Dilation and curettage
- Dale W Stovall, MD
Dale W Stovall, MD
- Ob/Gyn Chair and Residency Program Director
- Methodist Hospital
The gynecologist has a variety of tools available for evaluation and treatment of women with abnormal uterine bleeding. Dilation and curettage (D&C) will be reviewed here. Office procedures for endometrial sampling and an overview of diagnostic approaches to endometrial evaluation, including both noninvasive and invasive assessment, are discussed separately. (See "Endometrial sampling procedures" and "Evaluation of the endometrium for malignant or premalignant disease".)
D&C has both diagnostic and therapeutic indications.
Diagnostic indications — The development of equipment and techniques for office based endometrial sampling has obviated the need for diagnostic D&C in most patients. Numerous studies have shown that the endometrium is adequately evaluated with sampling techniques. (See "Endometrial sampling procedures".)
However, there are still some indications for diagnostic D&C, such as in women:
●With a nondiagnostic office biopsy who are at high risk of endometrial carcinoma. (See "Endometrial carcinoma: Epidemiology and risk factors", section on 'Risk factors'.)
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- Diagnostic indications
- Therapeutic indications
- PREOPERATIVE PREPARATION
- General issues
- Endocervical curettage
- Cervical dilation
- - Complicated cases
- - Curettes
- - Sharp curettage
- - Suction curettage
- Uterine perforation
- Cervical injury
- Intrauterine adhesions
- Trophoblastic embolization
- POSTOPERATIVE CARE AND FOLLOW-UP
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS