Dilation and curettage (D and C) is a surgical procedure of the uterus. It consists of manually dilating, or opening, your cervix. A thin instrument called a curette is then inserted into the uterus. The end of it is shaped like a spoon in order to scrape out uterine tissue.
There are several purposes for a D and C. The main one is to remove uterine cells to check for infection or cancer, or to remove a cyst or tumor. It can help treat certain conditions, such as abnormal bleeding. A D and C may be done after a miscarriage. This is if your body does not naturally expel the fetus and tissues.
Path to Improved Health
Before the procedure
Depending on the purpose, a D and C can be done in an outpatient office, surgery center, or hospital. To help with dilation, the doctor may give you medicine to soften your cervix. They may give you a form of anesthesia as well.
During the procedure
You lie in a bed, on your back, with your feet in stirrups. First, the doctor inserts a speculum to open your vagina. Then, the doctor begins the process to dilate your cervix. Typically, they do this by inserting a sequence of thin to larger rods through the opening of your cervix. For most D and Cs, your cervix needs to open about half an inch in diameter.
Once the cervix is open, the doctor inserts the curette. They scrape the tissue lining to remove abnormal uterine cells or unwanted tissue. A suction curettage may be performed instead. The doctor removes the curette and speculum once the procedure is complete.
Recovery after the procedure
If you get anesthesia, you have to wait a couple hours before going home. You won’t be able to drive, so someone has to drive you home. After 1 or 2 days, you can return to your normal routine. You may experience cramping, spotting, or light bleeding following surgery. Pain is usually mild and can be controlled with over-the-counter pain medications such as acetaminophen (one brand: Tylenol) or ibuprofen (one brand: Advil).
A D and C may affect your menstrual cycle. Your body produces a new uterine lining after part of it gets removed. Your next monthly period may be early or late because of this.
Things to Consider
There are some risks to a D and C. You could get an infection in your uterus. To help prevent this, avoid putting anything in your vagina following the procedure. This includes tampons, douches, and some forms of birth control. You also should avoid having sex. This can damage your uterus, which will be sensitive. Other risks include getting cut by the curette and bleeding (hemorrhaging).
If you have a D and C after miscarriage, you will have scar tissue in your uterus and/or cervix. Most of the time the amount of scar tissue is minimal. If there is a lot of scar tissue it is called Asherman syndrome. This much scar tissue can cause changes in your menstrual cycle and flow. With Asherman syndrome, there is a chance it could cause infertility. Surgery can treat most cases of Asherman syndrome.
When to see a doctor
After a D and C, call your doctor if you have:
- Heavy or prolonged vaginal bleeding
- Severe pain in your stomach or uterus
- Foul smell or discharge coming from your vagina
- Fever and/or chills
Questions to Ask Your Doctor
- What are the side effects of anesthesia?
- How long does it take for my cervix to close?
- How long does it take for my uterine lining to grow back?
- When can I exercise, have sex, and use tampons again?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.