Endometrial Ablation

Surgery Overview

Endometrial ablation is a type of procedure that's often used to treat heavy menstrual bleeding. It can also be used for other types of bleeding in the uterus. It's not recommended if you plan to get pregnant.

Ablation works by destroying the lining of the uterus (endometrium). As it heals, the lining will scar. This scarring reduces or prevents bleeding.

You may be given gonadotropin-releasing hormone agonists (GnRH-As) 1 to 2 months before endometrial ablation. This can help thin the lining of the uterus before the procedure.

For the procedure, your doctor may give you medicine to help you relax. You may also get medicine to help with pain. First, your doctor places a tool called a speculum into your vagina. This opens the vagina a little bit. Next, the doctor may put a lighted tube through your cervix. This is called a hysteroscope or scope. It helps the doctor see inside your uterus. Then the doctor inserts a device to destroy the lining. This device may work in one of many ways. It may use a laser beam, heat, electricity, freezing, or microwaves.

Ablation can be done in a doctor's office. Or it may be done in a hospital. It usually takes less than an hour. You can go home after the procedure.

What To Expect

After the procedure, you may have some side effects, such as cramping, nausea, and vaginal discharge that may be watery and mixed with blood. This discharge will become clear after a couple of days. It can last for around 1 to 2 weeks.

It takes a few days to 2 weeks to recover. You will probably go home the same day.

Why It Is Done

Endometrial ablation is used to control heavy, prolonged uterine bleeding when:

• Bleeding has not responded to other treatments.
• You don't plan to get pregnant in the future.
• You prefer not to have a hysterectomy to control bleeding.
• Other medical problems prevent a hysterectomy.

How Well It Works

Most people who have endometrial ablation are pleased with the results. It usually reduces menstrual bleeding or stops periods altogether.

But in some cases, more treatment may be needed several years after endometrial ablation. If you're younger, you are more likely to need a repeat procedure.

Risks

Problems that can happen during endometrial ablation include:

• Accidental puncture (perforation) of the uterus.
• Infection of the uterus, fallopian tubes, or ovaries (pelvic infection).
• Bleeding (hemorrhage).
• Blood collecting in the uterus (hematometra).
• Tearing of the opening of the uterus (cervical laceration).

These problems are uncommon but can be severe.