What is Endometrial Ablation?

November 12, 2012

What is Endometrial Ablation?

An Endometrial ablation procedure is carried out in women who are suffering from irregular and unusual or dysfunctional uterine bleeding.

An endometrial ablation destroys (ablates) the endometrium which is the lining of the uterus. A doctor may use a hysteroscope to look at the inside of the uterus.

The following methods may be used to perform an endometrial ablation:

  • Saline

  • Thermal ablation using radiofrequency

  • Laser thermal ablation

  • Thermal balloon ablation

  • Microwave

  • Freezing

  • Electricity using a resectoscope

Scarring occurs during the healing process of the uterus lining and this normally prevents or reduces the occurrence of uterine bleeding.

This may be performed as an outpatient or at the surgery of the doctor and can take approximately 45 minutes to carry out. A spinal or local anesthetic may be given and in some cases a general anesthetic may be used.

After this procedure has been carried out there may be some side effects. These include a vaginal discharge mixed with some blood which clears after a few days. It may be that a discharge without any blood can last for a couple of weeks. Feeling nauseas and cramps have also been side effects that women have reported. It may take two weeks for a full recovery.

The procedure is effective in controlling prolonged, heavy vaginal bleeding in women who no longer wish to have children and do not want a hysterectomy. Women who have medical problems which makes them unable to get a hysterectomy and the prolonged bleeding has not been reduced with other treatment would also benefit from an endometrial ablation.

After this procedure has been carried out most women will experience less bleeding when menstruating. Approximately half of the women who have had this procedure will stop menstruating. Younger women tend to continue menstruating and a repeat procedure of the surgery may have to be carried out.

Before the procedure is carried out in younger women they may be given GnRH-As (gonadotropin-releasing hormone analogues) for between one to three months before the procedure. By using this hormone the production of estrogen is reduced and the uterus lining becomes thinner.

An endometrial ablation has uncommon but severe risks associated with it and they are cervical laceration, pulmonary edema, pulmonary embolism, accidental perforation of the uterus and accidental burns in the uterus or bowel.

If there is any chance the patient may be at risk of endometrial cancer this procedure is not suitable. The procedure would not be carried out if a woman is considering pregnancy. The lining of the uterus is destroyed and may cause a woman to become sterile. After this procedure some women report regrowth in the uterus lining. If there is any piece of the endometrium left and a woman becomes pregnant serious problems may occur. And if a woman is menopausal other forms of birth control will have to be considered and required.

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