Concierge gynaecology · London
Dilation and curettage (D&C), a modern patient guide.
A consultant-led guide to D&C in 2026 — when it is still the right step, when outpatient hysteroscopy with a Pipelle biopsy is better, and how the procedure is done safely.
Why patients choose us
- 01
A consultant gynaecologist, in theatre
A named gynaecologist, a licensed theatre, and the anaesthetic that suits you — not a training list and not a rushed slot.
- 02
Outpatient hysteroscopy first, where possible
In modern UK practice most diagnostic D&Cs have been replaced by outpatient hysteroscopy and a Pipelle biopsy. We say so before you commit to theatre.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private D&C — or its outpatient alternative — costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A surgical management of miscarriage in our network: £2,600–£4,800, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Diagnostic D&C under GA | £2,400–£4,500 | 30 min | Same visit |
| Surgical management of miscarriage (SMM) | £2,600–£4,800 | 30–45 min | Same visit |
| Evacuation of retained products (ERPC) | £2,600–£4,800 | 30–45 min | Same visit |
| Outpatient hysteroscopy + Pipelle biopsy | £950–£1,600 | 20 min LA | Same visit |
| Pipelle endometrial biopsy alone | £350–£650 | 10 min | Same visit |
| Consultant gynaecology consultation | £220–£400 | 30 min | Same visit |
Prices vary by clinic, by which gynaecologist does the case, by the anaesthetic chosen, and by whether hysteroscopy is done at the same visit. We come back with a firm quote within one working day.
The problem
The right test, the right anaesthetic, the right pathway.
A D&C is offered too readily in some clinics and refused too readily in others. We map the alternatives — outpatient hysteroscopy, Pipelle biopsy, medical management — before agreeing to theatre.
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Not sure it is needed?
An outpatient hysteroscopy with a Pipelle biopsy may answer the question without theatre. We say so before you agree.
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Miscarriage, and choosing?
Expectant, medical or surgical — all three are valid. A consultant helps you weigh them without pressure.
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Want it done properly?
A named consultant gynaecologist, a proper theatre, vacuum aspiration where appropriate, and anti-D if you are RhD negative.
The journey
From enquiry to histology — what happens, in order.
One clinician from first message to the follow-up conversation about your results.
Phase 1 · Before your procedure
Assessment and imaging
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Histology and review
- 01
Before
You tell us what is going on
A short, confidential form. Bleeding pattern, pregnancy status, previous scans, and any suspected miscarriage or retained tissue.
- 02
Before
Assessment and imaging
Transvaginal ultrasound, bloods and — where appropriate — outpatient hysteroscopy with a Pipelle endometrial biopsy first, to avoid theatre if we can.
- 03
Before
We arrange the D&C if needed
If a D&C is the right step, we book it under LA, sedation or GA — usually within one to two weeks. Anti-coagulation and anti-D status are reviewed with the team.
- 04
On the day
Arrival at the clinic
Consent, and a chat with the gynaecologist and anaesthetist. Fasting only if sedation or GA is planned.
- 05
On the day
The procedure itself
Speculum, cervical dilation with Hegar dilators, and gentle curettage or vacuum aspiration of the uterine lining. 15 to 30 minutes. Samples go to histology.
- 06
On the day
Home the same day
A short recovery, written aftercare, and home within a few hours. With sedation or GA you will need someone to collect you.
- 07
After
Histology and follow-up
Endometrial or products-of-conception results in one to two weeks. A review to discuss findings, anti-D if needed, and next steps.
Typical end-to-end: 1–2 weeks from enquiry to procedure. Histology: 1–2 weeks after.
When it helps
When a D&C is still the right step.
The clinical situations where D&C — or its close relative, vacuum aspiration — is still the standard of care, plus the red flag that means an emergency rather than an appointment.
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Postmenopausal bleeding
Any bleeding after menopause needs the endometrium sampled — usually by hysteroscopy and Pipelle, occasionally by D&C.
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Incomplete miscarriage
Retained pregnancy tissue after an early miscarriage — a surgical management of miscarriage (SMM) is one of three valid options.
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Retained products of conception (RPOC)
Persistent bleeding or infection after delivery, medical abortion or miscarriage when tissue remains in the uterus.
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Intermenstrual or heavy bleeding
Investigation of unexplained bleeding when outpatient hysteroscopy is inconclusive or not tolerated.
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Missed miscarriage
A pregnancy that has stopped developing but not yet passed — SMM by vacuum aspiration is one option alongside expectant and medical.
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Surgical abortion up to 12–13 weeks
Vacuum aspiration under LA, sedation or GA — one of the standard, safe methods of surgical abortion in the UK.
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Endometrial sampling in a difficult uterus
Cervical stenosis, tolerance issues or a distorted cavity where outpatient sampling has failed.
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Red flag: heavy bleeding with pain and fever
Heavy bleeding, severe pain or fever after any uterine procedure is not normal — same-day A&E, not a clinic booking.
Procedure options
D&C is not the only option.
What each option on the table actually involves — and which fits which problem.
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Diagnostic D&C
Cervical dilation and gentle curettage to sample the endometrium. Now largely replaced by outpatient hysteroscopy with Pipelle biopsy.
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Surgical management of miscarriage (SMM)
Vacuum aspiration of the uterus for missed or incomplete miscarriage — the quickest way to complete the process for those who prefer surgery.
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Evacuation of retained products (ERPC)
For retained pregnancy tissue after delivery, medical abortion or miscarriage causing bleeding, pain or infection.
