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Medical Disability Advisor  >  Dilation And Curettage

Dilation and Curettage


Specialists


  • Family Practice Physician
  • Gynecologist

Comorbid Conditions


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Factors Influencing Duration


Length of disability may be influenced by the underlying reason the procedure was performed (e.g., menorrhagia, incomplete abortion, miscarriage, or testing and diagnosis) and the development of complications.

Medical Codes


ICD-9-CM:
69.0 - Dilation and Curettage of Uterus
69.01 - Dilation and Curettage for Termination of Pregnancy
69.02 - Dilation and Curettage Following Delivery or Abortion
69.09 - Other Dilation and Curettage of Uterus; Diagnostic D and C

Definition


Dilation and curettage (D&C) is a common minor surgical procedure in which the opening to a woman's uterus (cervix) is enlarged (dilated) and the lining of the uterus (endometrium) is scraped with a spoon-shaped instrument (curette). The scraping or removal of the endometrium causes no side effects, and the endometrium soon grows back to become a part of the normal menstrual cycle.

Individuals with a history of heavy periods (menorrhagia), bleeding between periods, bleeding during or after intercourse, bleeding after menopause, cancer of the uterus or other growths in the uterus, an incomplete miscarriage, or with tissue remaining after a delivery may require a D&C procedure. D&C can also be used to terminate a pregnancy (elective or therapeutic abortion) or to remove tissue remaining after an incomplete abortion.

Source: Medical Disability Advisor



Reason for Procedure


The D&C is used to treat or evaluate dysfunctional uterine bleeding (DUB), which includes heavy periods (menorrhagia), bleeding between periods, bleeding during or after intercourse, or bleeding after menopause. By removing excess uterine lining, D&C may prevent DUB, albeit sometimes only temporarily. D&C serves as a basis for testing and diagnosis of cancer of the uterus or other growths in the uterus, such as polyps and fibroid tumors. Testing procedures that may be employed with the D&C include ultrasonography, laparoscopy, and hysteroscopy.

D&C is also used to remove the remaining tissue of an incomplete miscarriage, of an incomplete abortion, and of retained pregnancy tissue after a delivery, as well as to terminate a pregnancy (elective or therapeutic abortion).

Source: Medical Disability Advisor



How Procedure is Performed


A D&C is performed with the individual in the same position that she assumes for a pelvic examination: lying on an examination table with legs apart and supported in stirrups. With the individual anesthetized (using local, general, or spinal anesthesia), the gynecologist begins the surgery by inserting a thin rod called a sound into the uterus to measure its depth. Next, a dilator is inserted and as the cervix stretches open (dilates), the gynecologist inserts larger and larger dilators of increasing thickness until an opening is large enough to begin the second phase of the surgery. In the second phase of the surgery, a spoon-shaped surgical scraping instrument (curette) is inserted into the uterus to scrape away the endometrium. The endometrium can also be removed by suction by inserting a hollow tube (catheter) that is connected to a vacuum pump through the cervix. Suction is applied to remove the retained tissue. The entire D&C procedure takes about 15 minutes. The individual is usually able to go home within 4 to 6 hours. However, if general or conscious sedation is used, she should arrange for someone to drive her home after the procedure.

Source: Medical Disability Advisor



Prognosis


The predicted outcome after a D&C procedure is good and after-effects are minimal. A few individuals may experience some bleeding and mild period-like cramping for a day or so following the procedure. Most individuals recover with no problems associated with the anesthesia or the procedure.

In general, D&Cs are successful in evaluating and treating abnormal uterine bleeding and in providing a diagnostic tool in addition to ultrasonography, hysteroscopy, and laparoscopy.

Source: Medical Disability Advisor



Complications


As with any procedure performed under general anesthesia, possibilities exist for the individual to experience a reaction to the anesthesia and to have breathing problems. Other complications include perforation of the uterus, excessive bleeding (hemorrhage), infection, trauma to abdominal organs, and injury to the cervix. If the cervix is injured during the procedure, the cervix may not be able to retain a baby within the uterus (cervical incompetence) in future pregnancies, possibly resulting in a spontaneous abortion (miscarriage) or premature birth.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Work restrictions or accommodations are generally not required following a D&C procedure. Most individuals who undergo a D&C are able to return to work or to resume previous activities within a day or so with only minor restrictions, such as refraining from strenuous exercise and activity or driving on the day of the procedure.

Source: Medical Disability Advisor



General References


Owen, Philip, ed. "Dilation and Curettage." NetDoctor.co.uk. Ed. Philip Owen. 1 Apr. 2005. 20 May 2005 <http://www.netdoctor.co.uk/health_advice/facts/curettage.htm>.

Source: Medical Disability Advisor






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