Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Health care professionals perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

In a dilation and curettage, small instruments or a medication is used to open (dilate) the lower, narrow part of your uterus (cervix). Next, a surgical instrument called a curette, which can be a sharp instrument or suction device, is used to remove uterine tissue.

Dilation and curettage is used to diagnose or treat a uterine condition.

To diagnose a condition

Before doing a D&C, your health care team might recommend a procedure called endometrial biopsy or endometrial sampling to diagnose a condition. Endometrial sampling might be done if:

• You have unusual uterine bleeding.
• You have bleeding after menopause.
• You have unusual endometrial cells, which are discovered during a routine test for cervical cancer.

To perform the test, a health care professional collects a tissue sample from the lining of your uterus, also called the endometrium, and sends the sample to a lab for testing. The test can check for:

• Endometrial intraepithelial hyperplasia — a precancerous condition in which the uterine lining becomes too thick
• Uterine polyps
• Uterine cancer

If more information is needed, you then might need a D&C, which is usually done in an operating room.

To treat a condition

When performing a D&C to treat a condition, a doctor removes the contents from inside your uterus, not just a small tissue sample. This might be done to:

• Prevent infection or heavy bleeding by clearing tissues that remain in the uterus after a miscarriage or abortion.
• Remove a tumor that forms instead of a typical pregnancy. This is also called a molar pregnancy.
• Treat excessive bleeding after delivery by clearing out any placenta that remains in the uterus.
• Remove cervical or uterine polyps, which are usually noncancerous, or benign.

A D&C might be combined with another procedure called hysteroscopy. During hysteroscopy, a doctor inserts a slim instrument with a light and camera on the end into your vagina, through your cervix and into your uterus.

Your doctor then views the lining of your uterus on a screen, checking for areas that look unusual. Your doctor also checks for polyps and takes tissue samples as needed. During a hysteroscopy, uterine polyps and fibroid tumors can be removed.

At times, a hysteroscopy might be done combined with an endometrial biopsy before a full D&C procedure.

During the procedure

For dilation and curettage, you'll receive anesthesia. The choice of anesthesia depends on the reason for the D&C and your medical history.

During the procedure:

• You lie on your back on an exam table while your heels rest in supports called stirrups.
• Your doctor inserts an instrument called a speculum into your vagina, as during a Pap test, to see your cervix.
• Your doctor inserts a series of increasingly thick rods into your cervix to slowly dilate it until it's open enough.
• Your doctor removes the dilation rods and inserts a spoon-shaped instrument with a sharp edge or a suction device and removes uterine tissue.

Because you're either unconscious or sedated during a D&C, you shouldn't feel any discomfort.

After the procedure

You'll likely spend a few hours in a recovery room after the D&C so that you can be monitored for heavy bleeding or other complications. This also gives you time to recover from the effects of anesthesia.

Typical side effects of a D&C can last a few days and include:

• Mild cramping
• Spotting or light bleeding

For discomfort from cramping, your care team might suggest taking ibuprofen (Advil, Motrin IB, others) or another medication.

You should be able to resume your activities within a day or two.

To prevent infection, don't put anything in your vagina until your care team says it's OK. Ask when you can use tampons and resume sexual activity.

Your uterus must build a new lining after a D&C, so your next period might be early or late. If you had a D&C because of a miscarriage, and you want to become pregnant, talk with your care team about when it's safe to start trying again.