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Vacuum aspiration for abortion
Surgical abortion up to 12 to 13 weeks. Suction aspiration through the cervix under LA, sedation or GA.
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Outpatient hysteroscopy
A camera into the uterus in clinic without a general anaesthetic — the modern first-line investigation for abnormal uterine bleeding.
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Pipelle endometrial biopsy
A thin plastic sampler passed through the cervix in clinic. Two minutes, no anaesthetic, and enough tissue for histology in most cases.
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Expectant management of miscarriage
Waiting for a miscarriage to complete on its own. Safe for many women — the trade-off is unpredictable timing.
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Medical management with misoprostol
Tablets to complete a miscarriage at home — an alternative to surgery, with a clear plan for pain relief and safety-netting.
Our vetted London network
A small panel of gynaecologists, we picked them.
Consultant gynaecologists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every gynaecologist in our network.
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Consultant gynaecologists, not trainees or general clinicians
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Outpatient hysteroscopy and Pipelle biopsy offered before theatre where appropriate
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Sedation and GA available for anxious patients or difficult procedures
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Rhesus status checked and anti-D given where indicated
Safety and recovery
The risks worth knowing about — honestly.
A D&C is a common, safe day-case procedure — but the risks are real. Uterine perforation, Asherman’s syndrome, incomplete evacuation, infection and haemorrhage are the ones worth naming.
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Uterine perforation (0.5–5%)
A dilator or curette occasionally passes through the uterine wall. Most perforations are small and settle with observation; a few need laparoscopy.
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Asherman’s syndrome
Over-vigorous curettage can create intrauterine adhesions, later causing scanty periods, pain or difficulty conceiving. Modern vacuum technique reduces the risk.
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Incomplete evacuation
Retained tissue after SMM or ERPC can cause continued bleeding and may need a repeat procedure — a scan at follow-up checks the cavity.
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Infection
Endometritis after any uterine procedure is uncommon but real. Fever, offensive discharge or worsening pain in the first two weeks needs antibiotics.
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Haemorrhage
Heavy bleeding can occur during or after the procedure. Rarely, this needs medication, a repeat procedure or transfusion.
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Cervical trauma and cervical stenosis
The cervix can be torn during dilation, or later scar down. Both are uncommon and usually treatable.
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Anti-D if you are Rhesus negative
Any uterine procedure in pregnancy in a RhD-negative woman needs anti-D immunoglobulin to prevent sensitisation of a future pregnancy.
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It is a diagnostic step, not a cure
A diagnostic D&C tells us what the endometrium looks like — the treatment depends on what the histology shows.
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Red flags
Fever, heavy bleeding soaking a pad an hour, severe pain or shoulder-tip pain after the procedure are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the procedure was a diagnostic D&C, an SMM or an ERPC, the note the gynaecologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and pregnancy status
Why the procedure was done — postmenopausal bleeding, missed miscarriage, RPOC, abortion — and the gestation or endometrial thickness at the time.
- 02 Technique
Anaesthetic and surgical technique
Whether it was done under LA, sedation or GA; the size of Hegar dilator used; and whether vacuum aspiration or sharp curettage was chosen.
- 03 Findings
Cavity, tissue obtained, and estimated blood loss
The appearance of the cavity, whether products of conception were seen, tissue sent to histology, and blood loss on the day.
- 04 Impression
Anti-D, follow-up and histology plan
Read this first: whether anti-D was given, when to expect histology, what to watch for, and when a follow-up scan or clinic is booked.
Recognised by major UK insurers
Cover for D&C varies by insurer and by indication — usually funded when medically indicated (postmenopausal bleeding, RPOC, SMM). We confirm cover before booking.
Frequently asked
Everything we get asked about D&C.
Straight answers on modern practice, alternatives, fertility, and recovery.
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Is a D&C still done in the UK in 2026?
Yes, but far less often than a generation ago. Most diagnostic D&Cs have been replaced by outpatient hysteroscopy with a Pipelle endometrial biopsy. D&C is still used for surgical management of miscarriage, evacuation of retained products of conception, surgical abortion up to 12–13 weeks, and occasionally for endometrial sampling when outpatient techniques have failed.
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What are the alternatives to a D&C for a miscarriage?
Three options are considered valid by NICE (NG126): expectant management (waiting), medical management with misoprostol tablets, and surgical management of miscarriage (SMM) by vacuum aspiration. None is medically superior — the right choice depends on the clinical picture, your preferences and the setting.
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Does a D&C hurt?
During the procedure you feel nothing — the area is fully numb under LA, or you are asleep under sedation or GA. Afterwards there is cramping and light to moderate bleeding for a few days, controlled with simple painkillers.
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Will a D&C affect my future fertility?
For most women, no. The main fertility-related risk is Asherman’s syndrome — intrauterine adhesions from over-vigorous curettage. Modern gentle vacuum technique makes this uncommon, but it is the reason we do not do a D&C without a clear indication.
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What is Asherman’s syndrome?
Scarring inside the uterus after aggressive curettage, causing scanty or absent periods, cyclical pain and sometimes infertility or recurrent miscarriage. Diagnosis is by hysteroscopy and treatment is by hysteroscopic adhesiolysis. The risk is higher after repeated procedures for retained products of conception.
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When should I get urgent help after a D&C?
Fever above 38°C, heavy bleeding soaking more than one pad an hour for two hours, severe worsening abdominal pain, offensive vaginal discharge, or shoulder-tip pain (a possible sign of uterine perforation) all need same-day medical attention.
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