Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Health care professionals perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.
In a dilation and curettage, small instruments or a medication is used to open (dilate) the lower, narrow part of your uterus (cervix). Next, a surgical instrument called a curette, which can be a sharp instrument or suction device, is used to remove uterine tissue.
Why it's done
Dilation and curettage is used to diagnose or treat a uterine condition.
To diagnose a condition
Before doing a D&C, your health care team might recommend a procedure called endometrial biopsy or endometrial sampling to diagnose a condition. Endometrial sampling might be done if:
- You have unusual uterine bleeding.
- You have bleeding after menopause.
- You have unusual endometrial cells, which are discovered during a routine test for cervical cancer.
To perform the test, a health care professional collects a tissue sample from the lining of your uterus, also called the endometrium, and sends the sample to a lab for testing. The test can check for:
- Endometrial intraepithelial hyperplasia — a precancerous condition in which the uterine lining becomes too thick
- Uterine polyps
- Uterine cancer
If more information is needed, you then might need a D&C, which is usually done in an operating room.
To treat a condition
When performing a D&C to treat a condition, a doctor removes the contents from inside your uterus, not just a small tissue sample. This might be done to:
- Prevent infection or heavy bleeding by clearing tissues that remain in the uterus after a miscarriage or abortion.
- Remove a tumor that forms instead of a typical pregnancy. This is also called a molar pregnancy.
- Treat excessive bleeding after delivery by clearing out any placenta that remains in the uterus.
- Remove cervical or uterine polyps, which are usually noncancerous, or benign.
A D&C might be combined with another procedure called hysteroscopy. During hysteroscopy, a doctor inserts a slim instrument with a light and camera on the end into your vagina, through your cervix and into your uterus.
Your doctor then views the lining of your uterus on a screen, checking for areas that look unusual. Your doctor also checks for polyps and takes tissue samples as needed. During a hysteroscopy, uterine polyps and fibroid tumors can be removed.