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Dilation and Curettage (D&C)

Overview

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Dilation and Curettage (D&C) is a surgical procedure used to remove tissue from the inside of the uterus. It is typically performed for diagnostic or therapeutic reasons, including abnormal uterine bleeding, miscarriage management, or to obtain a sample for further testing.

Purpose:

  • D&C is performed to diagnose and treat various conditions affecting the uterus, such as uterine fibroids, polyps, or abnormal bleeding. It can also be used after a miscarriage to remove remaining tissue.

     

Types:

  • Diagnostic D&C: For obtaining uterine lining samples for biopsy.
  • Therapeutic D&C: For removing excess tissue or treating complications.
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How is Dilation and Curettage (D&C) done?

  • Medical History: The doctor will review the patient's medical history and perform a physical examination.
  • Diagnostic Tests: Blood tests, pelvic exams, or imaging studies (like ultrasound) may be conducted to assess the condition.
  • Medications: Patients may be instructed to stop taking blood thinners or other medications before the procedure.
  • Fasting: Patients are usually advised to refrain from eating or drinking for several hours before the procedure.
  • Support: Arrangements for transportation home after the procedure should be made, as sedation may be used.

  • Anesthesia: The procedure can be performed under local or general anesthesia, depending on the patient's condition and preference.
  • Dilation: The cervix is dilated using instruments to allow access to the uterus.
  • Curettage: A curette (a surgical instrument) is used to gently scrape the uterine lining, removing tissue.
  • Completion: The procedure typically takes 20 to 30 minutes and may involve monitoring in a recovery area afterward.

While D&C is generally considered safe, potential complications include:
  • Infection: Risk of uterine or pelvic infection.
  • Heavy Bleeding: Possible excessive bleeding during or after the procedure.
  • Uterine Perforation: Rarely, instruments may accidentally puncture the uterine wall.
  • Scarring: Asherman's syndrome (formation of scar tissue in the uterus) can occur, leading to menstrual irregularities.
What are the benefits Dilation and Curettage (D&C)?
  • Diagnostic Accuracy: Provides tissue samples for accurate diagnosis of uterine conditions.
  • Symptom Relief: Can alleviate heavy bleeding, pain, or other symptoms related to uterine abnormalities.
  • Fertility: In some cases, D&C can improve the chances of future pregnancies by removing polyps or fibroids.
Specialty
  • Gynecology: D&C is primarily performed by gynecologists or obstetricians specializing in women's reproductive health.
  • Reproductive Endocrinology: In cases involving fertility concerns, reproductive endocrinologists may also perform D&C.
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Infrastructure & Facilities

D&C procedures are typically performed in:

  • Outpatient Surgery Centers: Facilities specifically designed for outpatient procedures.
  • Hospitals: Many hospitals offer D&C in their gynecology departments, equipped with necessary surgical and recovery rooms.
  • Gynecology Clinics: Specialized clinics may also perform D&C, offering a more focused environment for women's health.

FAQs

Recovery is usually quick; many women return to normal activities within a day or two.

Some discomfort is common, and pain management options will be provided by your healthcare team.

Most women can conceive within a few menstrual cycles after a D&C, but it's best to discuss this with your doctor.

Symptoms like heavy bleeding, severe pain, fever, or foul-smelling discharge should be reported to a doctor immediately.

While generally safe, all surgical procedures carry some risks. Discuss these with your doctor before the procedure.

Yes, D&C is commonly used to remove remaining tissue after a miscarriage.

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