Dilation and Curettage (D and C)
MEDICAL ANIMATION TRANSCRIPT: Your doctor will perform a dilation and curettage, also known as a D&C, to remove tissue from the inside of your uterus. The uterus is a muscular reproductive organ in your lower abdomen. The lower part of the uterus called the cervix connects the vagina to the uterus. A diagnostic D&C may be performed to investigate the cause of the following conditions. Abnormal or heavy bleeding, severe menstrual pain, difficulty becoming pregnant, or abnormal cells found in a Pap smear. A therapeutic D&C may be performed to treat certain uterine conditions, such as excessive bleeding after birth from remnants of the placenta, cervical or uterine polyps, fibroid tumors which are benign tumors formed on the uterine wall, and incomplete miscarriage or abortion in which parts of the embryo or fetus or associated tissues remain in the uterus. Your doctor may want to begin the dilation process the day before your procedure. If so your doctor will place a softening medication or a thin rod called a laminaria into your cervix. The laminaria slowly expands by absorbing fluid from your causing your cervix to open. During the procedure you will lie on your back with your legs placed in stirrups as you would for a standard pelvic exam. You will receive local or general anesthesia. Your doctor will insert a speculum into your vagina which widens the vaginal canal so the cervix can be seen. During dilation your doctor will insert a series of smooth rods into the cervical opening. Each rod will be replaced with a slightly thicker rod thereby slowly widening or dilating the cervical opening so the inside of the uterus can be accessed. Once the cervix has been expanded to about six to nine millimeters, your doctor may perform a hysteroscopy. A procedure in which a small light and camera are used to examine the inside of the uterus for abnormal areas. Next your doctor will perform curettage which is the surgical removal of part or all of the uterine lining called the endometrium. During curettage a surgical tool called a curette will be inserted to remove tissue by scraping or suction. If you're having a diagnostic D&C, your doctor will remove only a small sample of the endometrium and send it to a lab to test for various conditions. If you're having a therapeutic D&C, your doctor will remove the entire contents of the uterus to treat a known uterine condition. After the procedure you will be monitored in the recovery room for a few hours before you can go home. To prevent infection, do not have sexual intercourse or use tampons for about two weeks or until your doctor says it is safe to do so. Since your uterus will need to generate a new lining, your next menstrual period may not occur at the regular time.