Patient education: Dilation and curettage (D&C) (The Basics)

What is dilation and curettage? — Dilation and curettage is a procedure to remove tissue from the inside of the uterus (figure 1). It is also called a "D and C" or "D&C."

During a D&C, a doctor first opens (dilates) the cervix. (The cervix is the bottom part or the "neck" of the uterus.) Then, they put a surgical tool called a "curette" through the vagina and cervix, and up into the uterus. They use the curette to scrape and remove tissue from the uterus.

A D&C is done in an operating room in a hospital or clinic.

Why might my doctor do a D&C? — Your doctor might do a D&C to figure out the cause of a symptom or problem. During a D&C, a doctor gets a sample of tissue from your uterus. The sample can then be checked for abnormal cells, cancer, or other problems.

Reasons you might have a D&C include:

●To stop severe vaginal bleeding – For example, you might have a D&C if your period is too heavy.

●To figure out the cause of abnormal bleeding – For example, if you have very heavy periods, or if you have vaginal bleeding after going through menopause, a D&C might help your doctor figure out what is causing the problem.

●To get more information after an abnormal result from another test – For example, if you had a test to check for uterine cancer, your doctor might do a D&C to learn more.

Doctors can also do a D&C for other reasons. In pregnant or recently pregnant people, a doctor can do a D&C to:

●Remove any pregnancy tissue that is left in the uterus after a miscarriage – A miscarriage, or "pregnancy loss," is when a pregnancy ends on its own before the baby can live outside the womb.

●Remove any pregnancy tissue that is left in the uterus after childbirth

●Remove an abnormal growth called a "molar pregnancy" that has formed in the uterus

●Do an abortion (end a pregnancy) during the first trimester

What should I do before a D&C? — Your doctor will give you instructions about what to do before a D&C. They will probably tell you not to eat or drink anything starting the night before the procedure.

Your doctor might give you medicine to put inside your vagina near your cervix the day before your D&C. The medicine can soften your cervix or start to dilate it. Let your doctor or nurse know if you have any trouble getting ready for your D&C, or if you have questions about what to expect.

What happens during a D&C? — You will have a thin tube that goes into a vein, called an "IV," put in your arm or hand. Your doctor or nurse will give you fluids and medicines through the IV. Some of these medicines will make you feel relaxed, sleepy, or numb during the procedure.

When a doctor does a D&C to find out why a person is having symptoms, they might do another test called a "hysteroscopy" at the same time. During a hysteroscopy, the doctor puts a small camera inside the uterus to look for problems that could be causing the symptoms. If they find a growth in the uterus, they might do a procedure during the D&C to remove it.

When a doctor does a D&C to treat a problem or condition, they will remove anything concerning that is inside the uterus. They might also scrape away some of the lining of the uterus.

What happens after a D&C? — After a D&C, your doctor or nurse will watch you for a while to make sure you don't have any problems. This might take up to a few hours. When you are able to go home from the hospital, someone else should drive you.

Your doctor or nurse will tell you when you can start your usual activities again. They will also tell you when it is safe to have sex and put things, such as tampons, in your vagina.

Typically, you will get your period within 4 to 6 weeks after a D&C.

What are the side effects of a D&C? — The most common side effects are mild cramping and slight bleeding from the vagina (called spotting). These can last for a few days. If you have pain, you can take a pain-relieving medicine.

Other side effects are not common but can occur after a D&C. These include:

●A tear in the uterus

●Injury to the cervix

●Infection

●Areas of scar tissue that form in the uterus

Should I call my doctor or nurse? — Call your doctor or nurse if you have any of the following problems after your D&C:

●Fever higher than 100.4°F (38°C)

●Cramps that last more than 2 days

●Pain that gets worse

●Heavy vaginal bleeding, or vaginal bleeding that lasts more than 2 weeks

●Vaginal discharge that is green or smells bad

More on this topic

Patient education: Pregnancy loss (The Basics)
Patient education: Coping after pregnancy loss (The Basics)
Patient education: Abortion (The Basics)
Patient education: Heavy periods (The Basics)
Patient education: Endometrial ablation (The Basics)

Patient education: Dilation and curettage (D&C) (Beyond the Basics)
Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Miscarriage (Beyond the Basics)