{"categories":"SurgicalProcedure,Adult,Gender Concept,Adult,Clinical Care Concept","keywords":"Dilation and curettage,45 to 64 middle,Female,19 to 44 younger,Treatment","abstract":"\u003cp\u003eDilation and curettage (D\u0026amp;C) \u0026mdash; Overview covers risks, results of this uterine procedure.\u003c/p\u003e","title":"Dilation and curettage (D\u0026C)","body":"\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eDefinition\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eDilation and curettage (D\u0026amp;C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions \u0026mdash; such as heavy bleeding \u0026mdash; or to clear the uterine lining after a miscarriage or abortion.\u003c/p\u003e\u003cp\u003eIn a dilation and curettage \u0026mdash; sometimes spelled \"dilatation\" and curettage \u0026mdash; your doctor uses small instruments or a medication to open (dilate) your cervix \u0026mdash; the lower, narrow part of your uterus. Your doctor then uses a surgical instrument called a curette to remove uterine tissue. Curettes used in a D\u0026amp;C can be sharp or use suction.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eWhy it's done\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eDilation and curettage can diagnose or treat a uterine condition.\u003c/p\u003e\u003ch3\u003eTo diagnose a condition\u003c/h3\u003e\u003cp\u003eYour doctor might recommend a D\u0026amp;C to diagnose a condition if:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eYou have abnormal uterine bleeding\u003c/li\u003e    \u003cli\u003eYou experience bleeding after menopause\u003c/li\u003e    \u003cli\u003eYour doctor discovers abnormal endometrial cells during a routine test for cervical cancer\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eTo perform the test, your doctor collects a tissue sample from the lining of your uterus (endometrium) and sends the sample to a lab for testing. The test can check for:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eUterine cancer\u003c/li\u003e    \u003cli\u003eUterine polyps\u003c/li\u003e    \u003cli\u003eEndometrial hyperplasia \u0026mdash; a precancerous condition in which the uterine lining becomes too thick\u003c/li\u003e\u003c/ul\u003e\u003ch3\u003eTo treat a condition\u003c/h3\u003e\u003cp\u003eWhen performing a therapeutic D\u0026amp;C, your doctor removes the entire contents of your uterus, not just a small tissue sample. Your doctor can do this to:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eRemove a molar pregnancy, in which a tumor forms instead of a normal pregnancy\u003c/li\u003e    \u003cli\u003eTreat excessive bleeding after delivery by clearing out any placenta that remains in the uterus\u003c/li\u003e    \u003cli\u003eRemove cervical or uterine polyps, which are usually benign\u003c/li\u003e    \u003cli\u003eRemove fibroid tumors, which are benign tumors formed on the uterine wall that sometimes bulge into the uterine cavity\u003c/li\u003e    \u003cli\u003eClear out any tissue that remains in the uterus after a miscarriage or abortion to prevent infection or heavy bleeding\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYour doctor may perform the D\u0026amp;C along with another procedure called a hysteroscopy. During a hysteroscopy, your doctor inserts a slim instrument with a light and camera on the end into your vagina, through your cervix and up into your uterus. Your doctor then views the lining of your uterus on a screen, noting any areas that look abnormal, making sure there aren't any polyps, and taking tissue samples as needed. During hysteroscopy, your doctor can also remove uterine polyps and fibroid tumors.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eRisks\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eDilation and curettage is usually very safe, and complications are rare. However, there are risks. These include:\u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003ePerforation of the uterus.\u003c/strong\u003e Perforation of the uterus occurs when a surgical instrument pokes a hole in the uterus. This happens more often in women who were recently pregnant and in women who have gone through menopause. Most perforations heal on their own. However, if a blood vessel or other organ is damaged, a second procedure may be necessary to repair it.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDamage to the cervix.\u003c/strong\u003e If the cervix is torn during the D\u0026amp;C, your doctor can apply pressure or medicine to stop the bleeding, or can close the wound with stitches (sutures).\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eScar tissue on the uterine wall.\u003c/strong\u003e Rarely, a D\u0026amp;C results in development of scar tissue in the uterus, a condition known as Asherman's syndrome. Asherman's syndrome happens most often when the D\u0026amp;C is done after a miscarriage or delivery. This can lead to abnormal, absent or painful menstrual cycles, future miscarriages and infertility.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eInfection.\u003c/strong\u003e Infection after a D\u0026amp;C is possible, but rare.