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Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.
When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.
What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don’t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.
The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.
After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman’s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor. Consult an expert & get answers to your questions!
Hi doctor, What are the chances of me getting breast cancer if my mom has got it during her menopause? I am getting married soon and this has raised a concern in my fiance's mind.
Sir slip disk ka koi treatment hai without operation kyu ki mujhe slip disk ka problem hai 4 months ho gaye hai dawai khate khate par koi aram nai hai.
A Pap Smear is a screening test done to to test for occurrence of uterine cancer. Carried out in a quick and simple way to extract a sample, the sample is collected from the cervix area of a woman during a pelvic exam. The examination of the sample takes place under a microscope thereafter to find abnormalities that can point towards cancer and pre cancer changes.
There are many reasons why women should get a pap smear screening done:
1. Women who are HIV positive should get this test done regularly so as to detect any anomalies in the cervix. This condition usually comes with higher risk of infections and cancer, which is why regular screening is required.
2. Age is also another factor and women over the age of 30 should go through an annual screening on a compulsory basis. This is also true for women who have been through pregnancy and child birth.
Preparing for a Pap Smear: To prepare for a pap smear test, you need to ensure that you are not menstruating at the time. Also, you may want to avoid sexual activity just before the test so as to get the most accurate readings. During the process, remember to stay calm and relax your body physically.
Procedure: The pap smear procedure is a quick one that might be only slightly uncomfortable. This test is usually carried out on the examination table at the gynecologist's clinic. The legs will need to be spread and placed in stirrups. The doctor will insert a speculum to hold open the vaginal opening so that the spatula can be inserted easily to take a sample from the area. This sample of the cells will be tested in a lab after due preservation.
Test Results: The test results can either be normal or abnormal. An abnormal result does not point at the presence of cancer. Rather it can simply mean that abnormal cells exist in the cervix. The doctor may ask you to go through these tests and screening more frequently so as to study the anomalies in a more detailed manner. Consult an expert & get answers to your questions!
Kidney cancer or renal cancer is when kidney cells grow uncontrollably and form a tumour. Kidney cancer often begins in the tubules (tiny tubes in the kidneys). The prognosis may depend on the stage of the kidney cancer.
Different Stages of Kidney Cancer
The TNM system helps to categorize each stage of the kidney cancer.
Tumour (T) – Describes the size and location of the tumour.
Node (N) – Describes the spread of cancer to lymph nodes.
Metastatis (M) – Describes the spread of cancer to other body parts.
These results combined with the five stages (0 and 1 to 4) can help to identify the right treatment option for every patient. Zero stage describes no cancer presence. For instance –
Stage 1 – Here the tumour is confined to kidneys and its size is smaller than 7 centimetres. (T1 or T1, N0, M0)
Stage 2 – Here the tumour is confined to kidneys and its size is more than 7 centimetres. (T2)
Stage 3 – Here the tumour is in kidneys or blood vessels or fatty tissues but also a lymph node; cancer spreads to major veins but doesn’t extend beyond renal or Gerota’s fascia (connective tissues surrounding adrenal glands and kidneys). (T3)
Stage 4 – Here the cancer is in the fatty tissues surrounding kidneys and adjacent lymph nodes; has spread to other nearby organs and beyond renal fascia. (T4)
Treatment and management of kidney cancer
Once your doctor has determined the staging of your kidney cancer, a treatment plan can be formulated for you.
- Simple nephrectomy removes the affected kidney.
- Radical nephrectomy is a common surgery for kidney cancer. It removes all affected parts such as the kidneys, adrenal gland, lymph nodes and surrounding tissues.
- Partial nephrectomy is for small tumours and removes the kidneys and the surrounding tissues.
- Interventional radiology: This is a surgery aided by real-time images. An advanced surgery using a nano knife is minimally-invasive and is effective for inoperable kidney tumours.
- Targeted therapy: Drugs target specific tumour cells and destroy them.
- Immunotherapy: Used for kidney cancer that has spread to other organs, this therapy may use different types of drugs to either help immune cells find cancer growth or regulate the immune system activity to stop or slow cancer growth.
- Arterial embolization: It is a procedure to stop blood supply to the kidney tumour, in order to shrink it in size prior to surgery.
- Cryotherapy: This procedure involves using extreme cold to kill cancer cells.
Chemotherapy is not very effective for treating kidney cancer. Talk to your doctor about all possible treatment options for your cancer. You can lower your risk of kidney cancer by eating healthy, maintaining your ideal body weight and managing your blood pressure.
MY WIFE RECENTLY HAD A CT SCAN & THE IMPRESSIONS ARE AS FOLLOWS: * Bilateral vocal cord palsy (more prominent on left side) * Few enlarged left supraclavicular lymph nodes * ~3 x 2 cm irregular mass in medial aspect of right upper lobe of lung, infiltrating the mediastinal pleura-suggestive of malignancy (metastases - known carcinoma of left breast) * I11 defined soft tissue rind measuring ~1 cm in thickness in superior mediastinum, encasing the mediastinal structures- suggestive of malignancy (spread from pleura / metastatic lymphodes) * ~2 cm right perihilar mediastinal lesion. * Multiple nodules measuring about 2 mm to 5 mm in both lungs- suggestive of metastases. * Moderate pericardial effusion. * Thin layer of left pleural effusion. I KNOW IT IS RELATED TO CANCER, BUT I WANT TO KNOW EXACTLY WHAT TYPE OF CANCER IT IS & WHAT IS THE SURVIVAL CHANCE (PERIOD) FOR PATIENT TAKING TREATMENT & PATIENT NOT TAKING ANY TREATMENT. KINDLY GIVE YOUR VALUABLE SUGGESTION. Thanks & Regards
Different methods to treat Disc problems
Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.
Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.
They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.
All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.
If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.
You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.