Dilation and Curettage (D and C)

What is a dilation and curettage (D&C)?

(Dilatation and Curettage, D&C)

A dilation and curettage procedure, as well called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can exist scraped with a curette (spoon-shaped musical instrument) to remove abnormal tissues.

Other related procedures used for diagnosing and treating the endometrium include endometrial ablation, hysteroscopy, and hysterectomy. Please see these procedures for additional information.

Illustration of the anatomy of the female pelvic area

What are female pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium . This is the lining of the uterus.

  • Uterus (also called the womb). The uterus is a hollow, pear-shaped organ located in a adult female's lower abdomen, betwixt the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries. Two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sexual practice hormones estrogen and progesterone are produced.

  • Cervix. The lower, narrow part of the uterus located betwixt the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body.

  • Vagina (also called the nascency culvert). The passageway through which fluid passes out of the body during menstrual periods. The vagina connects the cervix and the vulva (the external ballocks).

  • Vulva. The external portion of the female genital organs.

  • Fallopian tube. Two thin tubes that extend from each side of the uterus, toward the ovaries, as a passageway for eggs and sperm.

The menstrual bicycle

With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone assistance to thicken its walls. If implantation of the fertilized egg does not occur, the lining of the endometrium, coupled with claret and mucus from the vagina and cervix (the lower, narrow part of the uterus located between the bladder and the rectum), make upward the menstrual flow (as well called menses) that leaves the body through the vagina. After menopause, menstruation stops and a adult female should not accept any bleeding.

Reasons for the process

A D&C may be used as a diagnostic or therapeutic procedure for abnormal haemorrhage. A D&C may be performed to determine the crusade of aberrant 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 equally fibroid tumors (benign tumors that develop in the uterus, too called myomas) polyps, or cancer of the endometrium or uterus. Tissues obtained from the D&C tin be examined under a microscope. Abnormal uterine bleeding may too be due a hormone imbalance or disorder (peculiarly estrogen and progesterone) peculiarly in women budgeted menopause or afterward menopause.

A suction D&C uses suction to remove uterine contents. A suction D&C may exist used following a miscarriage to remove the fetus and other tissues if they accept not all been naturally passed. Infection or heavy bleeding can occur if these tissues are not completely removed.

Occasionally following childbirth, small-scale pieces of the placenta (afterbirth) remain adhered to the endometrium and are non passed. This can cause bleeding or infection. A D&C may be used to remove these fragments so that the endometrium can heal properly.

In that location may be other reasons for your doctor to recommend a D&C.

Risks of the process

Every bit with any surgical procedure, complications may occur. Some possible complications of a D&C may include, but are not limited to, the following:

  • Heavy bleeding

  • Infection

  • Perforation of the uterine wall or bowel

  • Adhesions (scar tissue) may develop inside the uterus

Patients who are allergic to or sensitive to medications, iodine, or latex should notify their md.

If y'all are meaning or suspect that you may be pregnant, you should notify your health care provider.

There may be other risks depending on your specific medical condition. Be sure to discuss whatsoever concerns with your doctor prior to the process.

A vaginal, cervical, or pelvic infection may interfere with a D&C.

Before the procedure

  • Your medico will explain the process to you and offer you the opportunity to enquire whatever questions that you might accept well-nigh the process.

  • You volition be asked to sign a consent form that gives your permission to practice the procedure. Read the course carefully and ask questions if something is non articulate.

  • In addition to a consummate medical history, your doctor may perform a complete concrete examination to ensure you are in adept health before undergoing the procedure. You lot may undergo blood tests or other diagnostic tests.

  • If your procedure requires full general, spinal, or epidural anesthesia, you lot will exist asked to fast for eight hours before the procedure, more often than not after midnight. If your procedure is to be washed under local anesthesia, your doc will give you instructions about fasting.

  • If you are meaning or suspect that you are pregnant, yous should notify your health care provider. He or she may recommend a pregnancy examination prior to the process.

  • Notify your physician if yous are sensitive to or are allergic to whatsoever medications, iodine, latex, tape, and anesthetic agents (local and full general).

  • Notify your dr. of all medications (prescribed and over-the-counter) and herbal supplements that you lot are taking.

  • Notify your doctor if you have a history of bleeding disorders or if you are taking whatever anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. Information technology may be necessary for y'all to stop these medications prior to the procedure.

  • If a allaying is given before the process, you will need someone to drive you lot home later on.

  • You may want to bring a germ-free napkin to wearable home after the procedure.

  • Based on your medical condition, your doctor may request other specific grooming.

Illustration of a dilation and curettage procedure

During the procedure

A D&C may exist performed in a doctor'due south office, on an outpatient basis, or as role of your stay in a hospital. Procedures may vary depending on your condition and your doctor'southward practices.

The type of anesthesia will depend on the specific procedure being performed. Some D&C procedures may be performed while you are asleep under general anesthesia, or while y'all are awake under spinal or epidural anesthesia. If spinal or epidural anesthesia is used, you will have no feeling from your waist downward. The anesthesiologist will continuously monitor your eye rate, claret pressure, animate, and blood oxygen level during the surgery.

Generally, a D&C follows this process:

  1. You volition exist asked to remove wear and exist given a gown to vesture.

  2. You will exist instructed to empty your bladder.

  3. You volition be positioned on an operating or examination table, with your anxiety and legs supported as for a pelvic test.

  4. An intravenous (IV) line may exist started in your arm or hand.

  5. A urinary catheter may be inserted.

  6. Your dr. will insert an musical instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.

  7. Your neck may be apple-pie with an clarified solution.

  8. For local anesthesia, the doctor may numb the expanse using a small needle to inject medication.

  9. If general or regional anesthesia is used, the anesthesiologist will continuously monitor your middle rate, blood pressure, breathing, and blood oxygen level during surgery.

  10. A type of forceps, called a tenaculum, may exist used to hold the neck steady for the procedure.

  11. The inside of the cervical canal may be scraped with a small curette if the cervical tissue needs to be examined.

  12. A thin, rod-like instrument, called a uterine sound, may be inserted through the cervical opening to decide the length of the uterus. If you lot have local anesthesia, this may cause some cramping. The audio volition and then be removed.

  13. The cervix will be dilated by inserting a series of thin rods. Each rod will be larger in diameter than the previous one. This procedure will gradually overstate the opening of the cervix then that the curette (spoon-shaped instrument) tin exist inserted.

  14. The curette will be inserted through the cervical opening into the uterus and the abrupt spoon-shaped edges volition exist passed across the lining of the uterus to scrape away the tissues. In some cases, suction may be used to remove tissues. If yous have local anesthesia, this may cause cramping.

  15. The instruments will be removed.

  16. Any tissues nerveless with the procedure volition be sent to the lab for examination. Pregnancy tissues (called products of conception) may exist sent to the lab for civilisation or testing for genetic or chromosomal abnormalities.

Afterwards the procedure

The recovery process will vary depending on the blazon of procedure performed and blazon of anesthesia that was administered.

If yous received regional or general anesthesia, y'all volition be taken to the recovery room for observation. Once your claret pressure level, pulse, and breathing are stable and you lot are alert, you will be taken to your infirmary room or discharged to your domicile. If this procedure was performed on an outpatient basis, you should plan to accept another person drive yous dwelling house.

After a D&C using local anesthesia, y'all may remainder for about two hours earlier going home.

You may want to wear a germ-free pad for bleeding. Information technology is normal to take some spotting or light vaginal bleeding for a few days after the procedure.

You may experience cramping for the first few days later a D&C.

You may be instructed not to douche, use tampons, or have intercourse for 2 to 3 days after a D&C, or for a menses of fourth dimension recommended by your doctor.

Y'all 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 menses may begin before or later than usual.

Y'all may resume your normal diet unless your doctor advises you differently.

Have a pain reliever for cramping or soreness every bit recommended by your doctor. Aspirin or sure other pain medications may increase the hazard of bleeding. Be certain to accept only recommended medications.

Your dr. will advise you on when to return for further treatment or care.

Notify your doctor if y'all accept whatsoever of the following:

  • Heavy bleeding

  • Foul-smelling drainage from your vagina

  • Fever and/or chills

  • Severe abdominal pain

Your doctor may give yous additional or alternate instructions after the process, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a wellness problem or disease, or replace the professional medical advice you receive from your doc. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with data nearly this procedure and related health weather. We hope you find these sites helpful, but delight recall we do not control or endorse the information presented on these websites, nor do these sites endorse the data contained hither.

American Cancer Lodge

American College of Obstetricians and Gynecologists

American Club for Reproductive Medicine

National Cancer Constitute (NCI)

National Institutes of Health (NIH)

National Library of Medicine

National Women's Health Information Center