What is dilation and curettage?

Dilation and Curettage
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Dilation and curettage (D&C): Overview

Dilation and curettage is a type of procedure. It is often called a D&C. It removes tissue from inside your uterus. The doctor may do this to find out if the tissue is not normal. Or it might be done to stop severe bleeding.

During a D&C, the cervix is opened gently so that tissue can be removed, usually with a scraping or suction tool. A D&C may be done in a hospital or clinic.

The procedure usually takes 15 to 30 minutes. You will probably go home the same day.

Dilation and Curettage (D&C)

A dilation and curettage (D&C) is a procedure that is done to remove tissue from inside the uterus. During a D&C, the cervix is opened gently. Then a scraping or suction instrument is passed through the cervix and into the uterus to remove tissue from the lining of the uterus (endometrium).

A D&C may be done to:

  • Get a tissue sample for testing.
  • Remove tissue that may be causing abnormal vaginal bleeding. The tissue can then be examined for any abnormalities.

A D&C is usually done in a hospital without requiring an overnight stay. Pain medicine is given before the procedure. Many women choose to have a general anesthetic that makes them unconscious during the procedure.

How can you care for yourself after dilation and curettage (D&C)?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Most women are able to return to work the day after the procedure.
  • You may have some light vaginal bleeding. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding. Do not rinse your vagina with fluid (douche).
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

How well does dilation and curettage (D&C) work?

D&C usually stops heavy menstrual bleeding. The stop in bleeding may be temporary.

How do you prepare for a dilation and curettage (D&C)?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • You may go to your doctor's office on the day before the procedure. Your doctor may put a small sponge in your cervix or tablets behind your cervix. This helps to open it. Or the doctor may give you a pill to help open the cervix.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of dilation and curettage (D&C)?

A D&C has risks, but problems are rare. The risks include:

  • Infection.
  • Puncture of the uterine wall.
  • Heavy vaginal bleeding.
  • Scarring of the lining of the uterus. This can make it hard to get pregnant.

What can you expect as you recover from dilation and curettage (D&C)?

  • Most women are able to return to normal activities in a day or two.
  • You may have mild pelvic cramping for a few hours.
  • You may have a small amount of vaginal discharge.
  • Ask your doctor when it is okay for you to have sex.
  • Your next period may be early or late.

After dilation and curettage: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
  • You have vaginal discharge that increases in amount or smells bad.
  • You are sick to your stomach or cannot drink fluids.
  • You have pain that does not get better after you take pain medicine.
  • You cannot pass stools or gas.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

After dilation and curettage (D&C): Overview

Dilation and curettage (D&C) is a procedure to remove tissue from the inside of the uterus. The doctor used a curved tool, called a curette, to gently scrape tissue from your uterus.

You are likely to have a backache, or cramps similar to menstrual cramps, and pass small clots of blood from your vagina for the first few days. You may have light vaginal bleeding for several weeks after the procedure.

You will probably be able to go back to most of your normal activities in 1 or 2 days.

Why is dilation and curettage (D&C) done?

Dilation and curettage (D&C) may be used to:

  • Find and treat bleeding problems.
  • Control sudden, heavy vaginal bleeding that is causing heavy blood loss or a low number of red blood cells (anemia).
  • Get a tissue sample for testing. For example, a postmenopausal woman who has vaginal bleeding may be tested for signs of endometrial cancer.

How is dilation and curettage (D&C) done?

Your doctor may give you medicine to make you sleep or help you relax. You may also get medicine to help with pain. First, the doctor inserts a tool into your vagina to widen it. Then another tool is used to open the lower part of your uterus. This is called your cervix. Next, the doctor gently scrapes tissue from the uterus with a different tool. This tool may be attached to a vacuum to help remove the tissue.

What happens on the day of your dilation and curettage (D&C) procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don’t, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep.
  • The procedure usually takes 15 to 30 minutes.

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