You may need a dilatation and curettage (D&C) to investigate abnormal, heavy or irregular vaginal bleeding, or to remove what are called the products of conception following a miscarriage. In many cases, a hysteroscopy is carried out first to examine the lining of your uterus.
This page explains what each procedure involves, how it is performed, and what to expect during recovery.
A hysteroscopy is a procedure used to examine the lining of the uterus. It involves passing a small fibreoptic telescope (a hysteroscope) along the vagina and through the cervix, so the doctor can examine the uterine cavity directly.
It’s often carried out before a D&C to see what’s going on inside the womb, and in some cases small problems — such as a polyp — can be treated at the same time.
A dilatation and curettage is usually carried out as a day-case procedure under general anaesthetic and takes about 15 minutes.
Because it’s a day-case procedure, most women go home the same day, once they have recovered from the anaesthetic and are comfortable.
Fasting You are required to fast from 12 midnight on the night before the surgery, from all food and drink.
At admission You will be examined by a doctor, and blood samples may be taken in the admission room before you are admitted to the ward.
What to bring A nightdress or comfortable clothes, sanitary pads, slippers, and any regular medications you take. Leave valuables at home.
Consent The doctor will explain the procedure and answer any questions before asking you to sign a consent form.
Travel home Because you’ll have had a general anaesthetic, you must arrange for someone to collect you and stay with you for the first 24 hours.
You will usually recover rapidly, but may experience discomfort similar to period pain for a few hours after the procedure. Simple painkillers such as paracetamol will ease this.
There may also be some vaginal bleeding for a few days. The first period following a D&C may be heavier than normal, and occasionally small clots may be present.
If bleeding becomes heavy, or you develop a high temperature, severe pain or an offensive-smelling discharge, please seek medical advice.
Complications are rare but can include:
Infection Signs include fever, persistent pain or a smelly discharge. Treated with antibiotics.
Perforation of the uterus (<1%) Very rare, and usually heals on its own; occasionally requires further procedures.
Failure to visualise the uterine cavity Sometimes the cervix or cavity is difficult to access and the procedure may need to be repeated or approached differently.
Heavy vaginal bleeding Uncommon, but contact us if your bleeding is heavier than a normal period or doesn’t settle.
Damage to the cervix Rare and usually minor.
DVT (blood clot in the leg) Any surgery carries a small risk of clots; staying mobile after the procedure helps reduce this.
Adhesions in the uterus (Asherman’s syndrome) Rare scarring of the uterine lining that can affect future periods or fertility.
Anaesthetic complications As with any general anaesthetic; the anaesthetist will discuss these with you on the day.
