Dilation and Curettage

Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

In a dilation and curettage — sometimes spelled "dilatation" and curettage —the doctor uses small instruments or a medication to open (dilate) your cervix — the lower, narrow part of your uterus. The doctor then uses a surgical instrument called a curette to remove uterine tissue. Curettes used in a D&C can be sharp or use suction.

Dilation and curettage can diagnose or treat a uterine condition.

To diagnose a condition

The doctor might recommend a D&C to diagnose a condition if:

  • You have abnormal uterine bleeding
  • You experience bleeding after menopause
  • The doctor discovers abnormal endometrial cells during a routine test for cervical cancer

To perform the test, the doctor collects a tissue sample from the lining of your uterus (endometrium) and sends the sample to a lab for testing. The test can check for:

  • Uterine cancer
  • Uterine polyps
  • Endometrial hyperplasia — a precancerous condition in which the uterine lining becomes too thick

To treat a condition

When performing a therapeutic D&C, the doctor removes the entire contents of your uterus, not just a small tissue sample. Your doctor can do this to:

  • Remove a molar pregnancy, in which a tumor forms instead of a normal pregnancy
  • Treat excessive bleeding after delivery by clearing out any placenta that remains in the uterus
  • Remove cervical or uterine polyps, which are usually benign
  • Remove fibroid tumors, which are benign tumors formed on the uterine wall that sometimes bulge into the uterine cavity
  • Clear out any tissue that remains in the uterus after a miscarriage or abortion to prevent infection or heavy bleeding

During the procedure

For dilation and curettage, you receive anesthesia. General anesthesia makes you unconscious and unable to feel pain. Other forms of anesthesia provide light sedation or use injections to numb only a small area (local anesthesia) or a larger region (regional anesthesia) of your body. The choice of anesthesia depends on the reason for the D&C and your medical history

  • You lie on your back on an exam table while your heels rest in supports called stirrups
  • Your doctor inserts an instrument called a speculum into your vagina, as during a Pap test, in order to see your cervix
  • Your doctor inserts a series of thicker and thicker rods into your cervix to slowly dilate your cervix until it's adequately opened
  • Your doctor removes the dilation rods and inserts a spoon-shaped instrument with a sharp edge or a suction device and removes uterine tissue

Because you're either unconscious or sedated during D&C, you shouldn't feel any discomfort. The procedure usually takes about 15 to 30 minutes

Risks:

Dilation and curettage is usually very safe, and complications are rare. However, there are risks. These include:

  • Perforation of the uterus
  • Damage to the cervix
  • Scar tissue on the uterine wall
  • Infection

Contact your doctor if you experience any of the following after a D&C:

  • Bleeding that's heavy enough that you need to change pads every hour
  • Light bleeding that lasts longer than two weeks
  • Fever
  • Cramps lasting more than 48 hours
  • Pain that gets worse instead of better
  • Foul-smelling discharge from the vagina.

After the procedure

You may spend a few hours in a recovery room after the D&C so that your doctor can monitor you for heavy bleeding or other complications. This also gives you time to recover from the effects of anesthesia

If you had general anesthesia, you may become nauseated or vomit or you might have a sore throat if a tube was placed in your windpipe to help you breathe. With general anesthesia or light sedation, you may also feel drowsy for several hours

Normal side effects of a D&C may last a few days and include:

  • Mild cramping
  • Spotting or light bleeding

Wait to put anything in your vagina until your cervix returns to normal to prevent bacteria from entering your uterus, possibly causing an infection. Ask your doctor when you can use tampons and resume sexual activity

Your uterus must build a new lining after a D&C, so your next period may not come on time. If you had a D&C because of a miscarriage, and you want to become pregnant, talk with your doctor about when it's safe to start trying again