Dilation and Curettage (D&C)

Who is a candidate for dilation and curettage (D&C)?

A dilation and curettage is used to diagnose and treat uterine conditions.

Your Mercy Health doctor may recommend a type of D&C called endometrial sampling for the following symptoms:

• Abnormal uterine bleeding
• Bleeding after menopause
• Presence of abnormal endometrial cells

A D&C may be used to diagnostic the following conditions:

• Uterine cancer
• Uterine polyps
• Endometrial hyperplasia - if the uterine lining becomes too thick, this can indicate a precancerous condition
• Infertility

A D&C may also be used to treat uterine conditions such as:

• Miscarriage
  Your doctor may need to clear out any abnormal tissues in the uterus after a miscarriage to prevent infection.
• Abortion
  Your doctor may need to clear out left over tissue in the uterus after an abortion to prevent heavy bleeding or infection.
• Molar pregnancy
  During a molar pregnancy, a tumor forms instead of an embryo. Your doctor may need to perform a D&C to remove the tumor from the uterine wall.
• Excessive bleeding
  If you experience excessive bleeding after delivering a baby, your doctor may need to clear out the remaining placenta with a D&C.
• Cervical and uterine polyps
  Your doctor may need to perform a D&C to remove non-cancerous cervical or uterine polyps.

In some cases, your doctor may perform a hysteroscopy in combination with a D&C. During a hysteroscopy, any abnormal uterine growths such as polyps or fibroids can be removed.

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

Although a D&C is generally safe, complications can occur. Complications associated with a D&C include:

• Heavy bleeding
• Infection
• Hole in the bowel or uterine wall if a surgical instrument accidentally pokes through the walls
• Scar tissue can develop in the uterus - this could cause abnormal or painful menstrual cycles leading to miscarriages and infertility
• Damage to the cervix which can lead to heavy bleeding

What to expect during a dilation and curettage (D&C)?

A D&C can be performed in an outpatient setting such as your doctor’s office or in a Mercy Health hospital.

In preparation for a D&C, your doctor will start dilating your cervix. This could occur a few hours before the procedure or as long as a day before the procedure. Some types of procedures may need a greater opening, so this allows the cervix to open gradually.

Your doctor will either give you a general anesthesia, to put you asleep, or a local or regional anesthesia to numb a specific area. This varies based on why you need the D&C and your medical history.

You will be instructed to lie on an exam table with your feet in stirrups. When in position, your doctor will insert a speculum into your vagina to keep the walls open. The doctor will then insert medical instruments to completely dilate the cervix. Once the cervix is sufficiently opened, your doctor will take out the medical instruments and insert a curette with a sharp edge or suction device into the uterus to remove the endometrial tissue. You may experience cramping if you have a local anesthesia during this process. Let your doctor know right away if the pain is intense.

Your doctor will send the sample of tissue to the laboratory for evaluation. If the D&C was performed to remove tissue from a miscarriage, the tissue may be evaluated for chromosomal abnormalities.

Recovery from a dilation and curettage (D&C)

Recovery from a D&C will vary depending on why you had the procedure, what type of procedure was performed as well as if you needed general or local anesthesia.

Women who were given general anesthesia will be monitored in a recovery room until the anesthesia wears off. Some patients may be moved to a hospital room for recovery, while others may be able to go home. If you had the procedure performed as an outpatient, you will need to have someone drive you home after.

If you were given a local anesthesia, you will rest for a few hours before being discharged to go home.

Patients should expect the following after a D&C:

• You will likely experience spotting or bleeding for up to a week after the procedure and will need to wear a sanitary pad to collect the blood.
• Do not insert anything into the vagina for three days after the procedure. This includes tampons or douches.
• Do not have vaginal sexual intercourse for at least three days after the procedure.
• You could feel abdominal discomfort or cramping in the days after a D&C.
• Do not perform any strenuous activity or lift anything heavy until you have your doctor’s clearance.
• Your next menstrual period may not be on schedule - you may get it sooner or later than expected.
• Your doctor will give you a list of over-the-counter pain medications you can safely take to relieve pain. Do not take aspirin products.

Call your doctor right away if you experience any of the following side effects after a D&C:

• Fever
• Severe vaginal bleeding that causes you to change your pad or tampon every hour
• Cramping that persists more than 48 hours
• Pain that is intensifying
• Vaginal discharge that is yellowish or smells bad that indicates infection

Schedule a follow-up appointment with your doctor in the time frame he or she recommends.