What is endometrial ablation?
Endometrial ablation is an outpatient surgical procedure for the
treatment of abnormal uterine bleeding in pre-menopausal women.
This may be an alternative to hysterectomy in women who are having
heavy or prolonged menstrual periods. Before a woman has this
procedure she should have a thorough evaluation of her bleeding.
This may include blood tests, ultrasounds and a biopsy of the
endometrium (uterine lining). Hormonal therapy is usually tried
before surgery is performed. Women who fail hormonal therapy or who
cannot take hormones may be candidates for endometrial ablation.
This procedure is not recommended for post-menopausal women or
women who may have uterine cancer.
How is the procedure performed?
The procedure is generally performed in a hospital operating
room with the patient asleep. However, in selected patients it can
be performed in a physician’s office with intravenous or oral
sedation. The goal of the surgery is to destroy the lining of the
uterus, which is the source of the abnormal bleeding. There are
several devices that can accomplish this by utilizing electrical
energy, heated water, microwaves or cryotherapy (freezing). Each
device has its advantages and disadvantages, but there does not
appear to be a significant difference in the results among the
various techniques. The endometrial ablation procedure is performed
by inserting an instrument into the uterine cavity and activating
the energy source. The procedure takes about 10 minutes to
complete. The patient is discharged home shortly afterwards.
What to expect after the procedure
Uterine cramping and mild vaginal bleeding for several days
after the procedure should be expected. Patients are given oral
pain medication to take after the surgery to help with the pain.
Patients can usually return to work 1-2 days after this surgery.
This procedure does not affect your ovaries or ovulation. Therefore
if you were ovulating prior to this surgery, you will still ovulate
afterwards. Endometrial ablation is not a contraceptive procedure
and you should not rely on this for contraception. Pregnancies have
been reported in women who have had an endometrial ablation.
What should happen to your menstrual periods after this surgery
The ideal outcome of this procedure is complete elimination of
menstrual periods. This happens in about 20-25% of patients so you
should not necessarily expect that you will stop having periods
after this surgery. Approximately 60% of patients will still have
menstrual periods, but have a decrease in their flow. Approximately
15-20% of patients will have no improvement in their periods after