Endometrial ablation is a surgical procedure used to treat women suffering from excessive or prolonged menstrual bleeding and who have not responded to other treatments such as medication. Endometrial ablation removes or destroys the uterine lining, or endometrium, while leaving the ovaries and uterus intact. The endometrium heals by scarring, which reduces or stops future uterine bleeding.
Types Of Endometrial Ablation
There are several different methods of endometrial ablation. Most methods are performed under local or general anesthesia and a hysterscopy to examine the uterine area is commonly performed prior to the endometrial ablation procedure. Common methods of endometrial ablation may include:
Hydrothermal Endometrial Ablation
Hydrothermal endometrial ablation or HTA, uses heated water to destroy the lining of the uterus. Water is heated to 194 degrees and directed into the uterus using a pump device. The water is flushed through the uterus, carefully monitored at all times to ensure it does not enter the fallopian tubes, and drained after approximately 10 minutes.
Microwave Energy Endometrial Ablation
With microwave energy endometrial ablation, a probe is inserted into the uterus through the cervix and it applies microwave energy to the uterine lining, which destroys it.
Freezing Endometrial Ablation
A thin probe is inserted through the cervix and the end of the probe freezes the uterine lining.
Radio Frequency Endometrial Ablation
A probe is inserted through the cervix that emits radio frequency and heat which destroy the uterine lining. Suction is used to remove the destroyed tissue.
After some of the treatments that do not use suction to remove the destroyed tissue, the treated endometrial lining will naturally break down as it would during a typical menstrual period within a few weeks.
Recovery from Endometrial Ablation
After endometrial ablation, most patients experience cramping for up to two days and a watery discharge that may last a few weeks. Most normal activities may be resumed the following day, with the exception of tampon use and sexual activity.
Risks Of Endometrial Ablation
Although it is a common and safe procedure, there are risks to endometrial ablation:
- Burns to the vagina, vulva or bowel when using methods that use heat
- Fluid entering the bloodstream
These are, however, very uncommon. We would discuss all pertinent risks in deciding whether endometrial ablation is the right treatment for a particular patient.