Dilation and Curettage (D&C)

What is a D&C?

A D&C involves dilation of the cervix (neck of womb) to allow a curettage (washing out, or scraping) of the uterine lining. This is usually a day surgery procedure performed under general anaesthesia, and may be combined with other procedures such as hysteroscopy and polypectomy (removal of endometrial polyps).

D&C is frequently performed to obtain a sample of your uterine lining for microscopic assessment of the cells, and may be recommended if you have:

• Heavy periods
• Long periods
• Bleeding in between periods
• Bleeding after menopause
• Endometrial polyps

The main objective is to rule out endometrial hyperplasia, or endometrial cancer. The alternative of a D&C is endometrial pipelle, where a small thin straw is inserted into your uterus through your cervix and biopsy of tissue from your uterine lining obtained through gentle suction – this can generally be done in the clinic unless you are unable to tolerate this or have never had sex before.

D&C is generally a safe and commonly done procedure. 

Risks of D&C include:

Common

• Vaginal bleeding and discharge – this may last up to 1-2 weeks
• Pelvic discomfort 

Uncommon/rare

• Infection
• Cervical trauma
• Uterine perforation (<1%): this will require a laparoscopy to stop bleeding, check for injuries to surrounding organs e.g. intestines, bladder etc and for additional stitches if needed
• Excessive bleeding requiring blood transfusion 
• Anaesthesia complications
• Asherman’s syndrome (scar tissue formation within womb cavity causing problems with periods and infertility)
• Cervical incompetence: weakening of the neck of the womb leading to problems with subsequent pregnancies
• Death: the risk is approximately less than 3-8 in 100 000