Dilation and curettage (D&C) for dysfunctional uterine bleeding

Surgery Overview

Dilation and curettage (D&C) is a surgical procedure used to locate and treat the cause of sudden, heavy bleeding. It is done by passing a small instrument called a curette through the vagina into the uterus and scraping the lining of the uterus (endometrium).

D&C is usually done as an outpatient procedure. A general anesthetic is usually used, although a local or spinal anesthetic may be used.

What To Expect After Surgery

The recovery period after a D&C is short. Most women are able to return to normal activities within 1 to 2 days.

During the recovery period:

• Mild pelvic cramping may occur for a few hours after the D&C.
• A slight vaginal discharge may occur.
• Intercourse, douching, and the use of tampons are usually not permitted for 2 weeks.
• The next menstrual period may be early or late.

Why It Is Done

Dilation and curettage (D&C) is used to control sudden, heavy vaginal bleeding that is causing decreased blood volume (hypovolemia). It is the quickest way to stop uterine bleeding.

D&C is both a diagnostic and a therapeutic procedure.

• It can produce information about the cause of heavy bleeding, such as infection, uterine polyps, or an abnormal buildup of the uterine lining (endometrial hyperplasia).
• It is used to remove causes of uterine bleeding, such as endometrial polyps and hyperplasia.

D&C is also used in older women who are at high risk for having cancer of the uterus (endometrial cancer), particularly when attempts at endometrial aspiration have not been successful.¹

How Well It Works

Dilation and curettage provides complete clearance of the uterus, which stops uterine bleeding. When endometrial hyperplasia has caused heavy uterine bleeding, clearing of the endometrial tissue creates a clean uterine surface for healthy endometrial growth. Healthy growth can be aided with progestin hormone therapy that signals the endometrium when to start and stop thickening during the menstrual cycle.

Recurrence Sudden, heavy bleeding may stop for a period of time. However, without hormone therapy, heavy bleeding usually returns following D&C.

Risks

Complications are rare but may include:

• Infection of the uterus, fallopian tubes, or ovaries (pelvic infection).
• Tearing (perforation) of the uterine wall.
• Heavy vaginal bleeding (hemorrhage).

What To Think About

The hospital or surgery center may send you instructions on how to get ready for your surgery, or a nurse may call you with instructions before your surgery.

Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. You will stay in the recovery area for 1 to 4 hours before going home. In addition to any special instructions from your doctor, your nurse will explain information to help you during your recovery. Most people are given a sheet of care instructions including who to contact if a problem arises.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Author:	Kathe Gallagher, MSW Debby Golonka, MPH	Last Updated: February 12, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Liisa Honey, MD, FRCSC - Obstetrics and Gynecology
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