Dilation and Curettage (D&C)

Surgical removal of tissue from the lining of the uterus (endometrium) to diagnose or treat gynecologic or obstetric conditions.

Parts of the Body Involved

Vagina, cervix, uterus

Reasons for Procedure

  • Determine the reason for unusual bleeding, severe menstrual pain, or an enlarged uterus
  • Obtain a tissue sample to test for cancer
  • Remove tissue left in the uterus after a miscarriage or incomplete abortion to prevent subsequent infection
  • Remove any retained pieces of the placenta after childbirth
  • Terminate a pregnancy
  • Treat excessive bleeding
  • Remove a uterine polyp (a usually harmless growth) or a small benign fibroid tumor
  • Explore possible reasons for infertility

Risk Factors for Complications during the Procedure

  • Pre-existing infection
  • Pre-existing heart or other medical condition

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Pelvic exam
  • Blood tests
In the days leading up to your procedure:
  • Arrange for a ride to and from the procedure
  • The night before, eat a light meal and do not eat or drink anything after midnight
During Procedure - IV fluids, anesthesia, possibly a sedative

Anesthesia - General or local

Description of the Procedure - The doctor inserts a series of dilators, each tool slightly thicker than the next, into the vagina to gradually open the tightly contracted cervical muscles and increase the size of the opening to the uterus. A scoop-shaped instrument, called a curette, is inserted and used to scrape the uterine lining and remove tissue through the vagina. Suction may also be used to vacuum out tissue, especially after a miscarriage or during an abortion. Before leaving the operating room, a sanitary pad is placed to absorb any discharged blood.

After Procedure - Laboratory examination of removed tissue

How Long Will It Take? About 10 minutes

Will It Hurt? General anesthesia prevents pain during surgery. Among women who receive a local anesthetic, most report feeling some cramping and back pain during the procedure, which may last for a day after the procedure. Over-the-counter pain medications or a mild prescription drug are all that is usually needed to relieve this minor discomfort.

Possible Complications:
  • Puncture of the uterus
  • Damage to the cervix
  • Air embolus (air bubble in blood circulation)
  • Excessive bleeding or hemorrhage
  • Inaccurate diagnosis due to an incomplete removal of the uterine lining
  • Menstrual irregularities or infertility due to scar tissue formed as a result of the procedure
  • Infection
  • Anesthesia-related problems
Average Hospital Stay - None

Postoperative Care:
  • Some bleeding is normal and to be expected for several days to two weeks
  • Use a sanitary pad; do not use tampons for at least a week or until after procedure-related bleeding has stopped
  • Begin walking and resume non-strenuous activities as soon as it feels comfortable
  • If antibiotics are ordered, take the entire prescription, even if you are feeling fine
  • Do not douche for two weeks
  • Refrain from sexual intercourse for two weeks, or until approved by your doctor

Outcome

It generally takes a couple of days for your doctor to receive the lab report showing the analysis of the removed tissue. At your follow-up visit, your doctor will make recommendations for any additional treatment based on the results of the D&C. Patients can usually return to non-strenuous work after two or three days.

Call Your Doctor If Any of the Following Occurs

  • Excessive bleeding, which means more than your normal menstrual period or saturating a pad within an hour
  • A foul smelling or pus-like vaginal discharge
  • Severe abdominal pain
  • Signs of infection, including fever and chills
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting