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Definition of Dilation and curettage / D&C procedure
Dilation and curettage (D&C) is a surgical procedure, also called dilatation and curettage, in which the gynecologist widens the opening of the cervix enough to allow passage into the uterus of a narrow scraping instrument called a curette.
The gynecologist uses the curette to gently scrape the inside wall of the uterus, removing accumulated blood and tissue that may be causing dysfunctional uterine bleeding (dub) or that remains after a spontaneous abortion (miscarriage) or an induced abortion using abortifacients (drugs that terminate pregnancy).
The doctor performs a D&C in a hospital operating room or ambulatory surgical facility with the woman under general anesthesia. The procedure itself takes about 15 minutes; most women are able to go home a few hours after, when they have completely emerged from the effects of the anesthesia.
Discomfort similar to moderate menstrual cramps and mild bleeding may occur for up to two weeks after the D&C. Uncommon complications include unusual bleeding during or after the procedure, postoperative infection, and uterine perforation, in which the curette penetrates the wall of the uterus (a small wound that typically heals without intervention).
Most women are able to return to normal activities (except sexual intercourse) within a few days though may feel discomfort for up to a week.
Before undergoing a Dilation and Curettage (D&C), a woman should confirm with her gynecologist that the benefits of the procedure outweigh the discomfort and potential complications compared to noninvasive procedures such as ultrasound for diagnostic purposes or medications to treat DUB.
Minimally invasive procedures such as endometrial sampling (in which the gynecologist inserts a very thin catheter through the cervix, without dilation, and into the uterus to withdraw a small sample of tissue from the uterine wall) and hysteroscopy often can provide the same diagnostic information as would Dilation and Curettage (D&C) but with less risk and discomfort for the woman.
See also SURGERY BENEFIT AND RISK ASSESSMENT.
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