Dilation and Curettage (D&C)

What is dilation and curettage?

Dilation and curettage, called D&C, is a gynecological procedure that involves dilation (or dilatation) of the cervix and removal of tissue from inside the uterus. Your doctor may use D&C to help stop abnormal bleeding, such as after childbirth or during menopause. Other reasons for a D&C may be to remove remaining tissue during or after miscarriage or to diagnose and treat conditions such as uterine fibroids and uterine cancer. The dilation and curettage procedure may sometimes be used for abortion.

What to expect during a dilation and curettage procedure

Depending on your health condition and medical history, a D&C may be done under general anesthesia (you'll be asleep and won't feel anything), or with spinal anesthesia (you're awake but feel nothing from the waist down), or local anesthesia to numb a specific area.

In order to dilate the cervix, your doctor uses slim metal rods of graduating size to soften and widen the cervical opening. This part of the procedure may also be done with a special medication that has the same effect. Once the cervix is dilated, a "curette" — which is a long thin instrument with a small sharp "spoon" on the end — is used to gently scrape away the uterine tissue. This process is sometimes done with a suction device instead of a curette. Often the tissue is sent to the lab for sampling.

Risks of dilation and curettage

D&C is widely used and is considered a safe and effective treatment for abnormal bleeding. Like any surgical procedure, however, there are some risks involved, including perforation of the uterus, infection, damage to the cervix, and the development scar tissue (Asherman's syndrome) which can affect your ability to get pregnant.

Because of anesthesia and some discomfort afterward, you'll need someone to drive you home for rest and recovery. Dilation and curettage side effects may include some cramping and light bleeding as well as nausea and vomiting. It's important to take it easy for a few days and not do any heavy lifting or overexert yourself. You want to give your body a chance to heal and not to cause more bleeding. This includes refraining from sexual activity and use of tampons until your doctor says you can resume.

During dilation and curettage recovery, if you are having heavy bleeding and large blood clots, foul-smelling discharge from the vagina, fever, pain or abdominal tenderness, call your doctor right away.