DILATATION AND CURETTAGE

General Information

DEFINITION--Opening the cervix and scraping the inner wall of the uterus to remove tissue.

BODY PARTS INVOLVED--Uterus; cervix; vagina (as route for surgery).

REASONS FOR SURGERY

• Diagnosis of abnormal bleeding or possible cancer inside the uterus.
• Incomplete spontaneous miscarriage.
• Treatment of minor diseases of the uterus.
• Elective abortion during early pregnancy.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Excess alcohol consumption.
• Recent or chronic illness, including anemia, diabetes mellitus, and heart or lung disease.
• Use of drugs, such as: antihypertensives; cortisone; diuretics; or insulin.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Obstetrician-gynecologist, general surgeon or family doctor.

WHERE PERFORMED--Outpatient surgical facility or hospital.

DIAGNOSTIC TESTS

• Before surgery: Pap smear (See Glossary); pregnancy test; blood and hormonal studies.
• After surgery: Blood studies; Pap smear in 2 months.

ANESTHESIA--Local anesthesia by injection, or general anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The vagina is cleansed with an antiseptic solution.
• The cervix is carefully opened with a dilator, and a curette is inserted into the uterus.
• The curette is used to scrape away a small part of the uterine lining for laboratory analysis.
• The instruments are removed.
• Some surgeons now collect tissue by suction curettage (see Abortion in Surgery section) rather than by the procedure described here.

POSSIBLE COMPLICATIONS

• Surgical-wound infection.
• Excessive bleeding.
• Inadvertent injury to the uterus.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Tissue obtained successfully without complications in virtually all cases. Allow about 4 to 6 weeks for recovery from surgery.

Postoperative Care

† Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from nylon, polyester, silk or other non--

ventilating materials.

• Expect slight vaginal bleeding during recovery from surgery. Use a sanitary pad to protect clothing. Avoid tampons temporarily; they may lead to infection.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume sexual relations when spotting ceases.

DIET---No special diet.

Call Your Doctor If

† Vaginal discharge increases or smells unpleasant.

• You experience pain that simple pain medication does not relieve quickly.
• Unusual vaginal swelling or bleeding develops.
• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.