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Curettage (D&C) is a short surgery in which the cervix is dilated and used with a special tool to shave the lining of the uterus. Knowing what happens before, during and after surgery will reduce your worries.


Types of curettage

You may need curettage for a number of reasons. This is done for the following reasons:

Cause 1 (type 1- Evacuation curettage): Removal of placental tissue inside the uterus during or after abortion. This prevents infection or heavy bleeding.

Second cause (type 2- Diagnostic curettage) : Diagnosis or treatment of abnormal uterine bleeding. Curettage helps diagnose or treat growth conditions such as fibroids, polyps, hormonal imbalances or uterine cancer.To diagnose the disease, your doctor may take a sample of D&C as an endometrial biopsy to diagnose the disease:

- Abnormal uterine bleeding

- Bleeding after menopause

- The doctor finds abnormal endometrial cells during a routine cervical cancer test

To perform the test, the doctor collects a tissue sample from the lining of the uterus (endometrium) and sends the sample to the lab. The test can check for the following:

* Endometrial hyperplasia - a prognostic disease in which the lining of the uterus thickens

* Uterine polyps (diagnosis of uterine polyps | treatment of uterine polyps)

*  uterus cancer


What happens during curettage?

You can have a curettage at your doctor's office, clinic or hospital. The curettage usually takes 10 to 15 minutes, but you may stay up to 5 hours in an office, clinic or hospital. Before curettage, you must sign the consent form and inform your doctor about your medical history. Ask your doctor about the operation. Be sure to tell your doctor if you have any of the following:

  - You suspect you are pregnant

  - You are allergic to any medication, iodine or latex.

  - You have a history of bleeding disorders or are taking blood thinners.

You will faint. The type of anesthesia depends on the procedure:

  * If general anesthesia is used, you will not wake up during the operation.

  * If spinal or epidural (regional) anesthesia is used, you will not feel it from the waist down.

  * If local anesthesia is used, you will be awake and numb around the cervix.

Before curettage, you should wear hospital gowns and empty your bladder.


During the curettage

During the curettage, lie on your back and place your feet on a stirrup similar to the pelvic exam. The doctor then inserts a speculum into the vagina and clamps the cervix. Although the curettage does not involve a needle or incision, the doctor cleans the cervix with an antiseptic solution.


Curettage consists of two main stages:

first stage: Dilation involves opening the lower part of the uterus (cervix) to insert an instrument. The doctor may insert a thin tube (laminaria) into the cervix before starting, or use medication before the operation to soften the cervix and cause it to open.

second stage: Curettage involves cutting the lining of the uterus and removing the contents of the uterus with a spoon-shaped tool (a cortex). The doctor may also use a cannula to suck up any remaining material from the uterus. This causes muscle cramps. The tissue sample is then sent to a laboratory for testing.

Sometimes other surgeries are performed with curettage. For example, your doctor may insert a narrow device to look inside your uterus (what a hysteroscopy is).


Complications of performing curettage

After curettage, there are side effects and possible risks. Common side effects include:

* Eclipse

* Light spot or bleeding

* Complications such as cervical injury and perforation of the uterus or bladder and blood vessels are very rare. But if you have any of the following symptoms after curettage, contact your doctor.

* Severe or prolonged bleeding or blood clots

* Fever

* the pain

* Abdominal tenderness

 * Bad discharge from the vagina


Post-cure care

After curettage, a new covering will form in the uterus. The next menstrual period may not occur at regular times. It may be sooner or later.

Bacteria can enter the uterus from the vagina and cause an infection until the cervix reaches its normal size. Do not insert anything into the vagina at this time. Ask your doctor about the right time to have sex or use a tampon again.

Ask your doctor about restrictions. You may also have spotting and muscle cramps for a few days. This is normal. You may want to use a sanitary pad for spotting, and you can also use painkillers to reduce the pain.

You should also contact your doctor if you have any of the following:

 - Severe bleeding from the vagina

 - Fever

 - Pain in the abdomen

 - Stinky discharge from the vagina


What are the potential risks and side effects of curettage?

Risks associated with anesthesia such as adverse drug reactions and respiratory problems

 * Severe bleeding

 * Infection in the uterus or other pelvic organs

 * Perforation of the uterus

 * Fracture or weakening of the cervix

 * Uterine ulcers or cervical ulcers that may need further treatment

 * Incomplete action that requires another action