Endometrial Ablation

A procedure that surgically destroys or ablates the lining of your uterus or endometrium is called endometrial ablation and this is done to reduce the menstrual flow.

In some cases, the menstrual flow will stop completely. There are no cuts needed for this procedure.

Your doctor may insert slender tools through a passageway between your uterus (cervix) and your vagina.

The tools will be based on the method that will be used to ablate the endometrium. Your doctor may use heated fluids, extreme cold, high-energy or microwave energy frequencies.

Some of the types of endometrial ablation may be done in an operating room and some in your doctor’s office.

To determine which endometrial ablation method is going to be used, there are factors that will be considered such as size and condition of your uterus.

The main reason for an endometrial ablation is a treatment for excessive menstrual blood.

Your primary care doctor may suggest this if you have: bleeding that lasts longer than eight days; anemia from excessive blood loss; unusually heavy bleeding that sometimes defined as soaking a tampon or pad every two hours or less.

Your doctor may first prescribe medications or intrauterine device (IUD) to reduce the menstrual bleeding. This procedure will be an option if the said treatments do not help.

This procedure is not recommended for women who are on postmenopausal or who have: an active pelvic infection; certain abnormalities of the uterus; cancer of the uterus or an increased risk of uterine cancer.

The potential risks of endometrial ablation include a puncture injury of the uterine wall form surgical instruments, pain and bleeding of infection, cold or heat damage to nearby organs.

After this procedure pregnancy can occur but these pregnancies carry a high risk for both the mother and the baby.

The pregnancy may occur in the fallopian tubes or cervix instead of the uterus (ectopic pregnancy) or it may end in miscarriage because the lining of the uterus has been damaged.

Long lasting sterilization or contraception is recommended to prevent pregnancy if you are having endometrial ablation.

In preparing for the endometrial ablation, your doctor may:

• perform a pregnancy check because this procedure is not allowed if you are pregnant
• check for cancer by using a catheter that will be inserted through your cervix to get a sample of your endometrium
• remove an IUD because this procedure cannot be done with an IUD in place
• thin your endometrium because this procedure is mostly successful if the uterine lining is thin, your doctor may perform a dilation and curettage (D&C) or may prescribe a medication
• talk about anesthesia options because some methods will require a general anesthesia and some will be performed with conscious sedation or with numbing shots in your uterus or cervix

Read on to learn more about what to expect before, during, and after your endometrial ablation.

Some types of this procedure may be done in your doctor’s office and some may need general anesthesia.

The opening of your cervix will be dilated to allow the passage of the instruments used in endometrial ablation and this can happen by medication or the insertion of a series of rods that will increase in diameter gradually.

Some of the endometrial ablation procedures include:

Electrosurgery – this requires a general anesthesia and a slender scope will be used to see the inside of the uterus. A wire loop will be heated and used to carve furrows into the endometrium.

Cryoablation – an extreme cold will be used to create two to three balls that will freeze and destroy the endometrium. To track the progress of the ice balls, your doctor may use real-time ultrasound. Each freeze cycle can take up to 6 minutes and the number of cycles needed will depend on the shape and size of your uterus.

Free-flowing hot fluid – for about ten minutes, heated saline fluid is circulated within the uterus and the advantage of this method is that it can be performed in women who have irregularly shaped uterus from abnormal tissue growth.

Heated balloon – this procedure can take from two up to ten minutes depending on the type of balloon device and this is done by inserting the balloon through your cervix and will then be inflated with heated fluid.

Microwave – a wand will be inserted through your cervix and this wand emits microwaves that heat the endometrial tissue, this lasts three to five minutes.

Radiofrequency – a special instrument will be inserted into the uterus and this device will transmit radiofrequency energy that vaporizes the endometrial tissue in about one to two minutes and will be removed from the uterus after.

After endometrial ablation, you may feel vaginal discharge which a watery discharges that is mixed with blood and can occur for a few weeks; cramps that can occur for a few days but you can take over-the-counter medications such as ibuprofen or acetaminophen for the relief; frequent urination that can occur during the first 24 hours after the procedure.

The final results may be seen after a few months but endometrial ablation mostly reduces the amount of blood lost during menstruation though some women will have lighter periods and some will stop having periods entirely.

You should continue to use contraception because endometrial ablation is not a sterilization procedure. Pregnancy is still possible but may end in miscarriage.