very rarely and can be treated with medication.

Scar tissue on the uterine wall: occurs rarely and is known as Asherman’s syndrome. It can create further problems, such as painful periods, infertility, or miscarriage, but it can usually be treated with hormones or the removal of the scar tissue through a future procedure.

Should you experience heavy bleeding, long-term bleeding, cramping after 48 hours, increasing pain, foul-smelling discharge, or a fever following a D&C, you should contact your doctor immediately.

Patients might experience normal side effects in the hours and days following the procedure. These include nausea, vomiting, and sort throat, all of which are usually caused by the anesthetic. Other side effects include light spotting or bleeding and mild cramping.