What Is Dilation and Curettage (D&C)?

A D&C can help to diagnose a number of conditions, including uterine cancer or polyps.

A dilation and curettage procedure, also called a D&C, is performed to remove abnormal tissue from your uterus.

Dilation refers to opening up the cervix, and curettage (pronounced cure-eh-TAJ) means to remove the contents of the uterus.

During this surgical procedure, a woman's cervix (the lower, narrow part of the uterus) is dilated with an instrument or medication so that the uterine lining can be scraped with a spoon-shaped instrument, called a curette.

Curettes can be sharp or use suction.

Reasons for a D&C

A D&C may be performed to diagnose or treat a uterine condition.

Your doctor may recommend the procedure if you experience any of the following:

• Abnormal uterine bleeding
• Bleeding after menopause
• Abnormal endometrial cells (cells in the inner membrane of the uterus) that may indicate cancer
• Infertility or difficulty becoming pregnant

After collecting a tissue sample from the lining of your uterus, your doctor will send the sample to a lab to be tested for one or more of the following:

• Uterine cancer
• Uterine polyps
• Endometrial hyperplasia, a precancerous condition

If your doctor is performing a D&C for therapeutic reasons, he or she may remove the entire contents of your uterus in order to do one of the following:

• Remove a molar pregnancy that causes a tumor to form instead of a normal pregnancy
• Treat excessive bleeding after giving birth by clearing out parts of the placenta that remain in the uterus
• Remove cervical or uterine polyps
• Remove fibroid tumors
• Clear out any tissue that remains in the uterus after a miscarriage or abortion to prevent infection or heavy bleeding. According to the American Pregnancy Association, only about half of women who miscarry require a D&C. However, if you miscarry after 10 weeks, you may be more likely to need a D&C.

Some women may have a D&C when they have a hysteroscopy, in which a doctor inserts a slim instrument holding a light and camera into your vagina, through your cervix, and up into your uterus to look around.

This procedure lets your doctor view the lining of your uterus on a screen, so he or she can identify abnormal areas and polyps, as well as take a tissue sample.

Your doctor can also remove uterine polyps and fibroid tumors during a hysteroscopy.

What to Expect

During a D&C, you'll receive one of the following forms of anesthesia:

• General anesthesia, which makes you unconscious so that you can't feel pain
• Local anesthesia, which provides light sedation or uses injections to numb only a small area of your body
• Regional anesthesia, which provides light sedation or uses an injection to numb a larger region of your body

During the procedure, you can expect the following:

• You'll lie on your back with your heels in stirrups while your doctor inserts an instrument (speculum) into your vagina to hold open the vaginal walls in order to see your cervix.
• Your doctor will insert a series of thicker rods into your cervix to slowly dilate it.
• Once the cervix is dilated enough, your doctor will remove the rods and insert a spoon-shaped instrument with a sharp edge or a suction device to remove uterine tissue.

After a D&C

After the procedure, you may stay in the recovery room for a few hours to make sure you're not bleeding heavily or experiencing other complications.

You'll also need to wait for the anesthesia to wear off.

Side effects of a D&C may last a few days and can include mild cramping, spotting, or light bleeding.

To help ease cramping, your doctor may recommend taking ibuprofen (Advil, Motrin) or another medication.

To prevent infections, your doctor will most likely tell you to refrain from putting anything in your vagina until your cervix returns to normal.

After a D&C, your uterus needs to build a new lining. This means your next period may not come at its normal time.

If the D&C was required because of a miscarriage, and you want to become pregnant again, ask your doctor when it's safe to start trying to conceive.

Risks

While dilation and curettage is usually a safe procedure, there is some risk of developing the following complications:

• Heavy bleeding
• Infection, in rare cases
• Perforation of the uterus (hole poked by a surgical instrument). This happens more often in women who were recently pregnant and in women who have gone through menopause. Perforation of the bowel can also occur.
• Development of scar tissue inside the uterus. This is rare and happens most often when a D&C is performed after a miscarriage or birth. Known as Asherman's syndrome, this scarring can lead to abnormal, absent, or painful menstrual cycles, future miscarriages, and infertility.
• Injury of the cervix. If this happens, your doctor can apply pressure or medicine to stop the bleeding, or can stitch the wound closed.

If you experience any of the following after a D&C, contact your doctor immediately:

• Heavy bleeding that requires changing pads every hour
• Light bleeding that lasts longer than 2 weeks
• Fever
• Cramps lasting longer than 48 hours
• Pain that worsens
• Foul-smelling discharge from your vagina