As the second most frequently performed gynecologic operation, uterine curettage is used for diagnostic and therapeutic considerations and for the following indications:

1. Polymenorrhea: menstrual cycle interval less than 21 days.

2. Oligomenorrhea: menstrual cycle interval more than 37 days.

3. Metrorrhagia: menstrual bleeding longer than 7 days, or interval bleeding.

4. Menorrhagia: excessive or prolonged menstrual bleeding.

5. Postmenopausal bleeding or uterine bleeding occurring more than 12 months after the last menstrual period in a menopausal woman.

6. Breakthrough bleeding or intermenstrual bleeding in a menstrual cycle that is the result of exogenous hormones.

7. Dysfunctional uterine bleeding: characterized by any abnormal uterine bleeding in the absence of pregnancy, neoplasm, infection, or uterine lesion.

8. Spontaneous abortion, fetal death in utero, septic abortion, legal termination of pregnancy, dilation and evacuation of gestational trophoblastic neoplasias, incomplete abortion, or inevitable abortion.

The most common of the above complications are incomplete abortion, postmenopausal bleeding, and dysfunctional uterine bleeding. Curettage of the uterus responds to these conditions by removing endometrial or endocervical tissue for histologic study and evacuating products of conception.

It is extremely important that dilation and curettage be performed correctly for the proper indications and with minimal morbidity, as serious complications and even death may result from poor and inappropriate application. While regional and local anesthesia may be used, general anesthesia is usually administered to allow more abdominal relaxation for optimal bimanual examination of the pelvic viscera. The operative time for dilation and curettage is less than 15 minutes. Transfusion is rarely indicated unless significant preoperative hemorrhage has occurred, usually associated with pregnancy.