Dilation and curettage (D&C) is a surgical procedure; in this procedure, the uterine lining is scraped by dilating the cervix and then using a special instrument. The process sounds scary and intimidating, but being aware of the procedure will help you to combat stress. It would be better and helpful to be at ease when you know what to expect before, during and after a dilation and curettage. Being aware of the situation will help you to go through the process smoothly. So let’s see what is there to know about this process:

WHY IS IT DONE:

First, you need to know when and why the doctor will need to administer such a procedure. Some of the basic reasons for the dilation and curettage procedure are:

  1.    Removal of the tissue in the uterus: this is done to eliminate little pieces of placenta that might be present after the childbirth and is usually performed during or after a miscarriage or even abortion. This is done to prevent any kind of possible infection or even to stop heavy bleeding.
  2.    Diagnose or treatment of any abnormal uterine bleeding: This procedure is helpful in detecting and diagnosis or even treat any growth like fibroids, polyps, uterine cancer or hormonal imbalances. In this case, a microscope is used to diagnose a small uterine tissue portion to check for abnormalities.

What to expect when you are undergoing the dilation and curettage:

This procedure is carried out in the doctor’s room. It is not really a surgical procedure, and hence you wouldn’t have to go on an operation table.  It is a short procedure; takes 10 to 15 minutes. But the doctor might ask you to stay back in the clinic for a few hours.

What happens before dilation and curettage?

Before the procedure, there are some formalities that the doctor has to finish. You will be given a consent form to be signed. A complete history is taken into account. This is your chance to discuss all your queries about the procedure. If you have any queries or any questions or curiosity regarding the procedure, this is when you would like to address them. Some things that you should mention to the doctor without any fail are:

  1.    Maybe you are pregnant.
  2.    You are sensitive or even allergic to some medicines.
  3.    Any bleeding disorder or if you take any sort of blood thinning drugs.

You will receive anesthesia, but before he does that the doctor will discuss it with you. The type of anesthesia used depends on the procedure that you require.

  1.    If the procedure is not that complicated then the doctor most probably administers General anesthesia. In this case, you will be asleep during the procedure.
  2.    If you have spinal or epidural anesthesia, you will be numb from the waist down.
  3.    The other type of anesthesia that you might encounter is local anesthesia. In this case, you will be awake and only the area around your cervix will be numb.

Before the procedure, you will need to have an empty bladder and the clothes will be removed and change into a gown.

What happens during the dilation and curettage?

For this procedure, you will have to lie down on your back. For your legs there will be stirrups, you will have to place your legs on them. It is just like the pelvic exam. The doctor will then insert a speculum into the vagina and hold the cervix in place with a clamp. The cervix will be cleaned by the doctor with some antiseptics. This is done as an extra precautionary step; this procedure doesn’t require any kind of incisions or stitches.

Let’s go through the process in detail:

The process of dilation and curettage, clearly, has two steps.

  1.    The first step is the dilation: in this step, all that is needed is to widen the opening of your lower part of the uterus. This is done to allow the insertion of an instrument. The doctor will insert a slender rod into the opening prior to the procedure or even use some medication beforehand to soften the cervix. This allows the cervix to open and widen.
  2.    The next step is curettage: In this step, the actual procedure happens. It involves the scrapping of the lining and removal of the uterine contents. This removal is done with a long spoon-shaped instrument. The instrument is called a curette, hence the name of the procedure. But the doctor may also use a cannula to suck out any remaining contents from the uterus. This is something which can cause some cramping.

At times, some other procedures are performed along with this procedure. For instance, the doctor may insert a slender device to view inside the uterus; or he may have to do another procedure along with the D&C to remove the fibroids.

What happens after dilation and curettage?

There are obviously some after effects of this procedure, just like any other medical procedure:

  1.    Cramping.
  2.    Spotting or light bleeding.

These two are one of the most common side effects of the procedure, and it is quite common and nothing much to be worried about.

Some of the other side effects that are quite rare but a possibility are:

  1.    Damaged cervix.
  2.    Perforated uterus or bladder and blood vessels.

Some more post-procedure symptoms include:

  1.    Heavy or long term bleeding; or even blood clots.
  2.    Fever.
  3.    Pain.
  4.    Abdominal tenderness.
  5.    Foul-smelling vaginal discharge.

In some rare cases, there is a probability of scar tissue that may form inside the uterus. In such a case there is a possibility of infertility.

The recovery:

After the procedure, there is some assistance needed for you to take you back home. In case you had general anesthesia, a groggy feeling is common and expected. You might even feel nauseous for a while. It will take you one or two days to get back to your normal daily chores. The doctor will let you know in case of any specific restrictions. Mild cramping and little spotting is common and nothing to worry about. You can use some sanitary pads and take some pain medicines to ease the pain if any. There can be a change in the dates of your menstrual cycle. Ask the doctor regarding things like sex and use of tampon; he will let you know when it will be safe for you to indulge in such affairs.

Follow-up visits to the doctor are important, this way you will know whether the recovery is steady or not.