Normal anatomy

The uterus is located in the abdomen and is the site of fetal development during pregnancy. The body (fundus) of the uterus narrows and forms the cervix. The cervix opens to the vagina.

Indication

D and C or dilatation and curettage is a procedure to scrape and collect the tissue (endometrium) from inside the uterus.

D and C or uterine scraping may be done to:

• diagnose conditions using the tissue samples collected (biopsies)
• treat irregular bleeding
• remove fetal or placental tissue (used for some elective or therapeutic abortions and to remove any remaining tissue after a spontaneous abortion (miscarriage)

D and C or uterine scraping may be recommended for:

• bleeding between periods
• heavy menstrual bleeding
• bleeding after intercourse
• investigation of infertility
• uterine fibroids
• endometrial polyps
• uterine cancer (early diagnosis)
• cervical cancer (early diagnosis)
• thickening of the uterus (endometrial hyperplasia)
• an embedded IUD (intrauterine device)
• therapeutic or elective abortion
• miscarriage

Procedure

D and C or dilatation and curettage (uterine scraping) is a fairly minor surgical procedure. The procedure may be performed in the hospital or in a clinic using general or local anesthesia. The vaginal canal is held open by a speculum and the opening to the uterus (cervix) is anesthetized (not always). The cervical canal is widened (dilated) using a metal rod and a curette (a metal loop on the end of a long thin handle) is then passed through the canal into the uterine cavity. The inner layer of the uterus (endometrium) is scraped away and the tissue is collected for examination.

Aftercare

Uterine scraping (D and C) has relatively few risks, can provide relief from bleeding, and can help diagnose problems including infection, cancer, infertility and other disease.

Normal activities may be resumed as soon as the patient feels well, even the same day. There may be vaginal bleeding, as well as pelvic cramps and back pain for a few days after the procedure. Pain can usually be managed well with medications. Tampon use is not recommended for a few weeks and sexual intercourse is not recommended for a few days.