Claire Dawson
Dilation and curettage (D&C) is a brief surgical procedure to remove tissue from the inside of the uterus or womb. It is often carried out to diagnose or treat abnormal bleeding, or following a miscarriage. The procedure itself takes around 5-15 minutes, but the entire process is longer, including receiving anaesthesia and recovery. Patients are advised to have someone drive them home after the procedure and to avoid strenuous activity.
| Characteristics | Values |
|---|---|
| Procedure | Dilation and Curettage (D&C) |
| Purpose | To remove tissue from the uterus/womb |
| Procedure Time | 5-15 minutes |
| Anaesthesia Options | General, Regional, Local |
| Recovery Time | A few hours in the recovery room |
| Post-Procedure | Cramping, light bleeding, sanitary pads recommended |
| Restrictions | No tampons, no intercourse for a week, no heavy lifting |
| Complications | Infection, bleeding disorders, allergies |
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What You'll Learn
D&C procedure: removing tissue from the uterus
Dilation and curettage (D&C) is a brief surgical procedure to remove tissue from the inside of the uterus. It can be used as a diagnostic tool or a treatment for abnormal bleeding, or after a miscarriage or abortion. It can also be used to remove small pieces of the placenta after childbirth.
Before the procedure, your doctor will go over your complete medical history and discuss the options for anaesthesia. Depending on your medical history and the specifics of the procedure, your doctor will recommend the best anaesthesia option for you. There are several options for anaesthesia during a D&C: general anaesthesia, where you are asleep during the procedure; regional anaesthesia (like an epidural), which means you won't have feeling from the waist down but you will be fully conscious; and local anaesthesia, where only your cervix is numb and you are awake and have feeling in all other areas of the body.
During the procedure, a doctor will use a small instrument and/or medicine to open your cervix. They will then use another instrument, called a curette, to remove tissue from your uterine lining by scraping the surface. Sometimes, they may use suction instead. The procedure itself usually takes about 5 to 15 minutes, but the entire process, including anaesthesia and recovery, can take a few hours.
After the procedure, you will be taken to a recovery room for observation. Once your vital signs are stable and you are alert, you will be discharged to your hospital room or sent home. If the procedure was performed on an outpatient basis, you should plan to have someone else drive you home. It is normal to experience mild cramping and light bleeding (or spotting) for a few days after a D&C. Doctors recommend using sanitary pads instead of tampons for any bleeding. You may also be instructed to refrain from douching, using tampons, or having intercourse for a few days after the procedure.
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Reasons for D&C: abnormal bleeding, miscarriage, molar pregnancy
Dilation and curettage (D&C) is a surgical procedure used to remove tissue from the inside of the uterus. During the procedure, a doctor uses a small instrument and/or medicine to open the cervix, and then uses another instrument called a curette to remove tissue from the uterine lining by scraping the surface. Suction may be used instead.
D&C is often carried out in response to abnormal bleeding. Any bleeding that occurs after menopause is considered abnormal, as is any bleeding that is unpredictable or excessive. D&C can be used to investigate the causes of abnormal bleeding, such as fibroids, polyps, hormonal imbalances, or cancer.
D&C is also used following a miscarriage, to remove tissue from the uterus. In the case of a molar pregnancy, D&C with suction is used to remove abnormal tissue from the uterus. A molar pregnancy occurs when an abnormal placenta forms, with no embryo present. This can cause vaginal bleeding, severe nausea, and vomiting. Molar pregnancies can lead to serious complications if left untreated, and D&C is a recommended treatment to prevent this.
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Anesthesia options: general, regional, local
The type of anaesthesia used during a D&C procedure depends on the patient's medical history, the procedure's specifics, and the preferences of the patient, anaesthesiologist, and doctor.
If you receive general anaesthesia, you will be asleep during the procedure and will not feel any pain. If you receive spinal or epidural (regional) anaesthesia, you will remain conscious but will not feel anything from the waist down. With local anaesthesia, you will also be awake, but only your cervix area will be numbed. Local anaesthesia may cause some cramping.
