Dilation and Curettage, or commonly known as D&C or ‘raspa’ by Filipinos, is a medical procedure designed to clean the interior of the uterus”. It’s often recommended when dealing with things such as heavy periods or a miscarriage.

Why is it done?

1. To Figure Stuff Out: Sometimes, before undergoing D&C, your doctor might recommend something called an endometrial biopsy or sampling. They do this to check what’s happening in your uterus. This biopsy deal might be considered if:

   – You’re dealing with some unusual uterine bleeding.

   – You’re bleeding even though you’re menopausal.

   – They spot some abnormal endometrial cells during a routine cervical cancer check.

Basically, they take a little piece of tissue from your uterus lining (the endometrium) and take it off to the lab for a closer look. This helps check for things like a thickened uterine lining that could spell trouble, pesky uterine polyps, or even the big C: uterine cancer. If they need more info, that’s when the D&C usually steps in.

2. To Fix Things Up: Now, when they’re doing a D&C to treat something, they’re not just taking a tiny tissue sample. The doctors have to remove contents from inside your uterus. This might be on the agenda to:

   – Prevent any infections or heavy bleeding after a miscarriage by taking out leftover tissues in your uterus.

   – Remove a tumor that forms instead of a normal pregnancy (known as a molar pregnancy).

   – Stop excessive post-delivery bleeding by clearing out any lingering placenta bits in the uterus.

   – Remove cervical or uterine polyps, which are noncancerous (benign) in most cases.

Sometimes, they combine a D&C with another procedure called hysteroscopy. During this duo act, the doctor slips a tool with a light and camera into your uterus to check for any abnormalities or polyps, and grabs tissue samples if needed. Sometimes, they might even do a hysteroscopy and a biopsy before the D&C.

What Goes Down When Getting a D&C?

1. Where It Happens: You can get the procedure done at your doc’s office or the hospital. It’s usually super quick, like 10 to 15 minutes tops, but you might have to stay at the office, clinic, or hospital for up to five hours.

2. Getting Started: Before the D&C, you’ll chat with your doc about your health history and give the green light by signing a consent form. Got questions about the whole D&C deal? Ask away! Plus, make sure to mention if:

   – You suspect you’re pregnant.

   – You’re sensitive or allergic to any meds, iodine, or latex.

   – You’ve got a history of blood clotting issues or you’re taking any blood-thinning meds.

3. Going Under: Since you’re going to need anesthesia, your doc will chat with you about which kind suits your situation. Here’s the rundown:

   – If it’s general anesthesia, you’ll be catching some Zzzs during the procedure.

   – With spinal or epidural anesthesia (the regional kind), you won’t be feeling anything from the waist down.

   – And if it’s local anesthesia, you’ll be awake, and they’ll numb up the area around your cervix.

4. Getting Prepped: Before the main event, you might need to slip into a hospital gown, and take a bathroom break to empty your bladder.

5. The D&C: During the D&C, you have to lay on your back and put your feet up in stirrups, like in a pelvic exam. The doctor slides in a speculum, gives the cervix a gentle hold with a clamp, and while there are no stitches or cuts involved, they give the cervix a good cleanse with an antiseptic solution.

6. The Procedure Itself: The D&C’s a two-part deal:

Dilation: This part’s all about opening up the lower part of your uterus (the cervix) to make way for an instrument. Sometimes, they might use a slender rod or medications to prep the cervix and help it widen.

Curettage: This involves scraping away the lining of your uterus and scooping out any uterine contents using a spoon-shaped tool called a curette. They might also use a cannula to suck out any leftover bits from the uterus, which can lead to some cramping. Afterward, they send a tissue sample off to the lab for a checkup.

7. Extra Steps: Sometimes, alongside the D&C, they might throw in a couple of extra procedures. Like a hysteroscopy, where they slip a tool with a camera into your uterus to get a closer look inside. They could also remove polyps or fibroid tumors if they spot ’em.

8. After Everything’s Done: Following the D&C, you might experience some things. The usual suspects are:

   – Cramping

   – A bit of spotting or light bleeding

If you notice any heavy or prolonged bleeding, fever, pain, abdominal tenderness, or funky-smelling discharge afterward, give your doctor a call.

9. Road to Recovery: You’ll need a lift home after a D&C, especially if you had general anesthesia. You might feel a bit groggy with a hint of nausea and maybe some brief vomiting. Most women can get back to their regular routines within a day or two. Just check in with your doctor about any do’s and don’ts. Expect some mild cramps and light spotting for a bit, which is totally normal. A sanitary pad and some pain relievers might be your new besties for a few days.

10. Timing Matters: Your next period might decide to show up early or late after a D&C. To keep things well and prevent any unwanted bacteria in your uterus, hold off on sex and tampons until your doctor gives you the green light.

11. The Follow-Up: Schedule a follow-up visit with your doc and any further treatments if needed. If they sent any tissue for a biopsy, ask about when to expect the results. It is usually available within several days.

Sources:

Mayo Clinic Staff. (October 19, 2021). Dilation and curettage (D&C). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910 

Stuart, A. (November 7, 2022). D and C (Dilation and Curettage). WebMD. https://www.webmd.com/women/d-and-c-dilation-and-curettage