D and C

Definition:

D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus.

Alternative Names:

Dilatation and curettage; Uterus scraping

Description:

Uterine scraping (dilatation and curettage: D and C) is a fairly minor surgical procedure. The procedure may be performed in the hospital or in a clinic using general or local anesthesia.

The vaginal canal is held open by a speculum, and the opening to the uterus (cervix) may be anesthetized. The cervical canal is widened (dilated) using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is then passed through the canal into the uterine cavity. The inner layer of the uterus (endometrium) is scraped away, and the tissue is collected for examination.

Indications:

Uterine scraping (D and C) may be done to:

Diagnose conditions using the tissue samples collected (biopsies)
Treat irregular or heavy bleeding
Remove fetal or placental tissue -- used for some elective or therapeutic abortions and to remove any remaining tissue after a spontaneous abortion (miscarriage)

Uterine scraping (D and C) may be recommended for:

Bleeding between periods
Heavy menstrual bleeding
Bleeding after intercourse
Investigation of infertility
Endometrial polyps
Uterine cancer (early diagnosis)
Thickening of the uterus (endometrial hyperplasia )
An embedded IUD (intrauterine device)
Therapeutic or elective abortion
Miscarriage
Postmenopausal bleeding, or abnormal bleeding while taking hormone replacement therapy medications

Risks:

Risks for any anesthesia are:

Reactions to medications
Problems breathing

Risks for any surgery are:

Bleeding
Infection

Additional risks include:

Puncture of the uterus (perforation)
Laceration (tear) of the cervix
Scarring of the uterine lining (endometrium)

Expectations after surgery:

Uterine scraping (D and C) has relatively few risks, can provide relief from bleeding, and can help diagnose problems including infection, cancer, infertility, and other diseases.

Convalescence:

Normal activities may be resumed as soon as the patient feels well, possibly even the same day. There may be vaginal bleeding, as well as pelvic cramps and back pain for a few days after the procedure.

Pain can usually be managed well with medications. Tampon use is not recommended for a few weeks, and sexual intercourse is not recommended for a few days.

Review Date: 1/30/2002
Reviewed By: Catherine S. Bradley, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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