What is Dilation and Curettage?

 By: Dr. Eric Daiter MD
Dilation and Curettage is commonly referred to as a D&C. A D&C is a surgical procedure that helps doctors to determine if the uterine lining cells are abnormal. This procedure is usually performed in an attempt to diagnose abnormal menstrual bleeding. It can also be used to help determine the presence of or severity of endometrium cancer. A D&C can also be used to remove scar tissue, polyps or other growths inside of the uterus.

A D&C is almost always performed under general anesthesia. The surgery itself does not take very long and you can usually go home soon after the procedure is over. General anesthesia is used because it is essential that you do not move during the surgery. Some women prefer to have an epidural, spinal block or local anesthetic. Talk with your doctor and anesthesiologist about which options are available and make your decision based on your doctor’s advice.

You will be placed in the stirrups, much like you are for a gynecological exam. The surgeon will go in vaginally and dilate your cervix with a tube that will give access to your uterus. A metal instrument called a curette will be inserted through the cervix. The curette is a metal handle with a loop at the end. The loop is used to scrape cells from the uterine lining. Tissue is removed from the endometrium and sent to the lab for examination. If there are polyps, scar tissue or other growths present, the surgeon may be able to remove them at this time. An ultrasound may be used to identify tissues that might be removed.

Risks are generally minimal with the D&C procedure. The uterine lining usually heals itself with little complication. There is a chance of bleeding and infection. Risks are higher if there is already an infection present in the uterus or if you have undergone any other previous uterine surgeries. Your doctor may prescribe antibiotics if you are in a higher risk category.

The D&C procedure is not as commonly performed as it used to be. Advances in medicine and hormone treatment have reduced the number of D&C’s necessary to manage abnormal bleeding. Smaller plastic curettes are commonly used to get uterine lining samples during office visits. You need to talk to your doctor about the risks and all of your options. Make sure that you ask all of your questions and choose the procedure that best suits your needs.
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