Curettage

Curettage meaning

Medical term for scraping or removal of tissue from a body cavity, organ or lesion with a surgical instrument known as curette, a spoon-shaped or ring-shaped instrument. May be performed for diagnosis or treatment.

Common types of curettage

Dilation and Curettage (D&C): Cervix is dilated and tissue is scraped from the inside of the uterus (endometrium). It can be done to:

• Determine the cause of irregular periods
• Remove tissue following a miscarriage.
• Treat excessive bleeding
• Have retained tissue removed after having a baby or abortion.

Skin Curettage (Removal of abnormal skin): A curette is used to remove abnormal skin such as some skin cancers, warts or benign growths. This is usually done in conjunction with cauterization (electrosurgery).

Dental Curettage: The removal of infected or inflamed tissue from gum pockets as part of periodontal treatment to help control gum disease.

Bone Curettage: abnormal tissue of any kind, including a benign bone tumour or a cyst, is removed from inside a bone.

Is curettage painful?

It is typically done with local, regional or general anaesthetic, as this is related to the type and the site of the curettage. Patients generally feel little or no pain while undergoing the procedure, but may feel some pain or cramping following the procedure.

Recovery

There is a different recovery process for each form of curettage:

• Uterine D&C: Most people will be fine in a few days; there may be cramping and some spotting for up to two weeks.
• Skin or dental curettage: Recovery usually is more rapid, and may occur in a few days to a week.

Dilation and curettage meaning

• Dilation and Curettage (D&C) is a minor surgical procedure performed in which the cervix, or opening of the uterus, is gently widened (dilation) and tissue from the lining of the uterus (endometrium) is removed with a curette or suction device.

Simple definition

• Dilation and Curettage (D&C) is a procedure that involves dilating the cervix and scraping and cutting the uterine tissue to diagnose or treat conditions of the uterus.

For what is D&C used?

A doctor may recommend a D&C to:

• Examine abnormal uterine bleeding (AUB).
• Remove the tissue that is left behind after a miscarriage.
• In the event of an incomplete abortion.
• Postpartum removal of retained placenta.
• Know how to obtain specimens for diagnosis of conditions like endometrial hyperplasia or cancer.
• In some instances, remove uterine polyps or other abnormal tissue

What is the procedure?

• The patient is given local, regional or general anaesthesia.
• Special instruments or drugs are used to slowly dilate the cervix.
• The curette, a spoon-shaped instrument, or a suction device is used to put into the uterus.
• The uterine lining is softly scrapped or sucked to take out tissue.
• If necessary, the collected tissue can be taken to a laboratory for analysis.

Recovery

• The majority of patients are discharged on the same day.
• Some cramping and slight vaginal bleeding may occur for several days.
• Normal activities can resume within 1-2 days, but strenuous exercise and sexual intercourse should be avoided for approximately 1-2 weeks or until the doctor says they can resume.

Dilation curettage procedure

Step-by-Step D&C Procedure

Preparation

• If general anaesthesia is to be used, the patient should be asked to fast for several hours.
• Medical history, medications and allergies are checked.
• A blood, pregnancy, or imaging test (such as an ultrasound) may be done if necessary.
• The procedure usually takes place under local, regional or general anaesthesia.

Positioning

• The patient is examined on an examination table, with feet in stirrups (like for a pelvic exam).
• Speculum insertion is not recommended.
• A speculum is inserted into the vagina, which allows the doctor to be able to see the cervix.

Cervical Dilation

• Gently dilating the cervix with increasing dilators.
• Sometimes, medications are given several hours prior to the procedure, or small rods (laminaria) are inserted to soften and loosen the cervix.

Taking out uterine tissue (curettage)

• A curette (a spoon-shaped surgical instrument) or a suction device is placed in the uterus.
• The inner lining of the uterus is scraped or sucked out to remove tissue.
• When done for diagnosis, the tissue taken is placed in a laboratory for a microscopic examination.

Completion

• The instruments are taken out and the patient is kept on a recovery table until the effects of the anaesthetic have passed.

The length of the procedure

• Typically, the process takes 10 to 30 minutes.
• Usually a patient will be transferred home after a short period of observation on the same day.

Surgical dilation and curettage

Surgical Dilation and Curettage (Surgical D&C) is a minor gynaecological procedure which involves the surgical opening of the cervix and the removal of tissue from the inside of the uterus with a curette, a spoon-shaped instrument or a suction device. It is used to help diagnose the condition of the uterus or to treat conditions like miscarriage, irregular uterine bleeding or the presence of fetal tissue in the uterus.

The advantages of surgical D&C include:

• Effectively removes abnormal or retained uterine tissue,
• Assesses and diagnoses uterine bleeding that is not normal for a woman
• Cures incomplete miscarriage and retained products of conception
• Typically done as a day care procedure
• Short procedure that can be recovered in a relatively short time.

Conclusion

Curettage is a common surgical procedure that involves the removal of abnormal or unwanted tissue for diagnosis or treatment. Curettage is a crucial part of diagnosis, symptom relief and treatment of disease whether it is part of a Dilation and Curettage (D&C) procedure for skin lesions or dental or bone disorders. With modern surgical techniques and anaesthesia, it is safe, minimally invasive and has a relatively quick recovery. An experienced specialist is sure to perform the procedure safely and patients will receive the proper follow-up care necessary for best results.

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FAQ

Is curettage a very serious procedure?

• Curettage is normally believed to be a minor surgical procedure and it can be performed as a day-care procedure where the patient is seen and ready to go home the same day.

Is curettage painful?

• Typically performed under local, regional or general anaesthesia, meaning that patients will not experience pain during the procedure. Following the curettage, moderate pain, cramping or soreness can happen– depending on the kind of curettage that was done.

Is it safe to do everyday activities once cured?

• The majority of patients will be able to resume their normal activities within 1-2 days, depending on the kind of curettage they have and what their doctor recommends. After uterine curettage, strenuous exercise and sexual activity may have to be avoided for a short time.

Will a tissue taken in the curettage be tested?

• When the procedure is done for diagnosis, the removed tissue is typically sent to a pathologist's lab for microscopic examination to aid in diagnosis of an underlying condition.

Is curettage safe?

• Yes. Curettage is safe and effective when performed by a qualified and experienced health care professional with a low risk of complications.