Dilation and Curettage or Vacuum Curettage

Dilation and curettage (D&C) and vacuum curettage are minor procedures. A D&C involves stretching (dilation) the cervix and scraping (curettage) the inside lining of the womb (uterus). During a D&C, tissue is gently scraped from the inside lining of the uterus. During a vacuum curettage, the lining and tissue in the uterus are removed with the use of gentle suction.

Curettage may be performed to either diagnose or treat a problem. As a diagnostic procedure, curettage is performed to examine tissues from the uterus. A diagnostic curettage may be performed for the following symptoms:

  • Irregular bleeding in the uterus.  

  • Bleeding with the development of clots.  

  • Spotting between menstrual periods.  

  • Prolonged menstrual periods.  

  • Bleeding after menopause.  

  • No menstrual period (amenorrhea).  

  • A change in size and shape of the uterus.  

As a treatment procedure, curettage may be performed for the following reasons:

  • Removal of an IUD (intrauterine device).  

  • Removal of retained placenta after giving birth. Retained placenta can cause an infection or bleeding severe enough to require transfusions.  

  • Abortion.  

  • Miscarriage.  

  • Removal of polyps inside the uterus.  

  • Removal of uncommon types of noncancerous lumps (fibroids).  

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.  

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.  

  • Previous problems you or members of your family have had with the use of anesthetics.  

  • Any blood disorders you have.  

  • Previous surgeries you have had.  

  • Medical conditions you have.

RISKS AND COMPLICATIONS

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Excessive bleeding.  

  • Infection of the uterus.  

  • Damage to the cervix.  

  • Development of scar tissue (adhesions) inside the uterus, later causing abnormal amounts of menstrual bleeding.  

  • Complications from the general anesthetic, if a general anesthetic is used.  

  • Putting a hole (perforation) in the uterus. This is rare.  

BEFORE THE PROCEDURE

  • Eat and drink before the procedure only as directed by your health care provider.  

  • Arrange for someone to take you home.  

PROCEDURE

This procedure usually takes about 15–30 minutes.

  • You will be given one of the following:

  • A medicine that numbs the area in and around the cervix (local anesthetic).  

  • A medicine to make you sleep through the procedure (general anesthetic).

  • You will lie on your back with your legs in stirrups.  

  • A warm metal or plastic instrument (speculum) will be placed in your vagina to keep it open and to allow the health care provider to see the cervix.

  • There are two ways in which your cervix can be softened and dilated. These include:  

  • Taking a medicine.  

  • Having thin rods (laminaria) inserted into your cervix.  

  • A curved tool (curette) will be used to scrape cells from the inside lining of the uterus. In some cases, gentle suction is applied with the curette. The curette will then be removed.  

AFTER THE PROCEDURE

  • You will rest in the recovery area until you are stable and are ready to go home.  

  • You may feel sick to your stomach (nauseous) or throw up (vomit) if you were given a general anesthetic.  

  • You may have a sore throat if a tube was placed in your throat during general anesthesia.  

  • You may have light cramping and bleeding. This may last for 2 days to 2 weeks after the procedure.  

  • Your uterus needs to make a new lining after the procedure. This may make your next period late.