A dilatation and curettage (D&C) is primarily a diagnostic procedure to sample the endometrium (lining of the uterus) but may also be used to treat conditions such as incomplete miscarriage.
The procedure removes tissue from inside the uterus (womb).
A sample of the endometrium is helpful in diagnosis of the cause of heavy menstrual bleeding or bleeding after menopause.
About dilatation and curettage (D&C)
A dilatation and curettage (D&C) is an operation performed on women to scrape away the uterus (womb) lining. The cervix (neck) of the uterus (womb) is dilated using an instrument called a dilator. The endometrium (lining of the uterus) or contents of the uterus are removed and sent to a laboratory for analysis, if required.
Reasons for D&C
D&C can be used as a diagnostic test or as a form of treatment for a range of conditions, for instance:
A history of abnormal menstrual bleeding, such as heavy bleeding (menorrhagia), bleeding between periods or bleeding after menopause
Investigation of uterine infection
Incomplete abortion (miscarriage)
Surgical abortion when combined with suction
Incomplete medication abortion
Investigations of female infertility.
Procedure for D&C operation
D&C is regarded as a relatively minor procedure and can be done as day surgery, but a general anaesthetic is usually given. The typical D&C procedure includes the following steps:
Once you are anaesthetised, your uterus is examined to determine its size and position.
A general inspection of the vulva and walls of the vagina is performed.
A speculum is inserted, so the walls of the vagina can be seen.
The cervix is gently widened using surgical dilators, which allows samples to be taken from the lining of the uterus.
The samples are sent to the laboratory for investigation.
Immediately after D&C
You will be discharged home the same day in most cases.
If you have had a general anaesthetic, you will need someone to take you home.
You will be given instructions about self-care after the procedure.
The treating team will arrange followup.
Complications of D&C
Serious complications are rare. These include damage to the uterus, cervix or other pelvic organs.
All minor procedures are accompanied by some risk.
Some women will experience a urinary tract infection.
You may have a reaction to the medications used, such as allergic reaction to the general anaesthesia.
Taking care of yourself at home after D&C
Be guided by your doctor or surgeon, but general suggestions include:
Some cramping or mild abdominal discomfort is considered usual after a D&C. See your doctor if you are concerned or in pain.
You should take any medication as advised by your doctor.
If you are taking antibiotics, make sure to take the whole course, even if you feel well.
Two weeks after your procedure, or a few days after bleeding has stopped:
Shower instead of taking a bath
Avoid sexual intercourse
Use sanitary pads instead of tampons
Avoid going swimming
If you experience any signs of infection (such as fever, pain or discharge), see your doctor immediately.
What happens next
D&C is used to help diagnose certain conditions. Long-term outlook depends on your medical history and the need for surgery.
The doctor will arrange follow up and timing will depend on the reason for the D&C and results.
Your doctor will let you know when the results of your laboratory tests (if any) are available.