Dilation and Curettage (D and C)

Dilation and Curettage (D and C)

Dilation and curettage (D and C) is a type of female surgical procedure. It consists of manually dilating, or opening, your cervix. A thin instrument called a curette is then inserted into your uterus. The end of it is shaped like a spoon in order to scrape out uterine tissue.

There are several purposes for a D and C. The main one is to remove uterine cells to check for infection or cancer, or to remove a cyst or tumor. It can help treat certain conditions, such as abnormal bleeding. A D and C may be done after a miscarriage. This is if your body does not naturally expel the fetus and tissues.

Path to improved health

Before the procedure

Depending on the purpose, a D and C can be done in an outpatient office, surgery center, or hospital. To help with dilation, the doctor may give you medicine to soften your cervix. They may give you a form of anesthesia as well.

During the procedure

You lie in a bed, on your back, with your feet in stirrups. First, the doctor inserts a speculum to open your vagina. Then, the doctor begins the process to dilate your cervix. Typically, they do this by inserting a sequence of thin to larger rods through the opening of your cervix. For most D and Cs, your cervix needs to open about half an inch in diameter.

Once the cervix is open, the doctor inserts the curette. They scrape the tissue lining to remove abnormal uterine cells or unwanted tissue. A suction curettage may be performed instead. The doctor removes the curette and speculum once the procedure is complete.

Recovery after the procedure

If you get anesthesia, you have to wait a couple hours before going home. You won’t be able to drive, so someone has to pick you up. After 1 or 2 days, you can return to your normal routine. You may have cramping, spotting, or light bleeding following surgery. Any pain you have should be mild.

A D and C may affect your menstrual cycle. Your body produces a new uterine lining after part of it gets removed. Your next monthly period may be early or late because of this.

Things to consider

There are some risks to a D and C. You could get an infection in your uterus. To help prevent this, avoid putting anything in your vagina following the procedure. This includes tampons, douches, and some forms of birth control. You also should avoid having sex. This can damage your uterus, which will be sensitive. Getting cut by the curette and bleeding (hemorrhaging) are other risks.

If you have a D and C after miscarriage, you may get scar tissue in your uterus and/or cervix. This condition is called Asherman syndrome. The scar tissue can cause changes in your menstrual cycle and flow. There is a chance it could cause infertility. Surgery can treat most cases of Asherman syndrome.

When to see a doctor

After a D and C, call your doctor if you have:

  • heavy or prolonged vaginal bleeding
  • severe pain in your stomach or uterus
  • foul smell or discharge coming from your vagina
  • fever and/or chills.

Questions to ask your doctor

  • What are the side effects of anesthesia?
  • How long does it take for my cervix to close?
  • How long does it take for my uterine lining to grow back?
  • When can I exercise, have sex, and use tampons again?

Resources

American Congress of Obstetricians and Gynecologists, Dilation and Curettage (D&C)

American Pregnancy Association, D&C Procedure After a Miscarriage

U.S. National Library of Medicine, Does Dilation and Curettage Affect Future Pregnancy Outcomes?