Dilation and Curettage (D&C)
A common gynecological procedure, a dilation and curettage — commonly referred to as a D&C — is a diagnostic or therapeutic procedure to remove tissue from your uterus. As a diagnostic procedure, the D&C is used to obtain a tissue sample for testing. As a therapeutic procedure, it’s used to remove or clean out malignant or benign growths. Both types of dilation and curettage are considered minimally invasive.
A diagnostic D&C is different from a biopsy in the technique and tools used in the procedure. The end result, however, is the same: to capture a tissue sample to analyze so your doctor can reach an accurate diagnosis. A therapeutic D&C is similar to a hysteroscopy, except again, a different instrument is used to complete the procedure. A D&C hysteroscopy combination offers a complete picture of the health of your uterus.
Why You May Need a D&C
The primary reason to undergo a D&C is to investigate and/or resolve a medical issue in your uterus. Some external tests, such as an ultrasound or even a pelvic exam, can’t confirm or reject certain uterine conditions. Only by examining inside your uterus can the conditions be identified and therefore treated. A D&C allows for both. Symptoms precipitating a D&C include:
- Bleeding after menopause
- Unusual bleeding from your uterus at any age
- Abnormal results from a Pap smear or other scheduled test
Your OBGYN examines the inside of your uterus for unusual growths, lesions or conditions. If necessary, tissue samples are taken and sent to the lab to test for uterine cancer, precancerous polyps or endometriosis. If your doctor finds something, he can use the curette to remove:
- A molar pregnancy, which is a tumor that looks like a pregnancy from the outside
- The remains of the placenta after birth
- Benign polyps from your uterus or cervix
- Any tissue left from an abortion or miscarriage
The goal of a D&C is to remove any tissue that may be causing abnormal bleeding and to keep your uterus healthy.
The Risks of a D&C
Your gynecologist has likely performed hundreds, if not thousands, of dilation and curettage procedures. It’s a safe, minimally invasive process with few complications. Like everything, however, there are a few risks to consider. They’re rare, but still possible. Your OBGYN possibly may:
- Introduce an infection. Since the curette is sterilized, infections are rare.
- Damage your cervix. To get into your uterus, your doctor has to pass the cervix. An injury can happen, but it’s usually minor and can be addressed at that time to stop any bleeding.
- Scar your uterine lining. While taking a sample or cleaning your uterus from a miscarriage or delivery, your gynecologist might cut too much. Any scarring can result in Asherman’s syndrome.
- Puncture your uterine wall. This is more common in menopausal women. If it happens in women who were pregnant, the punctures heal on their own. If a blood vessel or another organ is also injured, it must be addressed in a separate procedure.
The D&C Procedure
You prepare for the procedure as you would for a pelvic exam. After the anesthesia or sedation kicks in and you go to sleep, your doctor can begin by inserting a speculum into your vagina to gain access to your cervix. To dilate your cervix, either a medication or a series of dilation rods are used until your cervix is open wide enough for your doctor to get to your uterus.
Using the curette, your doctor examines your uterine lining, as well as the entrance to your fallopian tubes. If necessary, the curette extracts a tissue sample or removes abnormal tissue. This is the difference between a diagnostic D&C and a therapeutic D&C.
Curettes can remove tissue by either cutting or through suction. To double-check the results of your D&C, your gynecologist may choose to follow up the procedure with a hysteroscopy. A post-D&C hysteroscopy provides your doctor with a clear view of the work done. Sedated, you won’t feel any pain. The whole procedure may take less than 15 minutes or up to an hour to complete, depending on the severity and steps.
Recovery After D&C
If you were administered an anesthetic or sedative, you’ll need someone responsible to drive you home. D&C is an outpatient procedure, so you’ll spend your time at home recuperating. You may be sore for a few days, but you can return to your normal activities the next day or as soon as you feel up to it. There are no long-term side effects from undergoing a D&C.
Immediate side effects include some mild cramping and maybe some light bleeding and spotting. You should not feel any cramps from the procedure after a couple days or bleeding past two weeks. You can take over-the-counter medications for pain when you get home as instructed by your doctor, but your pain should improve to the point that it disappears over the next few days.
Do not insert anything into your vagina while you heal from the procedure. Even a fresh tampon can cause an infection. If you notice a bad-smelling vaginal discharge or experience excessive bleeding after D&C, contact your doctor immediately.
To be on the safe side, wait about a week before having sex after D&C. If you have to return for a follow-up to your OBGYN, you can ask your doctor for confirmation when it’s safe to resume sexual intercourse.
Issues with Pregnancy After D&C
Following a dilation and curettage, you have to wait for your uterus to grow a fresh inner wall. The D&C may have scraped (or suctioned) away the outermost layer of the endometrial lining. Particularly if your D&C procedure was the result of a miscarriage, your uterus needs time to heal.
If pregnancy is your goal, talk to your gynecologist or a fertility specialist to understand what effects the D&C had on your ability to get pregnant. Ask when you can expect to be ready to resume trying. Don’t rush back before you’re ready, or you can do more damage to your fragile uterus. If you’ve been having trouble with infertility, a little extra downtime may even help you emotionally.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Do you have questions about Dilation and Curettage (D&C) Procedure? Would like to schedule an appointment with an internationally recognized NYC OB Gynecologist, Dr. Pedram Bral of Manhattan Women’s Health and Wellness, please contact our office for OBGYN consultation.consultation.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575