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Dilation and Curettage
(D&C)

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What is dilation and curettage (D&C)?

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.



Next: What type of anesthesia is used for a D&C? »

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Dilation and Curettage (D&C)

The uterus

The uterus is part of a woman's reproductive system. It is the hollow, pear-shaped organ where a baby grows. The uterus is in the pelvis between the bladder and the rectum.

The narrow, lower portion of the uterus is the cervix. The broad, middle part of the uterus is the body, or corpus. The dome-shaped top of the uterus is the fundus. The fallopian tubes extend from either side of the top of the uterus to the ovaries.

The wall of the uterus has two layers of tissue. The inner layer, or lining, is the endometrium. The outer layer is muscle tissue called the myometrium.

In women of childbearing age, the lining of the uterus grows and thickens each month to prepare for pregnancy. If a woman does not become pregnant, the thick, bloody lining flows out of the body through the vagina. This flow is called menstruation.

Understanding cancer

Cancer is a group of many related diseases. All c...

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