Dilation and Curettage
Dilatation and curettage, also referred as D and C is a common gynaecological procedure that is used in diagnosing and treating various conditions in women that cause abnormal or heavy vaginal bleeding, inability to conceive or maintain a pregnancy to its full term. The procedure involves scraping and collection of the tissue lining the walls of the uterus (endometrium) using the surgical tool, curette. To allow curettes to be introduced into the uterus, the cervix needs to be widened or dilated with special instruments.
Your gynaecologist may perform a D and C procedure if you have any of the following conditions:
- Heavy menstrual bleeding with painful abdominal cramps, leading to substantial blood loss from the body
- Abnormal bleeding which occurs as "spotting" in between menstrual periods, after menopause or after sexual intercourse
- Benign growth such as fibroids or polyps in the uterus. Polyps and some fibroids can be removed during a D and C procedure
- Suspected uterine cancer
- Adenomyosis, a condition in which the innermost layer of the uterus has grown into the muscular layer of the uterus. This causes painful cramps and abnormal bleeding
- Pelvic inflammatory disease, in which infection in the uterus and fallopian tubes spreads into the pelvic cavities
- Miscarriage or elective termination of pregnancy - In both these conditions, a D and C procedure will be required for the removal of remaining tissue which otherwise would cause infections in the future
- A contraceptive intrauterine device (IUD) that has to be removed
Dilatation and curettage procedure may be carried out either in a hospital or outpatient clinic under local anaesthesia, general anaesthesia or regional anaesthesia depending on you and your gynaecologist's choice. Occasionally, your gynaecologist will provide you with medication to be used as a softening agent that softens and dilates your cervix. This agent may cause minor discomfort or spasm in the abdomen. You may be advised to take pain medication if the pain becomes severe.
During the procedure, you will be made to rest on the operating table with your legs propped up. Then a speculum will be inserted gently to open the vagina. With special instruments dilatation of the cervix is done followed by which curettes are inserted into the uterus to scrape out the inner lining. The scraped tissue is sent to the pathological laboratory for further tests.
Dilatation and curettage is a very safe procedure however may pose certain risks and complications such as infection in the vagina, uterus or pelvis; bleeding during or after the procedure; damage to the uterine wall or other pelvic organs such as bladder, intestines, blood vessels and nerves may occur. You may see a bloody or brownish vaginal discharge after the procedure which is normal and not a serious concern. Avoiding intercourse, lifting heavy objects, and using tampons for 1-2 weeks after the procedure is recommended.