How Long Does It Take for Your Cervix To Heal After a D&C?

D&C or dilation and curettage is a surgical procedure that involves the expansion of the cervical opening to remove the uterine lining (endometrium) with a spoon-shaped instrument known as a curette. D&C is mainly done to identify the cause of abnormal uterine bleeding.

Other related procedures used for diagnosing and treating endometrial issues include:

• Endometrial ablation
• Hysteroscopy
• Hysterectomy

D&C may be indicated:

• To identify the causes of abnormal uterine bleeding
• To end an unwanted pregnancy
• To determine the intensity of the endometrial cancer
• To identify polyps or tissue overgrowth
• To identify scar tissue
• To remove abnormal tissue

Some of the reasons to avoid D&C include:

• Women unfit for surgery
• Arthritis (in this condition, the woman cannot move their legs apart)
• Pregnancy unless it is an unwanted one

For a D&C procedure, you must follow these instructions:

• The physician might obtain your consent before the procedure
• Inform the physician about your current medications
• Eat light meals the evening before the surgery
• Do not eat or drink anything after midnight before the procedure day
• You might be given an enema on the previous night
• Stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), clopidogrel (Plavix), and other blood thinners or any other herbal supplement
• Ask the doctor about the drugs that you can continue till the day of surgery
• Inform about any bleeding disorders or other medical conditions
• Avoid smoking to help you recover quickly

D&C mostly follows this process:

• You will be positioned on an operating table.
• A urinary catheter may be placed before entering the operating room.
• An IV catheter will be started in the arm or hand.
• The hair around the surgical site may be shaved. The cervix will be cleaned with an antiseptic solution.
• You may get regional anesthesia, either an epidural or spinal block to numb you from the waist down.
• The doctor uses a type of forceps, called a tenaculum, to hold the cervix throughout the procedure.
• For dilation or opening of the cervix, the doctor may either insert slender rods (laminaria) into the cervix or use medication beforehand to soften and widen the cervix.
• Each rod will be wider than the previous one. This helps to gradually open the cervix or mouth of the uterus.
• Once the cervix is opened to a suitable size, the doctor inserts a curette to reach the uterus.
• Next, the doctor scrapes the endometrium or the uterine lining, which will be removed by suction.
• A hysteroscopy may help the physician to view the uterus as the procedure progresses.
• The collected samples are sent for further investigation.

Although a D&C is generally considered a safe procedure, there is always a risk of infection. Some signs of infection after a D&C include:

• Heavy or prolonged bleeding: If you are experiencing heavy bleeding after a D&C, it could be a sign of an infection or a complication from the procedure
• Blood clots
• Fever: A fever is one of the most common signs of an infection and indicates that the body is fighting off an infection.
• Pain: If you experience pain in your lower abdomen, pelvic area, or during intercourse, it could be a sign of an infection.
• Abdominal tenderness or discharge: 
• Foul-smelling discharge from the vagina
• Asherman syndrome (formation of scar tissue in the uterus)
• Infertility
• Changes in menstrual flow

It is important to follow your doctor's post-operative instructions and to report any concerns or complications to your doctor as soon as possible. If you have any questions or concerns about your recovery after a D&C, it is best to consult with your healthcare provider.