D and C Surgery: What to Expect

I got to the women's outpatient surgery center at 7 a.m., and in one of the curtained bays in the prep room changed into a hospital gown and got into the bed.The nurse took my temperature and blood pressure, put on my hospital ID bracelets, tucked an oven-warmed blanket around me, and skillfully inserted a needle into a vein behind my left thumb and secured it with tape, then hooked me up to an intravenous drip. The nurse said she used only thin needles for thin veins like mine. That was kind of her because I was afraid everything that was going to happen that morning would hurt.

I was going to be put to sleep for the D&C, a procedure in the uterus. Friends and my mom had been awake while they had D&Cs 20 years ago, and said it hurt, but another friend had a recent D&C,and said it takes a half hour or less and the patient is now almost always given general anesthesia. I was relieved because I did not want pain or to be awake in the operating room with my feet in stirrups and my personal parts starring in the show.

While I waited, each operating-room staff member came by to say hello: the nurse-anesthetist; the M.D. anesthetist supervisor, and my gynecologist, who was also the surgeon. The nurse-anesthetist gave in the IV a morphine-like painkiller she said would last for six hours. The IV drip made me sleepy. My friend was sitting with me; the nurse sent her to the waiting room, and set the bed so I was lying flat, and rolled my bed through double doors and down a short hall into the operating room. Its walls were blue and had some steel cabinets. I tried to see more, but just as they lifted me onto the table the anesthesia put me out.

"D and C" is "dilation and curettage," meaning that the cervix or opening to the uterus is opened to pencil width, and the contents of the uterus scraped with a tool called a "curette." This is not fun but it is a common and minor operation, an outpatient procedure, and most patients go right home. My surgeon had a special scope to see inside the uterus. He also wanted a biopsy. The reason for this was my post-menopausal bleeding. It might be nothing. It might also be a sign of cancer. He wanted to be sure.

An in-office biopsy had been tried but did not work. This is when the gynecologist ordered a D&C and I tried to talk him out of it. He ordered an ultrasound view of the uterus, which showed a thickened uterine lining, or endometrium. In some places the buildup measured 5 millimeters, in others a "prominent" 10 millimeters. It might be hiding a tumor, benign or otherwise. I had taken medicine known in rare cases to cause endometrial cancer. And truthfully I had twinges down there although I didn't tell anyone. So I had to give in. A D&C might also find fibroids or be done to scrape out clots or other sources of heavy menstrual cramping or bleeding.

I had received at home a booklet on how to prepare. No food or drink, even water or medicine, after midnight on the day of surgery. No aspirin for a week before; no alcohol or smoking the day before. I had to list all the medications I was taking. I did not have to shave the area. I was told to remove all jewelry and leave it at home, wear no makeup, wear casual clothes such as sweats, and a pair of warm socks. General anesthesia meant a friend or family member had to drive me there and back home (no cab riding allowed), and I had to take the day off from work. It was much like the colonoscopy experience I had four years ago.

The risks of the D&C surgery: infection, or perforation of the uterus (described as "a tiny hole" accidentally cut by the curette). If your clinic and surgeon are careful these are unlikely. The normal aftereffects: Spotty bleeding might last for up to 10 days, so wear a pad, but not tampons. I could return to work the next day, but must take "pelvic rest" (no sex!) for seven days. Showering was okay but no tub baths for seven days, because baths might invite post-op infection.

When I woke I asked "Is it over?" Twenty minutes had passed, and the gynecologist was right there saying he found nothing wrong and would call Friday or Monday with the biopsy results, expected to be negative. I asked when I could exercise and he said "tomorrow." He said to take ibuprofen if I had post-op cramping, as about half of patients do. My friend was allowed to sit with me while the nurse served me three halves of graham crackers and a glass of water, and then my friend went to get her car. I was taken to the clinic door in a wheelchair. I felt sleepy and as if I were drunk. I went to bed about 10 a.m. when I got home and slept until 1:30.There was minor cramping, hardly anything, so I took one ibuprofen but could have done without it, and I wore pads for spotting, which was light and watery. The first day afterward you are supposed to eat lightly, so I had a light lunch but ate a normal dinner except I also ate chocolate to celebrate.

The clinic phoned the next day to ask me how I was, and I said, "Just fine." And I'm fine.

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