Suction dilation and curettage (D&C) is a procedure performed to remove tissue from inside the uterus. The procedure involves dilation (opening) of the cervix (the mouth of the uterus). The tissues from within the uterus may be removed using a curette, which is usually sharp, or suction. D&C is performed to diagnose and/or treat certain uterine pathologies.
The doctor may perform D&C along with another procedure called a hysteroscopy. Hysteroscopy is a procedure performed by a gynecologist using a thin tube with a light and camera attached to it to view the uterine cavity clearly and up close. This device is called a hysteroscope. A hysteroscopy may be performed to diagnose pathologies in the uterus and cervix or a method for surgical treatment for uterine or cervical pathologies.
Why is suction dilation and curettage done?
Dilation and curettage (D&C) may be performed to diagnose or treat a uterine pathology.
D&C may be performed to obtain a uterine tissue sample to diagnose the cause of the following:
- Abnormal uterine bleeding, such as heavy bleeding during periods
- Uterine bleeding after menopause
- Abnormal endometrial cells found during a pap smear (a routine test done to detect cervical cancer)
D&C may be performed to confirm the diagnosis of the following:
- Uterine polyps
- Uterine tumors (cancerous and non-cancerous)
- Endometrial hyperplasia (a precancerous condition characterized by a thick uterine wall)
D&C may be performed to
- Clear out tissues from the uterus after a miscarriage or planned abortion.
- Remove a molar pregnancy (a tumor forms instead of a normal pregnancy).
- Treat excessive bleeding after delivery to remove remnants of the placenta from the uterus.
- Remove cervical or uterine polyps (benign, non-cancerous growth)
How is suction dilation and curettage performed?
During the procedure:
Dilation and curettage (D&C) may be performed in a clinic or hospital, depending on what D&C is being done for. The doctor may start the process of opening of the cervix a few hours or the day before the procedure. A medication called misoprostol (Cytotec) is usually given orally or vaginally to soften and ready the cervix, which helps the cervix gradually opens. The amount the cervix needs to be dilated depends on what is being done. Certain procedures require the diameter of the cervix to be more than standard D&C. A slender rod may be gently inserted into the cervix to aid in dilation.
The procedure is performed under anesthesia (general, regional, or local anesthesia). The choice of anesthesia depends on the reason for D&C and your medical history. The doctor removes the dilation rods and inserts the necessary instruments or a suction device to remove the uterine tissue.
After the procedure:
Patients would usually be discharged the same day or the next day after the procedure. Patients may experience mild pain, discomfort, cramping, and slight vaginal bleeding (patients may have to use a sanitary napkin for a few days). Tampons can increase the risk of infection, hence are avoided. Patients would be prescribed painkillers and antibiotics. Patients can resume their daily activities the next day after the procedure. Sexual activity, exercise, and sports may be resumed after consulting with the doctor.
What are the complications of suction dilation and curettage?
Dilation and curettage (D&C) is a relatively safe procedure. Although rare, some possible complications are as follows:
- Damage and/or perforation of the uterus
- Injury to the cervix
- Bleeding
- Infection
- Scarring of the uterine wall
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