Dilation and curettage

Dilation and curettage (D&C) is a common gynecological procedure involving the dilation (widening) of the cervix and the surgical removal of part of the lining of the uterus by scraping and scooping (curettage). It's often performed to diagnose and treat certain conditions that affect the uterus.

Dilation and curettage

Indications

Dilation and curettage can be employed both diagnostically and therapeutically. It is often indicated in cases of abnormal uterine bleeding to obtain samples for histological analysis and to rule out endometrial cancer or hyperplasia. It may also be utilized in the management of incomplete miscarriage or retained products of conception, to remove polyps or fibroids, and for the evacuation of a molar pregnancy^[1].

Procedure

• D&C is generally performed under local, regional, or general anesthesia. The cervix is first dilated using metal rods of increasing size or a medication to allow the curette, a spoon-shaped instrument, to enter the uterus. The curette is then used to gently scrape the lining of the uterus and remove tissue. The removed tissue can be sent to a lab for analysis if needed.
• In some cases, D&C may be combined with a procedure called hysteroscopy, where a small lighted camera is inserted into the uterus to allow the doctor to see inside the uterus during the procedure^[2].

Risks and Complications

While D&C is generally considered safe, it carries some potential risks, as with any surgical procedure. These include infection, bleeding, perforation of the uterus, and cervical injury. Rarely, a condition called Asherman's syndrome, or intrauterine adhesions, can occur after repeated D&Cs. Anesthesia-related complications may also occur^[3].

Recovery and Aftercare

• Recovery after D&C is typically straightforward. Mild cramping and spotting or light bleeding can be expected for a few days after the procedure. Over-the-counter pain relievers can usually manage any discomfort.
• Patients should contact their healthcare provider if they experience heavy bleeding, severe abdominal pain, or signs of infection such as fever, chills, or foul-smelling vaginal discharge. Regular gynecological follow-up is crucial, particularly if the procedure was performed for diagnostic purposes^[4].

See also

• Hysteroscopy
• Endometrial biopsy
• Asherman's syndrome
• Uterine polyps
• Uterine fibroids
• Miscarriage

References

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