Diagnostic and Therapeutic D&C

Pooyesh Fertility Clinic

 

Diagnostic and Therapeutic D&C

What is D&C?

Dilation and Curettage (D&C) is a common medical procedure used to diagnose or treat uterine problems.
It involves gently opening the cervix (dilation) and removing a layer of the endometrial tissue (curettage) for diagnostic or therapeutic purposes.
D&C can be performed alone or in combination with hysteroscopy (using a camera to view the inside of the uterus).

Indications for Diagnostic D&C

Diagnostic D&C is usually performed in the following situations:

  1. Evaluating Uterine Conditions:
    • Abnormal uterine bleeding: In women with heavy menstrual bleeding or postmenopausal bleeding, D&C can help identify causes such as polyps, fibroids, adenomyosis, or endometrial cancer.
    • Cellular abnormalities: If a Pap smear or ultrasound shows abnormal findings, endometrial sampling is required.
  2. Retained Products of Conception:
    • When placental tissue or pregnancy products are not completely expelled, D&C helps to prevent infection or excessive bleeding.
  3. Removal of Small Polyps or Fibroids:
    • In some cases, these lesions can be removed directly during D&C.
  4. Treatment of Endometrial Hyperplasia:
    • For non-cancerous thickening of the endometrium due to hormonal causes, D&C can be therapeutic.

 

Preoperative Considerations

  • Shower and shave the genital and abdominal area
  • Discontinue Aspirin, Warfarin, or Heparin if in use
  • Fast for at least 8 hours before the procedure
  • Remove all jewelry, watches, makeup, nail polish, glasses, dentures, hearing aids, or prosthetic nails
  • Empty the bladder immediately before surgery

How D&C is Performed

  • The patient lies on the operating table with legs in stirrups.
  • After disinfecting the cervix, general anesthesia is administered.
  • The gynecologist gently dilates the cervix using specialized dilators.
  • The targeted endometrial tissue is removed using a sharp curette or suction curette.
  • In some cases, hysteroscopy is used simultaneously for direct visualization.
  • The collected tissue is sent to the pathology lab for microscopic examination and final diagnosis.
  • The procedure typically takes about 15 minutes.

Postoperative Care

  • Rest for at least 24 hours and avoid heavy activity
  • Mild bleeding, spotting, or cramping similar to menstrual pain for 3–7 days is normal. Pain can be managed with Acetaminophen or Ibuprofen
  • Do not drive for 24 hours if general anesthesia was used
  • Avoid heavy lifting (>5 kg) and vigorous exercise for the first 48 hours
  • Light activities, such as short walks, can resume after 3–4 days
  • Avoid sexual intercourse, tampons, or vaginal douches for at least 2 weeks
  • Showering is allowed, but avoid soaking in a bathtub or jacuzzi; do not wash inside the vagina
  • Take prescribed antibiotics as directed

 

Warning Signs Requiring Immediate Medical Attention

Contact your doctor if you experience:

  • Fever above 38°C (100.4°F)
  • Heavy bleeding (soaking a pad every 1–2 hours)
  • Severe abdominal or pelvic pain not relieved by medication
  • Foul-smelling or purulent vaginal discharge
  • Severe dizziness or fainting (possible anemia or internal bleeding)

 

Return to Menstruation and Fertility

  • Menstruation usually resumes 4–6 weeks after the procedure
  • The first period may be heavier or irregular, but cycles typically normalize within 1–2 cycles
  • Fertility is generally not affected if there are no complications such as intrauterine adhesions or infection
  • The recommended time to attempt pregnancy after D&C depends on the underlying reason for the procedure; always consult your physician before trying to conceive