Hysteroscopy and Dilatation & Curettage (D&C)

What is it?


Hysteroscopy

Hysteroscopy involves the insertion of a scope with an attached camera to visualise the inner cavity of the uterus for diagnostic and /or therapeutic purposes.


Dilatation and curettage (D&C)

D&C is a brief surgical procedure in which the cervix is dilated progressively with metal dilators to allow the insertion of a spoon-shaped instrument (curette) to scrape the inner lining of the uterus for biopsy. This is done under intravenous sedation or general anaesthesia.

The entire procedure will last around 30 minutes. You should be able to resume your normal activities within a day or two. To prevent bacteria from entering your uterus, avoid sexual intercourse and use of tampons for 3 days.

If any tissue was sent for a biopsy, the results will be available by the next consultation about 1 week later.


Risks of the procedure

  • Infection

  • Bleeding

  • Scarring of uterine wall

  • Uterine perforation <1% risk

  • Damage to the cervix


Why do I need to do it?

  • Diagnose abnormal uterine bleeding. Abnormal uterine bleeding includes excessive vaginal bleeding during periods, vaginal bleeding / spotting between periods, or after sex. These procedures may help diagnose fibroids, polyps or uterine cancer. A sample of uterine scrapings is viewed under a microscope to check for abnormal cells.

  • Treatment of endometrial polyps or fibroids. Polyps or fibroids may be removed under visual guidance with the hysteroscope.


Fibroids

Fibroids are noncancerous growths that develop in or around the uterus. The growths are made up of muscle and fibrous tissue, and vary in size. Fibroids that protrude into the inner cavity of the uterus (i.e. submucosal fibroids) can cause abnormal uterine bleeding and may be diagnosed and treated via the hysteroscope.

Non-cancerous polyps

Polyps are an overgrowth of the inner lining of the uterus to extend into the uterine cavity. They are usually non-cancerous but can change your monthly period or make it more difficult to get pregnant.


Uterine cancer

Abnormal uterine bleeding, especially in women above the age of 40, may be a sign of uterine/endometrial cancer. Uterine cancer is a common and treatable gynaecological cancer, which is typically detected at early stages.


Common side effects

  • Mild cramping

  • Spotting or light bleeding

  • Change in timing of next menstrual period


References:

1. https://www.webmd.com/women/guide/d-and-c-dilation-and-curettage#1

2. https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910

3. https://www.nhs.uk/conditions/fibroids/

4. https://my.clevelandclinic.org/health/diseases/14683-uterine-polyps

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