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eContact your doctor if you experience any of the following after a D\u0026amp;C:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eBleeding that's heavy enough that you need to change pads every hour\u003c/li\u003e    \u003cli\u003eLight bleeding that lasts longer than two weeks\u003c/li\u003e    \u003cli\u003eFever\u003c/li\u003e    \u003cli\u003eCramps lasting more than 48 hours\u003c/li\u003e    \u003cli\u003ePain that gets worse instead of better\u003c/li\u003e    \u003cli\u003eFoul-smelling discharge from the vagina\u003c/li\u003e\u003c/ul\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eHow you prepare\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eDilation and curettage may be performed in a hospital, clinic or your doctor's office, and it's usually done as an outpatient procedure.\u003c/p\u003e\u003cp\u003eBefore the procedure:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eFollow your doctor's instructions on limiting food and drink.\u003c/li\u003e    \u003cli\u003eArrange for someone to help you get home because you may be drowsy after the anesthesia wears off.\u003c/li\u003e    \u003cli\u003eClear your schedule to allow enough time for the procedure and recovery afterward. You'll likely spend a few hours in recovery after the procedure.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYou should be able to resume your normal activities within a day or two.\u003c/p\u003e\u003cp\u003eIn some cases, your doctor may start the process of dilating your cervix a few hours or even a day before the procedure. This helps your cervix open gradually and is usually done when your cervix needs to be dilated more than in a standard D\u0026amp;C, such as during pregnancy terminations or with certain types of hysteroscopy.\u003c/p\u003e\u003cp\u003eTo promote dilation, your doctor uses a medication called misoprostol (Cytotec) \u0026mdash; given orally or vaginally \u0026mdash; to soften the cervix or inserts a slender rod made of laminaria into your cervix. The laminaria gradually expands by absorbing the fluid in your cervix, causing your cervix to open.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eWhat you can expect\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003ch3\u003eDuring the procedure\u003c/h3\u003e\u003cp\u003eFor dilation and curettage, you receive anesthesia. General anesthesia makes you unconscious and unable to feel pain. Other forms of anesthesia provide light sedation or use injections to numb only a small area (local anesthesia) or a larger region (regional anesthesia) of your body. The choice of anesthesia depends on the reason for the D\u0026amp;C and your medical history.\u003c/p\u003e\u003cp\u003eDuring the procedure: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eYou lie on your back on an exam table while your heels rest in supports called stirrups.\u003c/li\u003e    \u003cli\u003eYour doctor inserts an instrument called a speculum into your vagina, as during a Pap test, in order to see your cervix.\u003c/li\u003e    \u003cli\u003eYour doctor inserts a series of thicker and thicker rods into your cervix to slowly dilate your cervix until it's adequately opened.\u003c/li\u003e    \u003cli\u003eYour doctor removes the dilation rods and inserts a spoon-shaped instrument with a sharp edge or a suction device and removes uterine tissue.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eBecause you're either unconscious or sedated during D\u0026amp;C, you shouldn't feel any discomfort. The procedure usually takes about 15 to 30 minutes.\u003c/p\u003e\u003ch3\u003eAfter the procedure\u003c/h3\u003e\u003cp\u003eYou may spend a few hours in a recovery room after the D\u0026amp;C so that your doctor can monitor you for heavy bleeding or other complications.\u0026nbsp;This also gives you time to recover from the effects of anesthesia.\u003c/p\u003e\u003cp\u003eIf you had general anesthesia, you may become nauseated or vomit, or you might have a sore throat if a tube was placed in your windpipe to help you breathe. With general anesthesia or light sedation, you may also feel drowsy for several hours.\u003c/p\u003e\u003cp\u003eNormal side effects of a D\u0026amp;C may last a few days and include:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eMild cramping\u003c/li\u003e    \u003cli\u003eSpotting or light bleeding\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eFor discomfort from cramping, your doctor may suggest taking ibuprofen (Advil, Motrin IB, others) or another medication.\u003c/p\u003e\u003cp\u003eWait to put anything in your vagina until your cervix returns to normal to prevent bacteria from entering your uterus, possibly causing an infection. Ask your doctor when you can use tampons and resume sexual activity. \u003c/p\u003e\u003cp\u003eYour uterus must build a new lining after a D\u0026amp;C, so your next period may not come on time. If you had a D\u0026amp;C because of a miscarriage, and you want to become pregnant, talk with your doctor about when it's safe to start trying again.