DILATION AND CURETTAGE (D&C)
Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.
In a dilation and curettage — sometimes spelled “dilatation” and curettage — your doctor uses small instruments or a medication to open (dilate) your cervix — 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&C can be sharp or use suction.
Dilation and curettage can diagnose or treat a uterine condition.
To diagnose a condition
Your doctor might recommend a D&C to diagnose a condition if:
- You have abnormal uterine bleeding
- You experience bleeding after menopause
- Your doctor discovers abnormal endometrial cells during a routine test for cervical cancer
To 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:
- Uterine cancer
- Uterine polyps
- Endometrial hyperplasia — a precancerous condition in which the uterine lining becomes too thick
To treat a condition
When performing a therapeutic D&C, your doctor removes the entire contents of your uterus, not just a small tissue sample. Your doctor can do this to:
- Remove a molar pregnancy, in which a tumor forms instead of a normal pregnancy
- Treat excessive bleeding after delivery by clearing out any placenta that remains in the uterus
- Remove cervical or uterine polyps, which are usually benign
- Remove fibroid tumors, which are benign tumors formed on the uterine wall that sometimes bulge into the uterine cavity
- Clear out any tissue that remains in the uterus after a miscarriage or abortion to prevent infection or heavy bleeding
Your doctor may perform the D&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.
Contact your doctor if you experience any of the following after a D&C:
- Bleeding that’s heavy enough that you need to change pads every hour
- Light bleeding that lasts longer than two weeks
- Cramps lasting more than 48 hours
- Pain that gets worse instead of better
- Foul-smelling discharge from the vagina
Because you’re either unconscious or sedated during D&C, you shouldn’t feel any discomfort. The procedure usually takes about 15 to 30 minutes. Your doctor will share additional information on your D&C should you need one.