What Is D&C?

The D stands for dilation, refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage). It is a diagnostic gynecological procedure as well as a rarely used method of first trimester abortion. A D&C is seldom done as a lone procedure anymore. It is most frequently done as an adjunct procedure to a hysteroscopy and/or polypectomy.

Why is it done?

• Irregular bleeding: You may experience irregular bleeding from time to time, including spotting between periods.
• Too much bleeding: Bleeding with long, heavy periods, or bleeding after menopause, can signal a number of problems.
• Fibroids and polyps: Fibroid tumors are noncancerous growths appearing in and on the uterus. Fibroids can cause chronic pain and heavy bleeding. Polyps, like fibroids, are noncancerous growths and are a common cause of irregular bleeding.
• Therapeutic D&C: A D&C is often planned as treatment when the source of the problem is already known. One situation is an incomplete miscarriage or even full-term delivery when, for some reason, the uterus has not pushed out all the fetal or placental tissue inside of it. If tissue is left behind, excess bleeding can result, perhaps even life-threatening bleeding. This is an important reason why your doctor will want to remove any remaining tissue with a D&C.

What to expect after surgery?

After a D&C, if you had general anesthesia, you may feel groggy for a while and have some brief nausea and vomiting.

You can return to regular activities within one or two days. In the meantime, ask your doctor about any needed restrictions. You may also have mild cramping and light spotting for a few days. This is normal. You may want to wear a sanitary pad for spotting and take pain relievers for pain.

You can expect a change in the timing of your next menstrual period. It may come either early or late. To prevent bacteria from entering your uterus, delay sex and use of tampons until your doctor says it's OK.

What are the risks of the surgery?

• Introduction or spreading of infection
• Adverse reaction to general anesthesia required during the surgery or from instrumentation itself, as the procedure is performed blindly (without the use of any imaging technique such as ultrasound or hysteroscopy).
• Uterine perforation. Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman has an untreated sexually transmitted infection.
• Intrauterine adhesions, or Asherman's syndrome.
• Excessive dilatation may also lead to cervical incompetence in the future, which increases the chance of miscarriage.

What are the alternatives to the surgery?

X-rays and scans, such as ultrasound, CT and MRI scans, can be of some help in finding the cause for the bleeding. None of these tests produce samples of tissue. A D&C is the simplest way of doing this but nowadays it is usually combined with a hysteroscopy, which is diagnostically more accurate.