Uterine surgery | Dilation and curettage (D&C)

Hysterectomy is one of the most common surgical procedures in the Western world. In about 90% of cases, a hysterectomy is performed due to benign conditions or changes in the uterus. These include benign tumours in the muscle cells called fibroids. A prolapsed uterus or treatment-resistant endometriosis are common indications. Although these changes are benign, they can lead to severe symptoms that significantly affect the woman’s daily life. Only 10% of women who have a hysterectomy have a malignancy, e.g., cervical or ovarian cancer. In rare cases, removal of the uterus may be required in an obstetric emergency (for example, due to severe, unmanageable bleeding).


Removal of the uterus can be carried out in various ways. Surgery is possible via the vagina, via an open abdominal incision or laparoscopically. These days the most commonly used method is laparoscopic hysterectomy, in which access is via 5 to 10 mm-long incisions in the abdominal cavity. The uterus may be either partially (supracervical) or totally removed (i.e. including the cervix). This is performed via the vagina and then sutured. In a partial hysterectomy, the remaining cervix and the rectum are fixed in place. Different surgeons use different techniques for this, which can also help prevent future problems with prolapse. If the ovaries and/or fallopian tubes also need to be removed – removal of the fallopian tubes is known as salpingectomy – this is performed in the same step. The technique used in each specific case depends on the underlying condition and the woman’s individual situation (for example, previous surgery, size of the uterus, desire to preserve the cervix, menopause, etc.). The desire for children will also influence the type of treatment and the choice of procedure.

Side effects and follow-up-care

The procedure is low-risk and is generally without complications. As with all surgery, however, infection, nerve injury or bleeding may occur in rare cases. Even with the greatest of care from the surgeon, injuries to the surrounding organs cannot be ruled out, especially if there are adhesions present, for example. These problems can usually be detected and corrected during surgery, and rarely require a second operation. As a result of the laparoscopy, there may be slight abdominal cramping and flatulence for a few days after surgery. A hysterectomy takes between one and two hours and requires a stay of two to three nights at the clinic. Strenuous physical activity and lifting heavy loads must be avoided for some time after the operation. Sexual intercourse should also be avoided for some time.

Dilation and curettage (D&C)

Dilation and curettage (D&C) is performed following a miscarriage or abortion, as well as for excessive bleeding due to hyperactive uterine lining production. The hysteroscope is inserted into the uterus via the vagina in order to view the uterus. Tissue is removed from the uterus and cervix with a curette, which is like a sharp spoon. Strenuous physical activity should be avoided for around three weeks after the procedure and bathing, swimming and sexual intercourse should also be avoided.