What is the Difference Between a D&C and a Hysteroscopy?
A D&C (dilation and curettage) and a hysteroscopy are both procedures performed on the uterus, but they differ significantly in their approach and purpose. A D&C involves widening the cervix and using an instrument to scrape the uterine lining, while a hysteroscopy uses a thin, lighted tube inserted into the uterus to visualize and often treat internal issues.
A D&C is a procedure where the cervix (the opening of the uterus) is widened, and a special instrument is used to scrape some or all of the uterine lining. This procedure is used to:
- Remove tissue remaining after a miscarriage or abortion to prevent infection or heavy bleeding.
- Collect a tissue sample for examination (diagnostic D&C).
- Remove tumors.
A D&C allows for the collection of a larger tissue sample compared to a hysteroscopy. As noted by Mayo Clinic, a D&C can be used to "Prevent infection or heavy bleeding by clearing tissues that remain in the uterus after a miscarriage or abortion." It is important to note that sometimes a D&C is performed in conjunction with a hysteroscopy, as stated by UpToDate.
Hysteroscopy
Hysteroscopy is a minimally invasive procedure where a thin, flexible tube with a camera (hysteroscope) is inserted through the vagina and cervix into the uterus. This allows the doctor to directly visualize the inside of the uterus. The procedure's primary purpose is to diagnose and treat conditions such as:
- Abnormal uterine bleeding.
- Fibroids or polyps (which can then be removed during the procedure).
- Evaluate the uterine cavity after a miscarriage.
As detailed by Cleveland Clinic, "Hysteroscopy is primarily used to diagnose and treat the causes of abnormal uterine bleeding. The procedure allows your surgeon to look inside of your uterus." In contrast to a D&C's scraping method, a hysteroscopy allows for precise removal of growths using surgical instruments. Women's Healthcare states that "While a hysteroscopy enables your provider to find growths and remove them with precise surgical instruments, a D&C allows your surgeon to sample greater amounts of tissue from your uterine uterine lining by performing a gentle scraping."
Key Differences Summarized
| Feature | D&C | Hysteroscopy |
|---|---|---|
| Method | Scraping of uterine lining | Direct visualization using a hysteroscope |
| Purpose | Tissue sampling, removal of tissue | Diagnosis and treatment of uterine issues |
| Tissue Sample | Larger sample | Smaller, targeted sample |
| Precision | Less precise | More precise |
