(Dilatation and Curettage, D&C)
What is a dilation and curettage (D&C)?
A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the cervical canal and uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues. A suction D&C uses suction to remove uterine contents. This is sometimes called a dilation and evacuation (D&E).
Other related procedures used for diagnosing and treating the endometrium include endometrial ablation, hysteroscopy, and hysterectomy. Please see these procedures for additional information.
What are female pelvic organs?
The organs and structures of the female pelvis are:
Endometrium—the lining of the uterus
Uterus—also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.
Ovaries—two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sex hormones estrogen and progesterone are produced
Cervix—the lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body
Vagina—the passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia).
Vulva—the external portion of the female genital organs
The menstrual cycle
With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone help to thicken its walls. If fertilization does not occur, the endometrium, coupled with blood and mucus from the vagina and cervix (the lower, narrow part of the uterus located between the bladder and the rectum), make up the menstrual flow (also called menses) that leaves the body through the vagina. After menopause, menstruation stops and a woman should not have any bleeding.
Reasons for the procedure
A D&C may be used as a diagnostic or therapeutic procedure for abnormal bleeding. A D&C may determine the cause of abnormal or excessive uterine bleeding, to detect cancer, or as part of infertility (inability to become pregnant) investigation.
Causes of abnormal bleeding include the presence of abnormal tissues such as fibroid tumors (benign tumors that develop in the uterus, also called myomas) polyps, or cancer of the endometrium or uterus. Tissues obtained from the D&C can be examined under a microscope. Abnormal uterine bleeding may also be due a hormone imbalance or disorder (particularly estrogen and progesterone) especially in women approaching menopause or after menopause.
A D&C may be used following a miscarriage to remove the fetus and other tissues if they have not all been naturally passed. Infection or heavy bleeding can occur if these tissues are not completely removed. This type of D&C may also be called a surgical evacuation of the uterus or a D&E.
Occasionally following childbirth, small pieces of the placenta (afterbirth) remain adhered to the endometrium and are not passed. This can cause bleeding or infection. A D&C may be used to remove these fragments so that the endometrium can heal properly.
There may be other reasons for your physician to recommend a D&C.
Risks of the procedure
As with any surgical procedure, complications may occur. Some possible complications of a D&C may include, but are not limited to, the following:
Perforation of the uterine wall or bowel
Adhesions (scar tissue) may develop inside the uterus
Patients who are allergic to or sensitive to medications, iodine, or latex should notify their physician.
If you are pregnant or suspect that you may be pregnant, you should notify your physician.