Tips & tricks · 3 min read
Dilation and Curettage (D&C): A Topic We Need to Talk About
When a curettage is coming up – whether after a miscarriage or for medical investigation – you probably have a thousand thoughts racing through your head. Perhaps you are coming to terms with a loss right now, or you are simply nervous about the procedure. However you feel: you are not alone. We explain clearly and directly what happens during a curettage, what to expect and how to take good care of yourself and your body after the procedure.
What to expect in this article:
- Definition & reasons: Why a curettage is performed.
- Types & procedure: How the surgical procedure is carried out step by step.
- Aftercare & rest: What to bear in mind during the first few weeks.
- Alternatives: Which medication-based or gentler options are available.
What is a curettage and why is it performed?
A curettage is a short surgical procedure, usually carried out as a day case, in which the lining of the uterine cavity (endometrium) is carefully scraped away or removed by suction. The uterine lining then rebuilds itself within a few weeks, after which the menstrual cycle returns to its natural rhythm.
The procedure serves both diagnostic and therapeutic purposes:
- Unexplained or heavy bleeding disorders: Investigating very heavy or irregular bleeding, or bleeding that occurs again after the menopause.
- After a miscarriage or termination of pregnancy: Gentle removal of remaining pregnancy tissue (curettage after miscarriage or suction curettage) to prevent inflammation.
- Tissue examination: Taking tissue samples for the early detection of cell changes, polyps or fibroids.
The different types & how the procedure works
Different methods are used depending on the medical reason:
- Classic curettage: The lining is removed mechanically using a spoon-shaped instrument (curette).
- Suction curettage: Often used after miscarriages; the tissue is gently removed by vacuum suction.
- Hysteroscopy-assisted curettage: The scraping is combined with a simultaneous hysteroscopy so that the doctor can work with pinpoint precision.
What typically happens: The procedure is usually carried out as a day case under a brief general anaesthetic or sedation. After the intimate area has been cleaned, the cervix is gently widened (cervical dilation). The procedure itself only takes 5 to 15 minutes. After a short monitoring period of one to two hours, you can go home with someone accompanying you and recover there.
Aftercare: physical and emotional healing
Although curettage is considered a very safe routine procedure, the tissue needs time to recover fully. Possible risks such as wound infections, heavier bleeding afterwards or, more rarely, scarring (Asherman’s syndrome) can be minimised by taking the right precautions:
- Physical rest: Allow yourself at least 1 to 3 days of strict rest.
- Infection protection & gentle hygiene: For about two weeks, strictly avoid baths, swimming pools, saunas and sex, as well as tampons and menstrual cups. As the cervix is still slightly open shortly after the procedure, purely external, breathable hygiene products are the safest choice. Gentle washable pads and panty liners or soft period underwear protect the sensitive tissue without pressure and prevent germs from being introduced.
- Understanding your bleeding: Light bleeding or brownish discharge is completely normal for up to 10 days. Breathable protection gives you a clean, dry feeling on these days without putting strain on the irritated mucous membrane. If you experience sudden heavy bleeding, foul-smelling discharge or fever, see your gynaecologist immediately.
- Emotional space: Especially after a loss, your mind needs time too. Feelings such as grief or low mood are valid. Don’t hesitate to seek professional support or psychological counselling.
Are there alternatives to curettage?
Surgery is not always absolutely necessary. Depending on the findings, there are gentler alternatives:
- Medication: Can, for example, support the natural expulsion of tissue after a miscarriage.
- Hormone treatment: To regulate certain bleeding disorders.
- Monitoring ("watchful waiting"): For small, benign polyps or minor cycle irregularities, regular check-ups are often sufficient.
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