What is a dilatation and curettage?

Dilatation and curettage ('D&C') is an operation to scrape away tissue from the inside of the womb (uterus). It's used to diagnose and treat many conditions, including abnormal bleeding, and after a miscarriage.

Why is the procedure performed?

D&C refers to opening of the cervix (dilatation) followed by removal of tissue from inside the uterus (curettage).

The procedure is done to diagnose why you have abnormal bleeding, bleeding after menopause, or if you have abnormal endometrial cells. A small sample of the tissue is sent to a laboratory for testing, allowing a pathologist to identify conditions such as polyps or uterine cancer.

A D&C can also be used to remove all the contents from inside your womb, for example after a miscarriage or abortion (to prevent heavy bleeding), to remove remnants of the placenta after childbirth, or to remove polyps.

How to prepare for the procedure

Your doctor will ask you a series of questions before a D&C. Make sure you tell them if you are pregnant or might be pregnant, or if you have a history of bleeding or allergies. You should follow any instructions on drinking and eating.

Sometimes your doctor may start dilating your cervix a few hours before the procedure, either with medication or with a small rod called a laminaria, which is inserted into the cervix and left in place for a while.

What happens during the procedure?

A D&C is usually done under general anaesthetic, but can also be performed with an epidural, where you are relatively numb from the waist down, or with a local anaesthetic, where just the area around your cervix is numb.

Once you can't feel anything, your doctor will insert an instrument called a speculum into your vagina so they can see your cervix. They will slowly dilate the cervix using a series of thicker and thicker rods. They will then remove the rods and insert an instrument called a curette to scrape away the lining of the uterus. This can also be done with suction.

The procedure normally takes 5 to 10 minutes, but you will need to wait in recovery for a few hours afterwards.

What to expect after the procedure

It will take you a while to recover if you have had a general anaesthetic, and you should have someone with you when you go home. You should also not drive, operate machinery or drink alcohol for at least 24 hours after the procedure. You can get back to normal activities in a day or 2.

You might feel some cramping and discomfort after a D&C, which you can control with paracetamol and with a heat pack. You might have light bleeding for 10 to 14 days, which may become heavier when you do physical activity such as lifting. Use sanitary pads and not tampons. Your next period may also be heavier than usual.

You should see your doctor 1 to 2 weeks after the procedure, but call them earlier if you experience:

• heavy bleeding (you need to change the pad every 10 to 20 minutes)
• fever
• passing blood clots larger than a 50 cent piece
• cramps for more than 48 hours
• worsening pain that doesn't go away after taking painkillers
• a foul-smelling discharge from the vagina

What might go wrong

Complications during or after a D&C are rare, but include:

• bleeding
• infection
• perforation of the uterus
• a reaction to the anaesthetic
• scarring of the uterus, leading to infertility or changes to your menstruation - known as Asherman syndrome, this is very rare and can often be treated with surgery

More information

Visit healthdirect's surgical procedures pages for more general information, such as:

• Preparing for surgery
• How to find the right health professional