Introduction
Dilation and curettage (D&C) is a brief surgical procedure in which the cervix is widened (dilated) so that tissue can be removed from the lining of the uterus (endometrium) using a spoon-shaped instrument called a curette. A D&C is performed for both diagnostic and therapeutic reasons. It is commonly used to diagnose conditions like uterine cancer, to treat heavy menstrual bleeding, to clear the uterine lining after a miscarriage or abortion, or to remove noncancerous polyps. It is a very common and generally safe outpatient procedure that provides crucial information for treating various uterine conditions.

Surgical Procedure
The procedure is usually performed in a hospital or clinic under local, regional, or general anesthesia. You will lie on your back with your legs in stirrups, similar to a pelvic exam. The doctor inserts a speculum into the vagina to see the cervix. The cervix is then gradually widened using a series of smooth, tapered rods called dilators. Once the cervix is sufficiently dilated, the doctor inserts a curette (a surgical instrument with a loop or spoon at the end) into the uterus. The curette is used to gently scrape the uterine lining and remove tissue. Sometimes, a suction device is used instead of or along with the curette. The removed tissue is often sent to a laboratory for pathological examination. The entire procedure typically takes only 15 to 30 minutes.

Surgical Risks
D&C is a safe procedure, but like any surgery, it has risks. These include reactions to anesthesia and potential bleeding.

General Complications
Common, mild complications include:
– Mild pelvic cramping, similar to menstrual cramps, for a few days.
– Light vaginal bleeding or spotting for a few days to a couple of weeks.
– Nausea and dizziness, typically side effects of the anesthesia.

Rare but Serious Complications
Serious complications are rare but can include:
– Uterine perforation: The surgical instruments can poke a hole in the uterus. This is more common in women who have recently been pregnant or who have gone through menopause. Most perforations heal on their own, but some may require further surgery.
– Damage to the cervix: The cervix can be torn during dilation, which may require stitches.
– Infection: An infection can develop in the uterus or pelvic organs, requiring antibiotics.
– Asherman’s syndrome: The formation of scar tissue in the uterus, which can lead to abnormal menstrual cycles, future miscarriages, or infertility.

Pre-operative Preparation
– Medical Evaluation: Your doctor will review your medical history and may perform blood tests or a pregnancy test.
– Fasting: If you are having general anesthesia, you will need to fast (no food or drink) for several hours before the procedure.
– Medication Review: Inform your doctor about any medications, especially blood thinners, as you may need to stop them beforehand.
– Arrange for a ride: Because of the anesthesia, you will need someone to drive you home after the procedure.

Post-operative Care
After the D&C, you will rest in a recovery room for a few hours until the anesthesia wears off. You will be monitored for heavy bleeding or other immediate complications. Most women go home the same day. Over-the-counter pain relievers, such as ibuprofen, can help manage cramping.

Wound Care
There are no external incisions to care for. However, to prevent infection in the uterus while the cervix returns to its normal size, you should avoid inserting anything into the vagina. Do not use tampons, take baths, or have sexual intercourse until your doctor gives you clearance (usually a few days to a week).

Diet
You can usually resume your normal diet as soon as you feel ready. Start with light foods if you experience nausea from the anesthesia.

Post-discharge Notes
Recovery from a D&C is typically very quick.
– You can usually return to your normal activities, including work, within 1 to 2 days.
– Expect your next menstrual period to occur at a different time than usual.
– Contact your doctor immediately if you experience heavy bleeding (soaking through a pad in an hour), foul-smelling vaginal discharge, severe abdominal pain, or a fever.