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 for diagnostic or therapeutic purposes. As a diagnostic procedure, curettage is performed for the purpose of examining tissues from the uterus. Tissue examination may help determine causes or treatment options for symptoms. 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.

A therapeutic curettage is performed to remove tissue, blood, or a contraceptive device. Therapeutic curettage may be performed for the following conditions:

  • Removal of an IUD (intrauterine device).

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

  • Abortion.

  • Miscarriage.

  • Removal of polyps inside the uterus.

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

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • 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 caregiver.

  • Arrange for someone to take you home.

PROCEDURE

  • This procedure may be done in a hospital, outpatient clinic, or caregiver's office.

  • You may be given a general anesthetic or a local anesthetic in and around the cervix.

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

  • 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 scrape cells from the inside lining of the uterus and will then be removed.

This procedure usually takes about 15 to 30 minutes.

AFTER THE PROCEDURE

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

  • You will need to have someone take you home.

  • You may feel sick to your stomach (nauseous) or throw up (vomit) if you had general anesthesia.

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

  • You may have light cramping and bleeding 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.