Dilatation and Curettage (D&C)

What is dilatation and curettage?

Dilatation and curettage (D&C) is a surgical procedure in which the cervix is opened (dilated) and a thin instrument is inserted into the uterus . This instrument is used to remove tissue from the inside of the uterus (curettage).

Why is a dilatation and curettage done?

D&C is used to diagnose and treat many conditions that affect the uterus, such as abnormal bleeding.

A D&C also may be done after a miscarriage. A sample of tissue from inside the uterus can be viewed under a microscope to tell whether any cells are abnormal. A D&C may be done with other procedures, such as hysteroscopy, in which a thin, lighted telescope is used to view the inside of the uterus.

Where is a dilation and curettage done?

A D&C can be done in a surgery day-clinic or a hospital.

What preparation is needed for a dilation and curettage?

Your health care professional may prescribe medication to soften the cervix, making it easier to dilate. You will also receive some type of anaesthesia before or during your D&C.

What happens during the procedure?

During the procedure, you will lie on your back and your legs will be placed in stirrups. A speculum will be inserted into your vagina. The cervix will be held in place with a special instrument.

If your cervix needs to be dilated (opened), this will be done by inserting a series of rods through the cervical opening. Each rod will be slightly larger than the last one. Usually only a small amount of dilation is needed (less than one half inch in diameter).

Tissue lining the uterus will be removed, either with an instrument called a curette or with suction. In most cases, the tissue will be sent to a laboratory for examination.

What are the risks of dilation and curettage?

Complications include bleeding, infection, or perforation of the uterus (when the tip of an instrument passes through the wall of the uterus). Problems related to the anaesthesia used also can occur. These complications are rare.

In rare cases, after a D&C has been performed after a miscarriage, bands of scar tissue, or adhesions , may form inside the uterus. This is called Asherman syndrome. These adhesions may cause infertility and changes in menstrual Iow. Asherman syndrome often can be treated successfully with surgery.

What should I expect after the surgery?

After the procedure, you probably will be able to go home within a few hours. You will need someone to take you home. You should be able to resume most of your regular activities in 1 or 2 days. Pain after a D&C usually is mild. You may have spotting or light bleeding.

Is there anything I should watch out for or not do right after my dilation and curettage?

You should contact your health care professional if you have any of the following:

Heavy bleeding from the vagina
Fever
Pain in the abdomen
Foul-smelling discharge from the vagina

After a D&C, a new lining will build up in the uterus. Your next menstrual period may not occur at the regular time. It may be early or late.

Until your cervix returns to its normal size, bacteria from the vagina can enter the uterus and cause infection. It is important not to put anything into your vagina after the procedure. Ask your health care professional when you can have sex or use tampons again.