Endometrial curettage (or EMC) is a diagnostic procedure that involves removal of tissue from the endometrium (the inner lining of the uterus).
Why is endometrial curettage done?
EMC's are done to rule out endometrial cancer or pre-cancer in a woman with abnormal bleeding. This includes bleeding between menstrual periods, excessive bleeding during a menstrual period, or bleeding after menopause.
EMC's can be done as a screening test for endometrial cancer in postmenopausal women on estrogen replacement therapy.
EMC's can be done to rule out endometrial cancer or pre-cancer in women who have a thickened endometrial lining shown on ultrasound picture.
How is an endometrial curettage done?
EMC is usually performed in the health care provider’s office with no anesthesia necessary. The woman lies down on her back with knees apart and feet in stirrups.
A speculum is inserted into the vagina to bring the cervix into view and to hold the walls of the vagina open.
An instrument is inserted through the cervix into the uterus. This instrument is a thin, pliable straw-like tube (called a "pipelle") which is used to suction out a small amount of tissue.
The instruments are removed.
The procedure may cause cramping or slight pain, which is temporary.
What kind of comlpications can occur after an endometrial curettage?
Excessive or heavy bleeding may occur.
Endometritis (a rare infection of the uterus) can develop.
Inadvertent injury to the uterus or tearing of the cervix (rare).
Inadvertent injury to bladder or bowel (rare).
What is the outcome of the procedure?
The tissue is sent to the lab for examination to determine if there are any abnormal cells found in the uterine lining. A normal (or negative) result shows no cancerous or precancerous cells (however, a small chance of a false negative result is possible).
Abnormal appearance of the cells could also indicate uterine cancer, or the presence of fibroids or polyps in the uterus. Your health care provider will discuss further testing or treatment options.
You will have an appointment with your doctor about 10 to 14 days after your procedure to discuss results.
What preparation is needed before the procedure?
You should bathe or shower as usual.
If you have a lot of anxiety about having a procedure done ask your doctor to prescribe something to take before the appointment.
Take a non-prescription anti-inflammatory, such as Ibuprofen 800mg, one hour before the procedure. (If you cannot use Ibuprofen, you may take Tylenol)
If you have been advised to take an antibiotic before a procedure due to a heart problem or joint replacement, let your health care provider know. Take antibiotics as directed before the procedure.
You might want to have someone come with you to the appointment, however, it is usually not necessary. Many women drive themselves to and from their appointment.
What should I expect after the procedure?
Recovery time is usually minimal. You can resume daily activities and return to work after the procedure.
In the first week following the procedure, you should expect vaginal discharge and/or bleeding. If you have vaginal bleeding you should use sanitary napkins. Do not use tampons for at least 10 days.
Avoid inserting anything into the vagina for at least 10 days after the procedure. This means no intercourse or use of tampons.
Don’t douche unless your doctor instructs you to.
Your next menstrual flow may be heavier than usual.
You may use nonprescription drugs, such as Tylenol (acetaminophen) or Advil (ibuprofen) for minor pain.
When should I call the doctor?
If vaginal discharge increases or begins to have an unpleasant odor.
If you experience cramping or pain that simple medication does not relieve.
If you have unusually heavy vaginal bleeding or a fever (above 101° Farenheit) develops.
