Dilation and Curettage (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is dilation and curettage (D and C)?
- Why is a D and C done?
- What are reasons not to perform a D and C?
- Pre-op: What happens before surgery?
- What type of anesthesia is used for a D and C?
- How is a D and C performed?
- What are possible complications of a D and C?
- What happens after a D and C?
- Why is the D and C procedure becoming less common?
- Find a local Obstetrician-Gynecologist in your town
What are possible complications of a D and C?
The D and C procedure has a low risk of serious complications. It is normal to experience vaginal bleeding and/or pelvic cramping (similar to menstrual cramping) for a few days following a D and C. Typically, over-the-counter pain medications are sufficient for pain control.
The most common complication that can occur is perforation of the uterus with either the dilators or the curette. When this happens, as long as no internal organs (intestines, bladder, or rectum) or large blood vessels are damaged, the hole will almost always heal itself without further surgery. The risk for this problem is increased in patients with a narrowed opening to the cervix (cervical stenosis) or in patients with distorted internal uterine anatomy. This risk is also increased if the uterus is infected or has undergone previous surgeries such as cesarean sections or myomectomies.
Injury to the cervix is another possible complication. Tears or cuts in the cervix can usually be treated by application of pressure and application of local medications to stop bleeding. In some cases, stitches in the cervix may be required, but this is not common.
Other complications, as with any surgery, include bleeding and infection. Most bleeding is mild and resolves on its own. Infection is also rare and can normally be managed with oral antibiotics. Most D and Cs do not require the routine use of post-operative antibiotics. On occasion, in patients with certain heart defects, the surgeon may give the patient antibiotics before and after the surgery to prevent bacteria from the vagina from infecting the heart valves.
What happens after a D and C?
After the surgery, the patient is cared for in a post-anesthesia care unit during recovery from the anesthesia. Most patients can return to normal activities within a few days. Nonsteroidal anti-inflammatory medications may be recommended to relieve the mild pain and cramping that may follow. To decrease the chance of developing an infection, doctors advise that patients not use tampons or insert anything into the vagina for two weeks following the surgery, and to abstain from sexual intercourse for the same time period.
The follow-up office care depends on the surgeon. Most doctors have the patient return to the office to make sure that all is well and to discuss the results of the tissue samples that were removed. Usually, this is done 2 to 6 weeks post-operatively. Sometimes, the patient will simply be notified by a phone call with the results, and no direct contact with a health professional is necessary.
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