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D and C

Definition

D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus.

• Dilation ("D") is a widening of the cervix to allow instruments into the uterus.
• Curettage ("C") is the scraping of the walls of the uterus.

Alternative Names

Dilatation and curettage; Uterus scraping

Description

D and C, also called uterine scraping, may be performed in the hospital or in a clinic while you are under general or local anesthesia.

The health care provider will insert an instrument called a speculum into the vagina. This holds open the vaginal canal. Numbing medicine may be applied to the opening to the uterus (cervix).

The cervical canal is widened using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is passed through the opening into the uterus cavity. The doctor gently scrapes the inner layer of tissue, called the endometrium. The tissue is collected for examination.

Why the Procedure Is Performed

This procedure may be done to:

• Diagnose conditions such as uterine cancer
• Remove tissue after a miscarriage
• Treat heavy menstrual bleeding or irregular periods (See: Bleeding between periods)
• Perform a therapeutic or elective abortion

Your doctor may also recommend a D and C if you have:

• Abnormal bleeding while on hormone replacement therapy
• An embedded intrauterine device (IUD)
• Bleeding after menopause
• Endometrial polyps
• Thickening of the uterus

This list may not be all-inclusive.

Risks

Risks related to D and C include:

• Puncture of the uterus
• Scarring of the uterine lining (Asherman syndrome, may lead to infertility later)
• Tear of the cervix

Risks due to anesthesia include:

• Reactions to medications
• Problems breathing

Risks of any surgery include:

• Bleeding
• Infection

After the Procedure

D and C has few risks. It can provide relief from bleeding, and can help diagnose infection, cancer, and other diseases.

Outlook (Prognosis)

You may return to normal activities as soon as you feel better, possibly even the same day. There may be vaginal bleeding, as well as pelvic cramps and back pain for a few days after the procedure.

You can usually manage pain well with medications. Tampon use and sexual intercourse are not recommended for 1 - 2 weeks after this procedure.

References

Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 37.

Casablanca Y. Management of dysfunctional uterine bleeding. Obstet Gynecol Clin North Am. 2008;35(2):219-234.