Uterus Dilation and Curettage

Dilation and curettage of the endometrium (or simply uterine curettage) is one of the most common procedures.

When?

• Heavy bleeding independent of normal menstruation (metrorrhagia) or during the period (menorrhagia);
• New bleeding during menopause (read more);
• Endometrial polyps;
• Suspected endometrial hyperplasia;
• Suspected endometrial cancer;
• Incomplete miscarriage and missed miscarriage;
• Suspected ectopic pregnancy.

How?

• After 8 hours of fasting, at the hospital;
• The patient lies in a normal PAP-test position. She is given mild intravenous sedation (intoxication). Under antisepsis conditions, the cervix is dilated to allow for the curettage instrument (curette) to go through (see figure). Then the tissue lining the inner cavity of the uterus, i.e. the endometrium, is removed gently from inside the uterus and sent for biopsy;
• No instrument scars and stitches;
• After the procedure, the patient remains in recovery for a couple of hours and then she is allowed to return home;

The next day, the patient may return fully to her everyday activities.

Endometrial biopsy at the clinic:

When:

In the event of suspected hyperplasia or endometrial cancer, instead of performing the established curettage, an endometrial biopsy may be performed at the clinic.

How:

Using a very thin, sterilized, plastic, elastic, suction probe. This probe is inserted through the cervix, without dilation, into the endometrial cavity and by applying negative pressure, it suctions small parts of endometrial tissue. 

Advantages:

Significantly reduced cost; avoiding sedation; and returning immediately to ALL activities.

Disadvantages:

The diagnostic sensitivity AND range of endometrial biopsy at the clinic is lower compared to curettage. Therefore, uterine curettage should be also performed, especially in case of positive results (but often in case of negative results when symptoms are persistent).