If you receive general or regional anaesthesia, you will be taken to a recovery room for observation. Once your blood pressure, pulse, and breathing are stable, and you are alert, you will be discharged home or taken to your hospital room. If you receive local anaesthesia, you may rest for about two hours before going home.
If your procedure requires general, spinal, or epidural anaesthesia, you will need to fast for eight hours before the procedure. If local anaesthesia is used, your doctor will give you specific instructions about fasting.
Some studies have found that patients who receive general anaesthesia during a D&C may have a higher estimated blood loss compared to those who receive sedation.
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Recovery: cramping, bleeding, restrictions
Recovery from a dilation and curettage (D&C) procedure may involve cramping, bleeding, and other restrictions. The procedure itself takes about 5 to 15 minutes, but the recovery process may take longer. Here is what you can expect:
Cramping
You may experience cramping similar to menstrual cramps for the first few days after the procedure. Over-the-counter pain medication, such as acetaminophen (Tylenol®), can help relieve these cramps.
Bleeding
Light vaginal bleeding or spotting is normal for a few days after the procedure. It is recommended to use sanitary pads instead of tampons during this time.
Restrictions
There are several restrictions and recommendations to follow after a D&C procedure to ensure a safe recovery:
- Avoid douching, using tampons, or having intercourse for at least two to three days, or as recommended by your doctor.
- Refrain from strenuous activity or heavy lifting.
- Take medication to soften and dilate your cervix, such as misoprostol, as advised by your healthcare provider.
- Avoid vaginal, cervical, or pelvic activities to reduce the risk of infection.
- Schedule a follow-up appointment with your doctor one to two weeks after the procedure to monitor your recovery.
- Contact your doctor earlier if you experience heavy vaginal bleeding, such as needing to change your pad every 10 to 20 minutes.
It is important to follow the instructions provided by your healthcare team and reach out with any questions or concerns you may have during your recovery.
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Risks and complications: infection, bleeding disorders
Dilation and curettage (D&C) is a brief surgical procedure that is generally considered safe, with a low risk of complications. However, as with any surgical procedure, there are some potential risks and complications that patients should be aware of.
One potential risk associated with the D&C procedure is bleeding. Vaginal bleeding to some extent is expected after the procedure, and it is usually managed with pads and painkillers. However, if the bleeding is excessive or prolonged, it may indicate a complication that requires immediate medical attention. Patients with a history of bleeding disorders or those taking blood-thinning medications are at a higher risk of experiencing bleeding complications and should inform their doctor before the procedure.
Another potential complication of the D&C procedure is infection. While rare, it can occur, and symptoms may include abdomen pain, fever, and foul-smelling discharge from the vagina. In the event of an infection, a course of antibiotics is typically prescribed to manage the condition.
In addition to bleeding and infection, there are other rare complications associated with the D&C procedure. These include damage to the uterus, cervix, or other pelvic organs, as well as the development of scar tissue inside the uterus, known as Asherman's syndrome. Repeated D&C procedures may increase the risk of scar tissue formation, which can lead to subsequent menstruation issues and complications with future pregnancies.
To minimise the risk of complications, it is important for patients to disclose their complete medical history and any concerns to their doctor before the procedure. This includes informing the doctor of any allergies, sensitivities, or medications they are currently taking.
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Frequently asked questions
Dilation and curettage (D&C) is a brief surgical procedure to remove tissue from the inside of the uterus (womb).
You may need a D&C for several reasons, including to remove tissue after a miscarriage or abortion, to remove small pieces of the placenta after childbirth, or to diagnose abnormal vaginal bleeding.
Before the procedure, your doctor will go over options for anesthesia, which include general, regional, and local anesthesia. During the procedure, your doctor will open your cervix using a small instrument and/or medicine, and then use another instrument called a curette to remove tissue from your uterine lining by scraping or suction.
After the procedure, you will be taken to a recovery room for observation. You may experience mild cramping and light bleeding (or spotting) for a few days, and you should use pads instead of tampons. You should also refrain from intercourse until your healthcare provider advises it is safe.
A D&C can be performed in a doctor's office, an outpatient clinic, or a hospital.
