Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dilation and curettage (D&C) is a procedure in which the cervix of the uterus is expanded (dilated) so that the uterine lining (endometrium) can be removed with a spoon-shaped instrument called a curet or curette. The procedure is performed for a variety of reasons. Most commonly, this surgery is done in order to help determine the cause of abnormal uterine bleeding. It can also be done to help determine the degree of abnormality of the endometrium in cases of cancer or pre-cancerous cells that are detected by an in-office biopsy. D&C is also sometimes necessary to remove tissue after a miscarriage.
Why is a D&C done?
In general, a D&C is used to help determine the health of the uterine lining or to remove abnormal tissue. Occasionally, the procedure can correct some of the problems in the uterus such as polyps, scar tissue, or tissue overgrowth.
What are reasons not to perform a D&C?
There are very few contraindications to D&C. Generally if a patient is too ill to undergo surgery, then she should probably not have this procedure. Furthermore, if the patient is unable to move her legs apart, such as with severe
arthritis in the hips, the surgeon may not be able to perform the procedure since it requires enough movement of the legs to accommodate a speculum and the surgeon. If the patient is pregnant or thinks that she could be
pregnant, she should not have the operation unless the D&C is for the purpose of an abortion.
Pre-op: What happens before surgery?
Before a D&C, the same general recommendations as for other outpatient procedures apply. It is recommended that the patient take nothing by mouth (food, water, etc.) for at least 7 hours before the scheduled operation. Often, the doctor will see the patient the day before surgery to discuss the procedure and the potential complications in greater detail.
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Uterine fibroids are benign tumors that originate in the uterus and are usually round or semi-round in shape. The most common symptom of a uterine fibroid is abnormal vaginal bleeding. Other symptoms include pressure, pelvic pain, pressure on the bladder, or pain during a bowel movement. Treatment options vary from surgery to medication.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include: abdominal pressure, pelvic pain, and pain during intercourse. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Amenorrhea is a condition in which there is an absense of menstrual periods in a woman. There are two types of amenorrhea, 1) primary and 2) secondary. Treatment of amenorrhea depends on the type (primary or secondary). In prmiray, surgery may be an option and in secondary amenorrhea medication or lifestyle changes may be treatment options.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Amenorrhea is the medical term for the absence of menstrual periods, either on a
permanent or temporary basis. Amenorrhea can be classified as primary or
secondary. In primary amenorrhea, menstrual periods have never begun (by age
16), whereas secondary amenorrhea is defined as the absence of menstrual periods
for three consecutive cycles or a time period of more than six months in a woman
who was previously menstruating.
The menstrual cycle can be influenced by many internal factors such as
transient changes in hormonal levels, stress, and illness, as well as external or
environmental factors. Missing one menstrual period is rarely a sign of a
serious problem or an underlying medical condition, but amenorrhea of longer
duration may signal the presence of a disease or chronic condition.
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