Dilatation and Curettage
Dilatation and Curettage is a
procedure to scrape and collect the tissue (endometrium) from inside the uterus.
Uterine scraping (dilatation and curettage: ) is a fairly minor
surgical procedure. The procedure may be performed in the hospital or in a clinic using
general or local anesthesia.
Why a Dilatation and Curettage is performed
Dilatation and Curettage is commonly used to obtain tissue for microscopic evaluation
to rule out cancer. Dilatation and Curettage may also be used to diagnose and treat heavy
menstrual bleeding, and to diagnose endometrial polyps and uterine fibroids. A Dilatation
and Curettage can be used as a treatment as well, to remove pregnancy tissue after a
miscarriage, incomplete abortion, or childbirth. Endometrial polyps may be removed, and
sometimes benign uterine tumors (fibroids) may be scraped away. Dilatation and Curettage
can also be used as an early abortion technique up to 16 weeks.
- Bleeding between periods
- Heavy menstrual bleeding
- Bleeding after intercourse
- Investigation of infertility
- Endometrial polyps
- Uterine cancer (early diagnosis)
- Thickening of the uterus (endometrial hyperplasia )
- An embedded IUD (intrauterine device)
- Therapeutic or elective abortion
- Miscarriage
- Postmenopausal bleeding, or abnormal bleeding while taking hormone replacement therapy
medications
How is a Dilatation and Curettage
performed
Dilatation and Curettage is usually performed under general anesthesia, although local
or epidural anesthesia can also be used. A local lessens risk and costs, but the woman
will feel cramping during the procedure. The type of anesthesia used often depends upon
the reason for the Dilatation and Curettage
In the procedure (which takes only minutes to perform), the doctor inserts an
instrument to hold open the vaginal walls, and then stretches the opening of the uterus to
the vagina (the cervix) by inserting a series of tapering rods, each thicker than the
previous one, or by using other specialized instruments. This process of opening the
cervix is called dilation.
Once the cervix is dilated, the physician inserts a spoon-shaped surgical device called
a curette into the uterus. The curette is used to scrape away the uterine lining. One or
more small tissue samples from the lining of the uterus or the cervical canal are sent for
analysis by microscope to check for abnormal cells.
Although simpler, less expensive techniques such as a vacuum aspiration are quickly
replacing the Dilatation and Curettage as a diagnostic method, it is still often used to
diagnose and treat a number of conditions. |