Description of the procedure

In a dilation and curettage (D&C), the lining of the uterus is removed. Doctors often use this procedure to:

• take samples of tissue from the uterus to determine if an abnormality exists
• remove endometrial polyps
• remove tissue that is left in the uterus after an incomplete miscarriage (a miscarriage where some tissue is left in the uterus), an incomplete abortion (a situation where tissue is left in the uterus after an abortion), or childbirth
• perform an abortion (during the first 12 weeks of pregnancy)

This procedure is usually performed in a hospital or clinic. Most women go home the same day or the next day.

When should this procedure be performed?

This procedure is usually performed in a hospital or clinic. Most women go home the same day or the next day.

Why is this procedure performed?

This procedure allows doctors to detect problems with the uterine lining, rule out cancer, and help improve menstrual periods of women with heavier than normal menstrual flow. This procedure removes tissue that has remained in the uterus after childbirth or an incomplete miscarriage or abortion.

Are there any risks and precautions

Certain risks are common to all surgery and every time a local or regional anesthetic is used. These include side effects of the anesthetic, breathing problems, infection, and bleeding.

Although dilation and curettage is generally considered safe, it does have some risk of complications. The most common complications are:

• tearing or puncturing the uterus, bowel, or bladder.
• damage to the uterus or cervix walls, which may make pregnancy more difficult (this is more common for people who have repeated D&Cs)

Speak to your doctor immediately if you experience any of these signs of infection requiring medical attention:

• fever
• heavy bleeding (filling more than three sanitary pads in a few hours)
• severe cramps
• foul-smelling vaginal discharge

What happens during the procedure?

Either a general or a local anesthetic may be used. If general anesthesia is used, you will not be awake for the procedure. If a local anesthetic is used, the area will be numb but you will be awake.

The doctor then places an instrument called a speculum into the vagina to hold the vaginal walls open and allow a better view of the cervix. Metal dilators gradually stretch the cervix open and tissue is gently scraped from the inside walls of the uterus using an instrument called a curette.

Tissue may be suctioned from the uterus using a vacuum pump. Samples of tissue from the uterine lining are sent to a laboratory for analysis, if necessary.

How should I prepare for this procedure?

Tell your doctor about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any medication allergies and medical conditions that you may have.

Tell your doctor if you are allergic to anesthesia.

If general anesthesia is to be used, do not eat for 8 hours before the procedure. If your doctor has recommended different times, follow the timing recommended by your doctor.

Ask your doctor or pharmacist whether you need to stop taking any of your medications before the procedure.

Driving is not recommended for the first 24 hours after the procedure so arrange for someone to drive you home from the hospital.

What can I expect after the procedure?

After this procedure, you will likely feel these normal side effects:

• pain and cramping for a few days. Your doctor will likely prescribe pain medication.
• irregular vaginal bleeding for the first couple of weeks. Use sanitary pads instead of tampons.

It is important to rest to help you recover. You can return to your normal activities when you feel better, usually within a day or so.

For the first few weeks afterwards, avoid using tampons or douching.

Sexual intercourse is not recommended for two weeks (or longer, as recommended by your doctor) to avoid infection and to help the uterus heal.

Results

If you have had the procedure to check for abnormalities of the uterine lining, ask your doctor when your test results should be available.