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eResults\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eYour doctor will discuss the results of any lab tests or the procedure itself soon after the dilation and curettage or at a follow-up appointment.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e","doc_id":"PRC-20013836","object_id":"ad523418-caf4-422d-80b6-acb7f5b84ca8","updated_at":"2013-02-09","meta_keywords":"","benefit_summary":"","sections":{"Definition":"\u003cp\u003eDilation and curettage (D\u0026amp;C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions \u0026mdash; such as heavy bleeding \u0026mdash; or to clear the uterine lining after a miscarriage or abortion.\u003c/p\u003e\u003cp\u003eIn a dilation and curettage \u0026mdash; sometimes spelled \"dilatation\" and curettage \u0026mdash; your doctor uses small instruments or a medication to open (dilate) your cervix \u0026mdash; the lower, narrow part of your uterus. Your doctor then uses a surgical instrument called a curette to remove uterine tissue. Curettes used in a D\u0026amp;C can be sharp or use suction.\u003c/p\u003e","Why it's done":"\u003cp\u003eDilation and curettage can diagnose or treat a uterine condition.\u003c/p\u003e\u003ch3\u003eTo diagnose a condition\u003c/h3\u003e\u003cp\u003eYour doctor might recommend a D\u0026amp;C to diagnose a condition if:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eYou have abnormal uterine bleeding\u003c/li\u003e    \u003cli\u003eYou experience bleeding after menopause\u003c/li\u003e    \u003cli\u003eYour doctor discovers abnormal endometrial cells during a routine test for cervical cancer\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eTo perform the test, your doctor collects a tissue sample from the lining of your uterus (endometrium) and sends the sample to a lab for testing. The test can check for:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eUterine cancer\u003c/li\u003e    \u003cli\u003eUterine polyps\u003c/li\u003e    \u003cli\u003eEndometrial hyperplasia \u0026mdash; a precancerous condition in which the uterine lining becomes too thick\u003c/li\u003e\u003c/ul\u003e\u003ch3\u003eTo treat a condition\u003c/h3\u003e\u003cp\u003eWhen performing a therapeutic D\u0026amp;C, your doctor removes the entire contents of your uterus, not just a small tissue sample. Your doctor can do this to:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eRemove a molar pregnancy, in which a tumor forms instead of a normal pregnancy\u003c/li\u003e    \u003cli\u003eTreat excessive bleeding after delivery by clearing out any placenta that remains in the uterus\u003c/li\u003e    \u003cli\u003eRemove cervical or uterine polyps, which are usually benign\u003c/li\u003e    \u003cli\u003eRemove fibroid tumors, which are benign tumors formed on the uterine wall that sometimes bulge into the uterine cavity\u003c/li\u003e    \u003cli\u003eClear out any tissue that remains in the uterus after a miscarriage or abortion to prevent infection or heavy bleeding\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYour doctor may perform the D\u0026amp;C along with another procedure called a hysteroscopy. During a hysteroscopy, your doctor inserts a slim instrument with a light and camera on the end into your vagina, through your cervix and up into your uterus. Your doctor then views the lining of your uterus on a screen, noting any areas that look abnormal, making sure there aren't any polyps, and taking tissue samples as needed. During hysteroscopy, your doctor can also remove uterine polyps and fibroid tumors.\u003c/p\u003e","Risks":"\u003cp\u003eDilation and curettage is usually very safe, and complications are rare. However, there are risks. These include:\u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003ePerforation of the uterus.\u003c/strong\u003e Perforation of the uterus occurs when a surgical instrument pokes a hole in the uterus. This happens more often in women who were recently pregnant and in women who have gone through menopause. Most perforations heal on their own. However, if a blood vessel or other organ is damaged, a second procedure may be necessary to repair it.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDamage to the cervix.\u003c/strong\u003e If the cervix is torn during the D\u0026amp;C, your doctor can apply pressure or medicine to stop the bleeding, or can close the wound with stitches (sutures).\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eScar tissue on the uterine wall.\u003c/strong\u003e Rarely, a D\u0026amp;C results in development of scar tissue in the uterus, a condition known as Asherman's syndrome. Asherman's syndrome happens most often when the D\u0026amp;C is done after a miscarriage or delivery. This can lead to abnormal, absent or painful menstrual cycles, future miscarriages and infertility.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eInfection.\u003c/strong\u003e Infection after a D\u0026amp;C is possible, but rare.