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Dilation and Curettage (D&C) – Procedure & Uses

Dilation and curettage (D&C) is a gynecological procedure in which the lining of the uterus is scraped or suctioned away. It is used for both diagnostic and therapeutic purposes.

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Things worth knowing about "Dilation and curettage"

Dilation and curettage (D&C) is a gynecological procedure in which the lining of the uterus is scraped or suctioned away. It is used for both diagnostic and therapeutic purposes.

What is Dilation and Curettage?

Dilation and curettage, commonly referred to as D&C, is a gynecological procedure in which the uterine lining (endometrium) is partially or fully removed using a spoon-shaped surgical instrument called a curette. It is one of the most frequently performed gynecological operations and can serve both diagnostic and therapeutic purposes.

Indications

A D&C may be performed for a variety of medical reasons, including:

Diagnostic purposes: To collect tissue samples when uterine cancer or abnormal cell changes are suspected
Miscarriage: To remove remaining pregnancy tissue after a pregnancy loss
Incomplete miscarriage: When not all tissue is expelled naturally
Abnormal or heavy menstrual bleeding: To treat excessively heavy or irregular periods
Uterine polyps or fibroids: Removal of benign growths inside the uterus
Pregnancy termination: In some cases as part of a medical abortion procedure

How the Procedure Works

The procedure is typically performed under general anesthesia or local anesthesia and usually takes only a few minutes. The typical steps include:

The patient lies in the gynecological examination position (lithotomy position).
A speculum is inserted into the vagina to visualize the cervix.
The cervix is gently dilated (widened) if necessary.
The curette is used to systematically scrape or remove the uterine lining.
The collected tissue is usually sent to a laboratory for histological (microscopic) examination.

Today, a D&C is often combined with hysteroscopy (direct visual examination of the uterine cavity using a thin camera), allowing the procedure to be performed under direct visualization for greater precision.

Risks and Possible Complications

A D&C is considered a relatively safe procedure; however, like any surgical intervention, it carries certain risks:

Uterine perforation – accidental puncture of the uterine wall (rare)
Infection of the uterus or fallopian tubes
Asherman syndrome: Intrauterine adhesions (scar tissue) forming after the procedure
Postoperative bleeding or menstrual irregularities
Anesthesia-related risks if general anesthesia is used
Cervical injury during dilation (uncommon)

Recovery and Aftercare

Most patients are able to return home on the same day of the procedure after a short observation period. Important aftercare guidelines include:

Mild abdominal cramping and light spotting in the days following the procedure are normal.
Physical rest is recommended for several days.
Sexual intercourse, baths, and tampon use should be avoided for approximately 2 to 4 weeks.
A follow-up appointment with a gynecologist is essential to monitor healing and review laboratory results if tissue was sent for analysis.

References

American College of Obstetricians and Gynecologists (ACOG) – Practice Bulletin on Intrauterine Adhesions. Available at: www.acog.org
Berek, J.S.: Berek & Novak's Gynecology, 16th Edition, Wolters Kluwer, 2020.
World Health Organization (WHO) – Clinical Practice Handbook for Safe Abortion. WHO Press, Geneva, 2014.

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