What is a Dilation and Curettage (D&C)?
Dilation and Curettage, or D&C, is a surgical procedure used to diagnose and treat conditions that affect the uterus. Dilation refers to opening the cervix, the lower part of the uterus, while curettage involves removing tissue from inside the uterus. This procedure is done to obtain a sample for diagnosis, manage bleeding issues, or remove tissue from the uterus following a miscarriage or abortion.
Why is a D&C Done?
A D&C may be performed for various reasons, including:
- Diagnosing Abnormal Uterine Bleeding: A D&C can collect a sample of the uterine lining to be examined under a microscope, helping to determine the cause of unusual bleeding.
- Managing Miscarriage or Abortion: The procedure removes pregnancy tissue left in the uterus.
- Combining with Other Procedures: Sometimes, a D&C is done alongside a hysteroscopy, which uses a lighted telescope to view the uterus.
How is a D&C Performed?
A surgical center, or a hospital. Here’s what typically happens during the procedure:
- Anesthesia Options: You’ll receive either general anesthesia (where you’re asleep) or regional anesthesia (where you’re awake but drowsy and pain-free in the affected area). You and your provider will decide which type of anesthesia is best for you.
- Dilation Process: You’ll lie on your back with legs in stirrups. A speculum will open the vagina, and a series of rods will be inserted into the cervix, gradually increasing in size to gently widen the opening. Usually, only a small amount of dilation is necessary (less than half an inch).
- Tissue Removal: The provider uses a curette or a vacuum suction device to remove the uterine lining. If a suction device is used, this is sometimes called vacuum aspiration or suction curettage. The removed tissue is typically sent to a lab for further analysis.
Risks of D&C
Although complications are rare, risks associated with a D&C include:
- Bleeding: Some bleeding is normal, but heavy bleeding may require attention.
- Infection: An infection at the site or within the uterus is possible.
- Uterine Perforation: This is when an instrument creates a small hole in the uterine wall, which may require further surgery if nearby organs are affected.
- Scar Tissue: In rare cases, scar tissue, or adhesions, may form inside the.
- Recovery After D&C Recovery from a D&C is usually quick. Here’s what to expect:
- Discharge: You’ll likely go home a few hours after the procedure, but arrange for someone to drive you.
- Symptoms: Mild pain and cramping are common, as well as spotting or light bleeding, which can last a few days.
- Possible Side Effects of Anesthesia: If you had general anesthesia, you might experience nausea, grogginess, or a sore throat from the breathing tube.
You should avoid inserting anything into the vagina, such as tampons or engaging in sexual activity, until your cervix has returned to its normal size to reduce the risk of infection. Ask your provider when it’s safe to resume normal activities.
Signs to Watch For After D&C
Contact your healthcare provider if you experience any of the following symptoms:
- Heavy vaginal bleeding (soaking through two maxi pads in an hour for two hours in a row)
- Fever or chills
- Severe abdominal or back pain unrelieved by medication
- Foul-smelling vaginal discharge
- Flu-like symptoms or fainting
Managing Your Health Post-D&C
After a D&C, your uterus will gradually develop a new lining, and your next period may arrive earlier or later than usual. Follow-up appointments are recommended to discuss results and check recovery progress. If you have questions or concerns about the procedure, your healthcare provider can help answer them.