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 neck (lower, narrow role of the uterus) is dilated (expanded) so that the uterine lining (endometrium) tin can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues.

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

Illustration of the anatomy of the female pelvic area

What are female person 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 woman's lower abdomen, between 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 person reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sexual activity hormones estrogen and progesterone are produced.

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

  • Vagina (as well called the birth culvert). The passageway through which fluid passes out of the body during menstrual periods. The vagina connects the cervix and the vulva (the external genitalia).

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

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

The menstrual cycle

With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone help 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 upwardly the menstrual flow (also chosen menstruum) that leaves the body through the vagina. After menopause, catamenia stops and a woman should not have whatever bleeding.

Reasons for the procedure

A D&C may be used as a diagnostic or therapeutic process for abnormal bleeding. A D&C may be performed to determine the crusade of abnormal or excessive uterine bleeding, to discover cancer, or equally part of infertility (disability to become significant) investigation.

Causes of aberrant haemorrhage include the presence of abnormal tissues, such every bit coarse tumors (benign tumors that develop in the uterus, also chosen 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) particularly in women budgeted menopause or afterwards 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 take not all been naturally passed. Infection or heavy bleeding tin occur if these tissues are not completely removed.

Occasionally following childbirth, small pieces of the placenta (afterbirth) remain adhered to the endometrium and are not passed. This can crusade bleeding or infection. A D&C may be used to remove these fragments so that the endometrium tin can heal properly.

At that place may be other reasons for your physician to recommend a D&C.

Risks of the procedure

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

  • Heavy bleeding

  • Infection

  • Perforation of the uterine wall or bowel

  • Adhesions (scar tissue) may develop within the uterus

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

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

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

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

Earlier the procedure

  • Your physician volition explain the process to you and offering you the opportunity to ask any questions that you might take well-nigh the procedure.

  • You will be asked to sign a consent form that gives your permission to do the process. Read the course carefully and ask questions if something is not articulate.

  • In addition to a complete medical history, your md may perform a complete physical examination to ensure you are in good wellness before undergoing the process. You may undergo claret tests or other diagnostic tests.

  • If your procedure requires general, spinal, or epidural anesthesia, you volition be asked to fast for eight hours before the process, generally later midnight. If your procedure is to be done under local anesthesia, your doctor will give you instructions about fasting.

  • If y'all are significant or suspect that yous are meaning, you should notify your health intendance provider. He or she may recommend a pregnancy test prior to the procedure.

  • Notify your medico if you are sensitive to or are allergic to any medications, iodine, latex, tape, and anesthetic agents (local and general).

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

  • Notify your doctor if yous accept a history of bleeding disorders or if yous are taking whatsoever anticoagulant (blood-thinning) medications, aspirin, or other medications that affect claret clotting. It may be necessary for yous to stop these medications prior to the procedure.

  • If a allaying is given earlier the process, you volition need someone to drive you dwelling house afterwards.

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

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

Illustration of a dilation and curettage procedure

During the process

A D&C may be performed in a doctor's office, on an outpatient basis, or as part of your stay in a infirmary. Procedures may vary depending on your condition and your doctor's practices.

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

Generally, a D&C follows this process:

  1. You lot volition be asked to remove clothing and exist given a gown to wear.

  2. You will be instructed to empty your bladder.

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

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

  5. A urinary catheter may be inserted.

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

  7. Your cervix may exist cleansed with an antiseptic solution.

  8. For local anesthesia, the md 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 heart rate, blood pressure, breathing, and claret oxygen level during surgery.

  10. A type of forceps, called a tenaculum, may be used to concur the cervix steady for the process.

  11. The inside of the cervical canal may exist scraped with a pocket-size curette if the cervical tissue needs to be examined.

  12. A thin, rod-like instrument, called a uterine audio, may be inserted through the cervical opening to make up one's mind the length of the uterus. If you have local anesthesia, this may cause some cramping. The sound will then be removed.

  13. The cervix will be dilated by inserting a series of thin rods. Each rod volition be larger in diameter than the previous ane. This process will gradually overstate the opening of the neck so that the curette (spoon-shaped instrument) can be inserted.

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

  15. The instruments will be removed.

  16. Any tissues collected with the procedure volition be sent to the lab for examination. Pregnancy tissues (called products of formulation) may be sent to the lab for culture or testing for genetic or chromosomal abnormalities.

Later on the procedure

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

If you lot received regional or general anesthesia, you lot will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed on an outpatient ground, you should plan to have another person drive you dwelling house.

After a D&C using local anesthesia, you may rest for near two hours earlier going home.

You may want to habiliment a germ-free pad for bleeding. It is normal to have some spotting or calorie-free vaginal bleeding for a few days after the process.

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

You lot may be instructed not to douche, utilise tampons, or take intercourse for two to 3 days after a D&C, or for a menstruum of time recommended past your doctor.

Y'all may too have other restrictions on your activity, including no strenuous activity or heavy lifting.

Considering a D&C removes the lining of the uterus, the lining must build back up. Your next menstrual period may begin earlier or later than usual.

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

Accept a hurting reliever for cramping or soreness as recommended by your doctor. Aspirin or certain other hurting medications may increase the take chances of bleeding. Be sure to take simply recommended medications.

Your medico will advise you on when to render for further handling or care.

Notify your doctor if you have whatsoever of the following:

  • Heavy bleeding

  • Foul-smelling drainage from your vagina

  • Fever and/or chills

  • Astringent abdominal pain

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

Online resources

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American Cancer Society

American College of Obstetricians and Gynecologists

American Social club for Reproductive Medicine

National Cancer Plant (NCI)

National Institutes of Health (NIH)

National Library of Medicine

National Women'south Health Information Center