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eContact your doctor if you experience any of the following after a D\u0026amp;C:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eBleeding that's heavy enough that you need to change pads every hour\u003c/li\u003e    \u003cli\u003eLight bleeding that lasts longer than two weeks\u003c/li\u003e    \u003cli\u003eFever\u003c/li\u003e    \u003cli\u003eCramps lasting more than 48 hours\u003c/li\u003e    \u003cli\u003ePain that gets worse instead of better\u003c/li\u003e    \u003cli\u003eFoul-smelling discharge from the vagina\u003c/li\u003e\u003c/ul\u003e","How you prepare":"\u003cp\u003eDilation and curettage may be performed in a hospital, clinic or your doctor's office, and it's usually done as an outpatient procedure.\u003c/p\u003e\u003cp\u003eBefore the procedure:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eFollow your doctor's instructions on limiting food and drink.\u003c/li\u003e    \u003cli\u003eArrange for someone to help you get home because you may be drowsy after the anesthesia wears off.\u003c/li\u003e    \u003cli\u003eClear your schedule to allow enough time for the procedure and recovery afterward. You'll likely spend a few hours in recovery after the procedure.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYou should be able to resume your normal activities within a day or two.\u003c/p\u003e\u003cp\u003eIn some cases, your doctor may start the process of dilating your cervix a few hours or even a day before the procedure. This helps your cervix open gradually and is usually done when your cervix needs to be dilated more than in a standard D\u0026amp;C, such as during pregnancy terminations or with certain types of hysteroscopy.\u003c/p\u003e\u003cp\u003eTo promote dilation, your doctor uses a medication called misoprostol (Cytotec) \u0026mdash; given orally or vaginally \u0026mdash; to soften the cervix or inserts a slender rod made of laminaria into your cervix. The laminaria gradually expands by absorbing the fluid in your cervix, causing your cervix to open.\u003c/p\u003e","What you can expect":"\u003ch3\u003eDuring the procedure\u003c/h3\u003e\u003cp\u003eFor dilation and curettage, you receive anesthesia. General anesthesia makes you unconscious and unable to feel pain. Other forms of anesthesia provide light sedation or use injections to numb only a small area (local anesthesia) or a larger region (regional anesthesia) of your body. The choice of anesthesia depends on the reason for the D\u0026amp;C and your medical history.\u003c/p\u003e\u003cp\u003eDuring the procedure: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eYou lie on your back on an exam table while your heels rest in supports called stirrups.\u003c/li\u003e    \u003cli\u003eYour doctor inserts an instrument called a speculum into your vagina, as during a Pap test, in order to see your cervix.\u003c/li\u003e    \u003cli\u003eYour doctor inserts a series of thicker and thicker rods into your cervix to slowly dilate your cervix until it's adequately opened.\u003c/li\u003e    \u003cli\u003eYour doctor removes the dilation rods and inserts a spoon-shaped instrument with a sharp edge or a suction device and removes uterine tissue.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eBecause you're either unconscious or sedated during D\u0026amp;C, you shouldn't feel any discomfort. The procedure usually takes about 15 to 30 minutes.\u003c/p\u003e\u003ch3\u003eAfter the procedure\u003c/h3\u003e\u003cp\u003eYou may spend a few hours in a recovery room after the D\u0026amp;C so that your doctor can monitor you for heavy bleeding or other complications.\u0026nbsp;This also gives you time to recover from the effects of anesthesia.\u003c/p\u003e\u003cp\u003eIf you had general anesthesia, you may become nauseated or vomit, or you might have a sore throat if a tube was placed in your windpipe to help you breathe. With general anesthesia or light sedation, you may also feel drowsy for several hours.\u003c/p\u003e\u003cp\u003eNormal side effects of a D\u0026amp;C may last a few days and include:\u003c/p\u003e\u003cul\u003e    \u003cli\u003eMild cramping\u003c/li\u003e    \u003cli\u003eSpotting or light bleeding\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eFor discomfort from cramping, your doctor may suggest taking ibuprofen (Advil, Motrin IB, others) or another medication.\u003c/p\u003e\u003cp\u003eWait to put anything in your vagina until your cervix returns to normal to prevent bacteria from entering your uterus, possibly causing an infection. Ask your doctor when you can use tampons and resume sexual activity. \u003c/p\u003e\u003cp\u003eYour uterus must build a new lining after a D\u0026amp;C, so your next period may not come on time. If you had a D\u0026amp;C because of a miscarriage, and you want to become pregnant, talk with your doctor about when it's safe to start trying again.\u003c/p\u003e","Results":"\u003cp\u003eYour doctor will discuss the results of any lab tests or the procedure itself soon after the dilation and curettage or at a follow-up appointment.\u003c/p\u003e"},"has_flash":false,"flash_content_url":null,"flash_content_height":null,"flash_content_width":null}