Overview

Dilation and curettage (D&C) is a short surgical procedure in which the cervix is dilated and a special instrument is used to scrape the uterine lining.

Knowing what to expect before, during, and after a D&C may help ease your worries and make the process go more smoothly for you. Here’s what you need to know.

 

Reasons for Dilation and Curettage

A D&C is done to:

  • Remove tissue in the uterus during or after a miscarriage or abortion or to remove small pieces of placenta after childbirth. This helps prevent infection or heavy bleeding.
  • Diagnose or treat abnormal uterine bleeding. A D&C may help diagnose or treat growths such as fibroids, polyps or endometriosis, hormonal imbalances, or uterine cancer. A sample of uterine tissue is viewed under a microscope by a pathologist to check for abnormal cells.
  • May help diagnosis.
 

How it is done

You can have a D&C in an outpatient clinic or the hospital. It usually takes approximately 30 minutes.

Before a D&C, you will have a complete history taken and sign a consent form. Ask your medical provider any questions you have about the D&C. Be sure to tell your medical provider if:

  • You will be required to leave a urine specimen for a pregnancy test unless you have had a tubal ligation, or if you are, unfortunately, having this procedure for a miscarriage.
  • You are sensitive or allergic to any medications, iodine, or latex.
  • You have a history of bleeding disorders or are taking any blood-thinning drugs.

You will receive anesthesia, which your medical provider will discuss with you. The type you have depends upon the procedure you need.

  • If you have general anesthesia, you will not be awake during the procedure.
  • If you have spinal or epidural (regional) anesthesia, you will not have feeling from the waist down.
  • If you have local anesthesia, you will be awake and the area around you cervix will be numbed.

Before the D&C, you may need to remove your clothing, put on a gown, and empty your bladder.

During a D&C, you lie on your back and place your legs in stirrups like during a pelvic exam. Then the medical provider inserts a speculum into your vagina and holds the cervix in place with a clamp. Although the D&C involves no stitches or cuts, the medical provider cleanses your cervix with an antiseptic solution.

A D&C involves two main steps:

  • Dilation involves widening the opening of the lower part of the uterus (the cervix) to allow insertion of an instrument. The medical provider may give a preoperative medication to soften the cervix and help it widen.
  • Curettage involves scraping the lining and removing uterine contents with a long, spoon-shaped instrument (a curette). The medical provider may also use a cannula to suction any remaining contents from the uterus. This can cause some cramping. In many cases, a tissue sample goes to a lab for examination.

Sometimes other procedures are performed along with a D&C. For example, your medical provider may insert a slender device to view the inside of the uterus (called hysteroscopy).

After a D&C, there are possible side effects and risks. Common side effects include:

  • Cramping
  • Spotting or light bleeding

Complications such as a damaged cervix and perforated uterus or bowel are rare. But be sure to contact your medical provider if you have any of the following symptoms after a D&C:

  • Heavy or prolonged bleeding or blood clots
  • Fever
  • Pain
  • Abdominal tenderness
  • Foul-smelling discharge from the vagina

In very rare cases, scar tissue (adhesions) may form inside the uterus. Called Asherman’s syndrome, this may cause infertility and changes in menstrual flow. Surgery can repair this problem, so be sure to report any menstrual flow changes after a D&C.

 

What to Expect after surgery.

After a D&C, you will need someone to take you home. If you had general anesthesia, you may feel groggy for a while and have some brief nausea and vomiting. You can return to regular activities within one or two days. In the meantime, ask your medical provider about any needed restrictions. You may also have mild cramping and light spotting for a few days. This is normal. You may want to wear a sanitary pad for spotting and take pain relievers for pain.

You can expect a change in the timing of your next menstrual period. It may come either early or late. To prevent bacteria from entering your uterus, delay sex and use of tampons for 2 weeks.

See your medical provider for a follow-up visit and schedule any further treatment that’s needed. If any tissue was sent for a biopsy, your results will be discussed at your follow up appointment.