What is a D&C?
Dilation and curettage is a procedure to remove tissue from the inside of the uterus. It is also called a “D and C” or “D&C.” During a D&C, our OB/GYN Specialists first opens (dilates) the cervix (this is the bottom part or the “neck” of the uterus). Then she puts a surgical tool called a “curette” through the vagina and cervix, and up into the uterus. She uses the curette to scrape and remove tissue from the uterus.
Recovery time varies per patient but it’s typical to rest for 2-3 days after your surgery. You should be able to resume your normal activities after your rest period. You may also be instructed to take off a full week if pain and discomfort is keeping you from your normal activities.
Why is a D&C performed?
A D&C is performed to figure out the cause of a symptom or problem. During a D&C, a sample of tissue from your uterus is taken. The sample can then be checked for abnormal cells, cancer, or other problems.
Women might have a D&C:
- To figure out why they have abnormal bleeding from their uterus
- If they had an abnormal result from another test, such as a test for uterine cancer
- Doctors can also do a D&C for other reasons. In pregnant or recently pregnant women, a doctor can do a D&C to:
- Remove any pregnancy tissue that is left in the uterus after a miscarriage – A miscarriage 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 of a pregnant woman
- Do an abortion (end a pregnancy) during the first trimester.
In women who are not pregnant, a doctor can do a D&C to:
- Stop severe vaginal bleeding – For example, a woman might have a D&C if her period is too heavy or if she keeps bleeding too much after giving birth.
You and your doctor have many choices when it comes to anesthetics. With a general anesthetic, you’ll receive medicine through an intravenous line (IV) into a vein in your arm. This causes you to sleep deeply throughout the procedure. A general anesthetic is an option only in a hospital or day surgery setting.
Spinal anesthesia, also called a spinal block, involves injecting anesthetic into your spinal cord. You’ll remain awake for the procedure, but you won’t be able to feel anything below the injection site. As with general anesthetic, a spinal block is typically used only in hospitals and day surgery centers.
A local anesthetic means that the doctor will inject an anesthetic directly into your cervix. You may feel a pinch and a sting with the injection. Once your cervix is numb, you won’t be in any pain when your doctor dilates your cervix. However, you may experience some cramping in your uterus when the doctor removes the lining with a curette. A local anesthetic is an option in your doctor’s office or a clinic.
If you’re anxious about your D and C, ask your doctor if they can sedate you throughout the procedure. This may involve taking a pill for anxiety, or it may involve injecting medication through an IV. You’ll be in a light sleep during the procedure and will remember almost nothing about it afterward if you receive IV sedation.
D&C Procedure Process
Your doctor will give you instructions about what to do before a D&C. He or she will probably tell you not to eat or drink anything starting the night before the procedure.
Your doctor might give you a device or a medicine to put inside your vagina near your cervix the day before your D&C. The device or medicine can soften the cervix or start to dilate it. Let your doctor or nurse know if you have any trouble getting ready for your D&C.
You will have 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 woman is having symptoms, he or she might do another test called a hysteroscopy at the same time. During a hysteroscopy, a doctor puts a small camera inside the uterus to look for problems that could be causing the symptoms. If a woman has a growth in her uterus, a doctor might do a procedure during the D&C to remove it.
When a doctor does a D&C to treat a problem or condition, he or she will remove everything inside the uterus. He or she might also scrape away some of the lining of the uterus.
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 do your usual activities again. He or she will also tell you when you can have sex and put things, such as tampons, in your vagina.
Most women get their monthly period within 4 to 6 weeks after 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-reliever.
Other side effects are not as common but can occur after a D&C. These include:
- A tear in the uterus
- Injury to the cervix
- 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
This is a very low-risk procedure because it’s minimally invasive. However, any surgical procedure has some potential dangers. These may include:
- Anesthesia-related problems with the heart and lungs, which are rare infection
- Blood clots related to staying in bed and not moving around, which are rare if you follow your doctor’s instructions about getting up regularly damage to the uterus or cervix
These may be a sign of damage to your uterus or cervix:
- Heavy bleeding
- Foul-smelling discharge
- Severe pain
Go to your doctor or an emergency room immediately if you experience any of these symptoms.
It’s common to feel tired and experience light cramps for a day or two after the procedure. You’ll remain in the facility a short time for observation. You won’t be able to drive immediately after the procedure. Arrange for a friend or family member to take you home.
Light bleeding is common after a D and C, so you’ll probably want to wear a menstrual pad. Don’t use a tampon because it could cause an infection. You may notice cramping for a few days. If your doctor doesn’t prescribe pain medication, ask them which over-the-counter brand will best help with your discomfort.
Even if it’s uncomfortable, get up and move around as soon as possible. This will keep your muscles strong and help prevent blood clots from forming in your legs.
You should be able to resume most of your routine within a day or two after the procedure. However, your doctor will ask you to refrain from taking a bath, douching, or having intercourse for at least three days and possibly longer.
If your doctor removes potentially cancerous tumors or materials, you’ll get a report from your doctor’s office on the laboratory findings. If the results are benign (noncancerous), you may not need a follow-up. If the results show cancerous or precancerous cells, your doctor will probably refer you to a specialist to talk about your next steps.