Dilation and curettage is a minor surgical procedure involving cervix dilation to scrape the uterine lining using a special instrument. It is a quick procedure that takes about fifteen minutes and about five hours of recovery at the hospital. The operation is outpatient unless in the rare case of complications as it causes minimal tissue damage.
A speculum opens the vagina folds, allowing access to the cervix, which the practitioner pushes open to access the uterus. Afterwards, the doctor uses a special curette tool to scrape small portions of the endometrium. Sometimes, the procedure involves suction curettage, where a tube sucks up tissue for removal or evaluation.
Where D&C is necessary
Practitioners recommend D&C in these cases:
- Cancer screening- Tests use uterine lining samples when screening for endometrial and uterine cancers
- Infertility testing- D&C accompanies blood tests and other evaluation tests while diagnosing suspected infertility.
- Uterine bleeding- Occurs due to growths in the uterus such as fibroids and uterine polyps, hormonal imbalances, certain cancers, or menopause.
- After a miscarriage or abortion- D&C removes small placenta portions or gestational material left in the uterus after a miscarriage or abortion.
- After vaginal birth- D&C is useful to remove any placenta debris and avoid infections after childbirth.
Preparing for the surgery
1. Before the surgery
The first step before surgery is assessment. Here, the healthcare provider will check the vital signs and examine your medical history and prevailing health conditions. At this point, clarify what is unclear and ask all necessary to put you at ease. Discuss pain management, what to expect during the surgery, and how to facilitate healing.
If possible, have a loved one bring you to the hospital or take you home after the surgery.
2. During the Surgery
Any D&C procedure, including suction curettage, can happen seamlessly in the OR or the doctor's office. The basic steps are:
- Getting ready- The doctor will probably ask you to urinate one last time and then change into the hospital gown. After that, you will lay back on the operating table with the legs and feet on footrests for easier pelvic access.
- Medication- This includes necessary fluids and drugs for relaxation and anxiety reduction
- Cleaning- The urethra is connected to a urinary catheter, and a speculum will help visualize the cervix for cleaning.
- Anaesthesia- General anesthesia is acceptable but not mandatory. General or regional anesthesia is administered through a facemask, while local anesthesia entails a numbing shot near the cervix.
- Uterus measurement- A uterine sound measures the length of the uterus to help the doctor visualize how far in to go.
- Cervix expansion- A small curette may remove bits of the cervical tissue if necessary. Then, a series of gradually larger tubes open up the cervix.
- Scraping or suction- The curette then accesses the uterus and removes the tissue lining. Where the method is suction, tube positioning is at this point.
- Testing- When the doctor has enough tissue samples, they remove the tools, and the samples go to the lab for testing.
3. After the Surgery
Most patients are good to go a few hours after surgery but can stay longer in case of complications. General anesthesia will require time in the post-anesthesia care unit to wear off. When fully awake, getting up and walking around helps to prevent blood clot formation. You may need to use a pad in case of bleeding after the operation.
Total recovery takes two to four weeks. In that time:
- Have a helping hand for at least the first 24 hours, especially if you had general anesthesia.
- There may be bleeding in the first few days, so wear a pad
- Do not use tampons for at least the first two weeks or after clearance by the doctor
- Refrain from vagina sex for at least two weeks
- Stay on birth control until the doctor gives the green light for pregnancy
- Look out for these symptoms of complications:
- Abdominal swelling
- Foul-smelling vaginal discharge
- Persistent pain even after medication
Finally, consider your emotional health in the course of surgery and healing. Emotional recovery may be vital, especially where the procedure followed childbirth, a miscarriage or abortion, or is for cancer screening. Find support from family and loved ones, educate yourself on the condition, seek professional help if need be, and be patient, most of all.