What is diagnostic dilatation and curettage?

Diagnostic dilatation and curettage (D&C) is a minor surgical procedure used to get a sample of tissue from the lining of the uterus (the endometrium). The uterus is a muscular organ where menstruation begins and babies grow during pregnancy.

The tissue sample is sent to the lab for tests.

When is it used?

This procedure may be performed to learn more information about the condition of your uterus. For example, the doctor may want to discover the cause of unusual bleeding, recurrent pelvic pain, or enlargement of the uterus. With this information, the doctor may make a better diagnosis and treat the problem effectively.

In some situations, an alternative may be to have a hysteroscopy (dilating the cervix and using a scope to look at the inside of the uterus). Or the doctor may use a scope during the D&C to get samples of tissue from specific sites in the uterus. Another alternative is to choose not to have any procedure, recognizing the possible risks of your condition. You should ask your doctor about these choices.

How do I prepare for a dilatation and curettage?

Plan for your care and recovery after the procedure. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow instructions provided by your doctor. No special preparation is needed for regional anesthesia. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a sedative or a regional or general anesthetic. A sedative helps you relax. A regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor dilates your cervix and guides a scooplike instrument (a curette) into the uterus. The doctor uses the curette to scrape the lining of the uterus. This tissue is sent to the lab for analysis.

What happens after the procedure?

If there are no complications, you may go home a few hours after the procedure. Expect some bleeding and menstrual-type cramps for the first day or so. Your doctor may suggest a pain reliever.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The procedure may help the doctor arrive at a better diagnosis. In addition, depending on the diagnosis, the scraping of the uterine lining may help treat your problem.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Regional anesthesia is considered safer than general anesthesia.

• The uterus may be hurt or punctured by the curette.

• The walls of the uterus may bleed more after the procedure than they did before the procedure.

• There is a small chance that the uterus will become infected as a result of this procedure.

You should ask your doctor how these risks apply to you.

When should the doctor be contacted?

Call the doctor immediately if:

• You have heavy bleeding from the uterus (more than one pad per hour or bleeding heavier than your menstrual flow).

• You develop a fever.

• You have severe or persistent abdominal pain that continues even after you take acetaminophen or aspirin.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.