Dilation and Curettage (D&C)

Overview

Dilation and curettage, or D&C, is a short gynecological procedure in which the cervix is gently opened (dilation) and the lining of the uterus is removed or sampled with a spoon-shaped instrument called a curette or with suction (curettage). It is used both to diagnose and to treat problems affecting the uterus.

A D&C is one of the most commonly performed minor gynecological procedures. It is usually quick, done as day surgery, and followed by a rapid recovery. This page is an educational overview only, not medical advice, and no outcome can be guaranteed.

Who May Need This

A D&C may be recommended for abnormal or heavy uterine bleeding, to investigate the cause of bleeding after menopause, or to obtain a tissue sample when an endometrial biopsy in clinic is inconclusive. It is also used to remove retained tissue after a miscarriage or delivery, or to treat certain uterine conditions such as polyps.

The procedure can be diagnostic (to find out why bleeding is happening), therapeutic (to remove tissue), or both. Eligibility is determined by a gynecologist after reviewing your symptoms, examination, and any imaging.

When It May Be Recommended

A specialist may recommend a D&C when bleeding is unexplained or does not respond to medication, when tissue must be examined to rule out precancer or cancer of the uterine lining, or when tissue remains in the uterus after a pregnancy loss and is causing bleeding or infection.

The decision considers the cause of the problem, your age, and whether a less invasive test or treatment is appropriate first. The final recommendation always depends on individual evaluation.

Diagnosis and Evaluation

Before a D&C, evaluation typically includes a pelvic examination, a pelvic or transvaginal ultrasound to assess the uterine lining, and blood tests. A pregnancy test is done when relevant, and sometimes an in-clinic endometrial biopsy is attempted first.

Because a D&C is often combined with hysteroscopy, your doctor may plan to view the cavity directly during the procedure. Your medications and any bleeding disorders will be reviewed. A second opinion may be valuable if cancer is suspected.

Treatment Options

Depending on the problem, alternatives to a D&C may include medication to control bleeding, a hormonal intrauterine device, an office endometrial biopsy, or expectant or medical management of a miscarriage.

A D&C itself may be performed alone, combined with hysteroscopy for direct vision, or paired with removal of polyps or fibroids. Suction curettage is often used for pregnancy-related tissue. Your doctor selects the approach that best fits the reason for the procedure.

How It Is Performed

A D&C is usually done under general or regional anaesthesia, or sometimes sedation with local anaesthesia. You lie in the same position as for a pelvic exam. The surgeon inserts a speculum, gently widens the cervical opening with tapered dilators, and then removes or samples the uterine lining using a curette or gentle suction.

If hysteroscopy is included, a thin camera is passed into the uterus so the surgeon can see and treat the cavity directly. The procedure typically takes 10 to 20 minutes, and the tissue removed is usually sent to the laboratory for analysis.

Preparation

Preparation usually includes fasting for several hours if anaesthesia is planned, a review of your medications (especially blood thinners), and arranging for someone to take you home. You may be advised to avoid tampons or intercourse for a short time before the procedure.

If you are travelling for treatment, plan for the recommended in-country stay, bring your gynecological records and imaging, and arrange a companion, as you should not drive immediately after anaesthesia.

Benefits and Expected Goals

The goals of a D&C are to identify the cause of abnormal bleeding, obtain tissue for diagnosis, or remove problem tissue such as retained products of conception or polyps. In many cases it provides both answers and relief of symptoms in a single short procedure.

Benefits vary by individual and by the underlying cause. A D&C treats the tissue in the uterus but may not address the root cause of bleeding, which sometimes needs further treatment. Your specialist can discuss realistic goals for your case.

Risks and Possible Complications

A D&C is generally safe, but as with any procedure there are risks.

• Bleeding or infection of the uterus
• Perforation (a small hole) of the uterine wall, which is uncommon
• Injury to the cervix
• Scar tissue inside the uterus (Asherman syndrome), which is rare and can affect periods or fertility
• Reaction to anaesthesia

Your doctor will explain the risks specific to your situation. Report heavy bleeding, fever, or severe pain promptly.

Recovery, Follow-up & Aftercare

Recovery is usually quick. Mild cramping and light bleeding or spotting for a few days to about two weeks are normal. Use sanitary pads rather than tampons, and avoid intercourse, swimming, and heavy lifting until your doctor advises it is safe.

Your next period may come earlier or later than usual. Follow-up is arranged to review any laboratory results and plan further care if needed. Arrange follow-up with your local doctor before travelling home, and contact your team about warning signs.

Medical Tourism Planning

If you are considering a D&C abroad, choose a JCI- or ISO-accredited hospital with an established gynecology unit and on-site pathology so tissue results are reliable. Verify the gynecologist's experience and request a written treatment plan and cost estimate before you travel.

Because a D&C is minor, in-country stays are usually short, but confirm how your pathology results and any follow-up will be communicated, and arrange continuing care with your doctor at home.

Estimated Cost Factors

Cost depends on the country and hospital, the gynecologist's and anaesthetist's fees, whether hysteroscopy or polyp removal is included, the type of anaesthesia, and pathology testing.

Many destinations offer this procedure at a fraction of typical US prices, but figures vary by case. Online prices are only estimates — always request a personalized written quote for your specific situation before deciding.

Choosing a Hospital or Specialist

Look for a hospital with recognised accreditation, a gynecology programme, and reliable laboratory support, since accurate pathology is central to a diagnostic D&C. Confirm the gynecologist's board certification and experience.

Ask about international patient services, interpreter support, and how results and any complications would be handled. Transparent written cost and treatment plans are good signs of a quality programme.

Alternatives

Depending on the reason, alternatives may include an office endometrial biopsy, hysteroscopy alone, medication or a hormonal IUD for abnormal bleeding, or expectant or medical management for an early pregnancy loss.

Each option has different benefits and limitations. Discuss all of them with your healthcare provider so the plan fits your diagnosis and preferences.

Questions to Ask Your Doctor

• Is this D&C for diagnosis, treatment, or both?
• Would an office biopsy or hysteroscopy be a suitable alternative for me?
• What are the specific risks in my case, including any risk to fertility?
• Will hysteroscopy be done at the same time?
• When will I get my results, and what are the next steps?
• How long should I stay in-country, and when can I fly home?
• What is included in the written cost estimate?