Hysteroscopy/Dilation and Curettage (D&C)
The information provided by Advanced
Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes
only. As each woman is unique, do not rely on this information for diagnosis and
treatment. We cannot guarantee the accuracy of the content and advise that you see a
qualified Health Care Professional for individual needs and care.
Hysteroscopy and / or dilation and curettage
(D&C) are usually performed under general anesthesia (patient is asleep). Hysteroscopy
is performed with a skinny telescope-like instrument (hysteroscope) inserted into the
uterus (womb) through the cervix (mouth of the womb) and requires no incision. The
endometrial cavity (cavity of the womb) is examined for abnormalities using a small video
camera attached to the hysteroscope. In order to better see the inside of the uterus, the
walls of the cavity are kept apart by a gentle flow of fluid or gas, usually a fluid. This
can be compared to placing a small telescope inside a balloon - with the balloon
collapsed, not much could be seen; but if the balloon is inflated with air, there is room
to see.
The most common reason hysteroscopy / D&C is
performed is for abnormal uterine bleeding (see Abnormal
Uterine Bleeding in Patient Health Information). Several different
procedures can be performed at hysteroscopy.
Tissue such as polyps, fibroid tumors, scar tissue,
hyperplasia (overgrowth of tissue) or septa (dividing walls) can be removed.
With recanalization of the fallopian tubes, a
blockage of the tubes is opened using a small plastic catheter.
Endometrial ablation involves destruction of the
lining of the uterus with an electrocautery roller-ball to treat abnormal bleeding.
A dilation and curettage (D&C) may or may
not performed at the time of hysteroscopy. The D&C may be performed to remove a larger
amount of the lining tissue, either for treatment or diagnosis. The cervix is dilated (the
canal made larger), and the endometrium (lining of the uterus) scraped with an instrument
that resembles a long iced-tea spoon. D&C is also commonly performed in the case of a
miscarriage. This is called a suction D&C and removes tissue from the uterus with a
vacuum device.
D&C used to be commonly performed by itself to
diagnose and treat abnormal uterine bleeding. Diagnosing the cause of abnormal bleeding is
now done with fluid-contrast ultrasound (see Fluid-Contrast
Ultrasound in Patient Health Information). This avoids general anesthesia
in the operating room.
If the procedures are necessary, recovery from
hysteroscopy / D&C is usually very quick. Most patients are able to return to normal
activity the following day. |