Dilation and curettage is a procedure performed on the uterus to stop heavy vaginal bleeding. It is commonly referred to as a D&C or a “scraping”. It is a procedure most commonly performed on women with severe bleeding in which the bleeding has to be dealt with quickly. It is also one of the commonly used procedures for women who have used other treatments that were unsuccessful at stopping the heavy bleeding. The procedure can be done in conjunction with hysteroscopy. Hysteroscopy is a procedure to look inside the uterus with a thin telescope ( hysteroscopy will be discussed in a future post).
How Is a D&C Performed?
Dilation and curettage is generally performed in an operating room. Anesthesia is given since the procedure can be uncomfortable otherwise. The bottom part of the uterus called the cervix has a hole which is the entrance way to the inside of the uterus. This hole is typically much smaller than the instruments which would be placed inside. This hole in the cervix is stretched or dilated so that the instruments can fit inside. Your doctor may then take a scraping of the lining of the cervix. This will be followed by the curettage or scraping of the lining of the uterus. Your doctor will remove these scrapings and send them to the laboratory for a pathologist to analyze.D&C Can Make a Diagnosis
A great deal of information can be obtained from a D&C. Your doctor will be able to feel the walls of the uterus during the procedure. Internal fibroids called submucousal fibroids can often be noted during the procedure. Endometrial polyps can be scraped off during the procedure and diagnosed by the pathologist. Hyperplasia and cancer can also be diagnosed by obtaining this tissue. This makes the dilation and curettage a helpful diagnostic tool as well as a treatment for heavy bleeding.Will D&C Stop My Bleeding For Good?
It is the lining of the uterus (called the endometrium) which is responsible for the heavy bleeding in the majority of cases . By removing the tissue you can decrease if not completely eliminate the heavy bleeding. It is important to understand that the endometrial tissue will eventually grow back. And unfortunately, the heavy bleeding may come back along with it. D&C should not be considered a long term treatment for heavy bleeding. It is very effective in stopping severe bleeding in the short term. It can be combined with other treatments for long term control of the vaginal bleeding. How long do the effects last? It is extremely variable, from a few weeks to several months. There is no way to predict how long the effects will last for you individually.Do I Need a D&C?
This question is best answered by your physician. For the woman with severe bleeding which makes her blood pressure and pulse unstable or requires a transfusion, the D&C may be the quickest way to stop the bleeding. Treatment with intravenous estrogen can work quickly as well. Your doctor can discuss with you all of the factors in your case which affect the decision for a D&C. For the woman with bleeding that is not as severe, there are other options available to you which may be more appropriate.
