D & C With Hysteroscopy

What is a D & C?

“D & C” refers to dilation (dye-LAY-shun) and curettage (kyur-eh-TAHJ). It is a common procedure performed on many women each year. Often, another procedure called hysteroscopy (hiss-ter-OSS-koh-pee) is done at the same time.

 

Together, these procedures are used to:

  • Diagnose or treat abnormal bleeding from the uterus, such as heavy or long menstrual periods or bleeding between periods
  • Remove polyps (PAW-lips) or fibroids (FIE-broyds)
  • Find out whether a woman has cancer of the uterus

How is the procedure done?

The procedure may be done with either general or local anesthesia, depending on your needs. If you have general anesthesia, you will go to sleep during the procedure. If you have local anesthesia, you will be awake, but will not feel anything during the procedure. You may be asked not to eat or drink anything for a set time before your surgery.

 

Just before the D & C, the skin around the vagina and the cervix will be cleansed with an antiseptic solution. It is not necessary for pubic hair to be shaved.

Dilation means stretching the opening of the cervix with special instruments to make it wider for the procedure. The cervix is the lower part of the uterus (see diagram below).

Once the cervix is dilated, the hysteroscopy is performed. First, a thin telescope is inserted into the uterus. This instrument is called a hysteroscope (HISS-ter-oh-skope). Then, fluid is inserted to hold the walls of the uterus open, so they can be seen through the hysteroscope.

The lining of the uterus is examined. Then the doctor inserts another instrument to loosen and remove the lining. This is called curettage. It can be done with a tiny scraping instrument called a curette, or by gentle suction through a tube. After a D & C, a new lining builds up in the uterus during the next menstrual cycle.

Complications

Complications are rare, but may include:

  • Heavy bleeding
  • Infection
  • Taking in too much fluid during the procedure
  • Small holes (perforation) or other damage to the uterus or other organs

 

After the procedure

  • A relative or friend must drive you home.
  • You may be groggy or weak for a day or two from the anesthesia. These effects wear off at different times for different people.
  • You may have some mild cramping for 1 or 2 days.
  • You may notice spotting or slight bleeding from the uterus for up to 1 week.
  • Your next menstrual period may not occur at the regular time. It may be early or late.
  • You should be able to drive and do most normal activities in 1 to 2 days.
  • You may shower, bathe, or swim after the procedure.
  • Your doctor or nurse will discuss any special instructions.
  • If there was some complication during your surgery, you may have to stay in the hospital for 1 to 2 days.

 

Other precautions

Until your cervix returns to its normal size, there is a small chance that bacteria could enter the uterus and cause an infection. To prevent this, you should not have sex or use tampons for at least 1 week. You should never douche.

 

When to call the doctor

Call your doctor or nurse if you have any of the following:

  • Fever
  • Lower belly pain
  • Heavy bleeding
  • Vaginal discharge with a bad odor

 

Follow-up

Make a follow-up appointment to see your doctor soon after the procedure. He or she will tell you if you need more treatment.

 

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