Terms to be familiar with
What is a D & C?
Dilation means stretching the opening of the cervix with special instruments to make it wider. Once the opening of the cervix is enlarged, another instrument is inserted in the uterus to loosen and remove the lining of the uterus. This is called curettage. It can be done with an instrument called a curette or by suction applied through a tube, called suction curettage. After a D&C is performed, a new lining will build up in the uterus during the next menstrual cycle.

Reasons for a D & C
Whenever a woman has abnormal bleeding from the vagina, there is concern. A D&C may be needed to find out what the problem is or to treat it.

Menstrual Irregularities
A D&C is often done when a woman has heavy or prolonged menstrual periods or bleeding between periods. These menstrual irregularities have many different causes, one of which is hormone imbalance. Hormone imbalance leads to a thickening of the lining of the uterus and sometimes causes irregular or prolonged bleeding. This condition can occur at any age but is more common in young women just starting to menstruate and older women before menopause.

Growths and Cancer
Bleeding from the uterus can also be caused by certain types of growths, most of which are not cancerous. Polyps are growths that are attached by a stem or stalk usually to the lining of the uterus or to the cervix. Those inside the uterus can usually be removed by a D&C. Leiomyomas (fibroids) are tumors that grow from the cells that make up the uterine muscle. They are rarely cancerous. Although they can cause bleeding and cramping, there are often no symptoms. A doctor can detect some of these tumors with a D&C, but another operation may have to be done to remove the tumor. Bleeding may also be a sign of cancer of the endometrium. Women past age 40 have a higher risk of endometrial cancer. A D&C or another procedure, called endometrial biopsy, is often performed when a woman over 40 has abnormal Vaginal bleeding, especially after menopause.

Miscarriage or Abortion
Often after pregnancy ends with a miscarriage, the contents of the uterus may not be completely emptied. If this occurs, a D&C must be done to remove the remaining tissue. Induced abortions performed before the 12th week of pregnancy may be done by a method similar to a D&C. The cervix is dilated, a small tube is inserted in the uterus, and the contents are removed by suction curettage.

Recovery and Normal Living
After your surgery, your doctor will probably permit you to return home accompanied by a friend or relative a few hours afterward. You may be groggy or weak for a few hours from the anesthesia. These effects wear off at different time for different people. You should he able to drive and do most activities you would normally do in a day or two. If there was some problem during your surgery, you may have to stay in a hospital a day or two longer. After you get home, there are certain things to remember. Until the cervix returns to normal size, there is a small chance that bacteria could enter the uterus and cause an infection. To prevent this, you should not have intercourse, use tampons, or douche for at last a week. You can shower, bathe, or swim as soon as you feel like it. Fever, pain in the abdomen, heavy bleeding from the vagina, or a discharge from the vagina with a bad odor is signs that should be reported to your doctor. Make an appointment to see your doctor soon after the surgery. If further treatment is necessary, your doctor will discuss it with you.


Glossary

Curettage: Scraping of the inside of the uterus with a small spoon-shaped instrument to remove a sample of the endometrium. Dilation: Stretching of the walls of the cervix so that the opening of the cervix is widened.
General Anesthesia: The use of drugs that produce a sleep-like state to prevent pain during surgery. Local Anesthesia: The use of drugs that prevent pain in a part of the body.
Perforation: An injury to the wall of the uterus mused by me of the instruments used in a D&C.
Speculum: An instrument used to spread the walls of the vagina so that the cervix can be seen.