Hysteroscopy

Guide to hysteroscopy/dilation and curettage(d&c)
Why do you need a D & C?

You may need a dilatation and curettage (D&C) to investigate abnormal, heavy or irregular vaginal bleeding or to remove what are called the ‘products of conception’ following a miscarriage.
What is a hysteroscopy?
A hysteroscopy to examine the lining of the uterus may be carried out before a D&C. This involves passing a small fibreoptic ‘telescope’ along the vagina and cervix to examine the lining of the uterus.
How is the D & C performed?
A dilatation and curettage is usually carried out as a day-case procedure under general anaesthetic and takes about 15 minutes. The cervix is gently opened with a smooth instrument called a dilator. A curette, which is a small spoonshaped instrument, is then passed through the cervix to remove the tissue lining of the uterus (the endometrium). The tissue is then sent to the laboratory for examination.
After the procedure
You will usually recover rapidly, but may experience discomfort similar to period pain for a few hours after the procedure. Simple painkillers will ease this e.g. Paracetamol. There may also be some vaginal bleeding for a few days. The first period following a D&C may be heavier than normal , and occasionally small clots may be present. If bleeding becomes heavy, you should seek medical advice.
Complications of the procedure
Complications are rare but can include the following:
• Infection
• Perforation of the uterus <1%
• Failure to visualise the uterine cavity
• Heavy vaginal bleeding
• Damage to the cervix
• Risk of DVT (blood clot in the leg)
• Formation of adhesions in the uterus (Asherman’s syndrome)
• Anaesthetic complications
Before the operation
 • You are required to fast from 12 midnight on the night before the surgery, from all food and drink.
 • You will be examined by a doctor and bloods may be taken in the admission room prior to admission to the ward.
 • You will need toiletries, night wear, dressing gown and slippers.
• Avoid bringing valuables or jewellery to the hospital.

For 24 hours after a general anaesthetic, your reactions may not be as quick as normal, do not drive or do anything that needs concentration.
You may resume sexual relationships when the bleeding has stopped and/or after 2 days.
Review Appointment
If you need a review appointment, you will be told before you leave the ward and the appointment will be posted to you.
A letter will be posted to your GP. This will contain details of the tests carried out while you were in hospital.

CONTACT
Contact your own doctor if you have:
• Severe pain which your painkillers do not take away
and
• A foul smelling, itchy vaginal discharge

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