Surgery Overview
Endometrial ablation is a procedure that destroys (ablates) the uterine lining, or endometrium. This procedure is used to treat abnormal uterine bleeding. Sometimes a lighted viewing instrument (hysteroscope) is used to see inside the uterus. Endometrial ablation can be done
by:
- Laser beam (laser thermal
ablation).
- Heat (thermal ablation), using:
- Radiofrequency.
- A balloon
filled with saline solution that has been heated to
85°C (185°F) (thermal balloon
ablation).
- Normal saline (heated free fluid).
- Electricity, using a resectoscope with a loop or rolling ball
electrode.
- Freezing.
- Microwave.
The endometrium heals by scarring, which usually reduces or
prevents uterine bleeding.
Endometrial ablation may be done in an outpatient facility or your doctor's office. The procedure can take up to about 45 minutes. The procedure may be done using a
local or
spinal anesthesia. And general anesthesia is sometimes used.
What To Expect After Surgery
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 and can last for around 1 to 2 weeks.
It
takes a few days to 2 weeks to recover. You can usually go home the same day.
Why It Is Done
Endometrial ablation is used to
control heavy, prolonged vaginal bleeding when:
- Bleeding has not responded to other
treatments.
- Childbearing is completed.
- You prefer not
to have a
hysterectomy to control bleeding.
- Other
medical problems prevent a hysterectomy.
How Well It Works
Most women will have reduced
menstrual flow following endometrial ablation. And up to half will stop having
periods.footnote 1
Younger women are less likely
than older women to respond to endometrial ablation. After an endometrial
ablation, younger women are more likely to continue to have periods and need a
repeat procedure.
Young women may be treated with gonadotropin-releasing hormone analogues (GnRH-As) 1 to 3
months before the procedure. This will decrease their production of
estrogen and help thin the lining of the uterus (endometrium).
Risks
Problems that can happen during endometrial
ablation include:
- Accidental puncture (perforation) of the
uterus.
- Burns (thermal injury) to the uterus or the surface of the
bowel.
- Buildup of fluid in the lungs (pulmonary edema).
- Sudden blockage of arterial blood flow within the
lung (pulmonary embolism).
- Tearing of the
opening of the uterus (cervical laceration).
These problems are uncommon but can be severe.
What To Think About
Regrowth of the endometrium may
occur after you have endometrial ablation. This procedure is not recommended if
you have a high risk for
endometrial cancer.
Do not consider this
procedure if you plan to become pregnant in the future.
Although
this surgery usually causes sterility by destroying the lining of the uterus,
pregnancy may still be possible if a small part of the endometrium is left in
place. This can lead to severe pregnancy problems.
Birth control of some form is needed if you have not
finished
menopause.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Fritz MA, Speroff L (2011). Abnormal uterine bleeding. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 591-620. Philadelphia: Lippincott Williams and Wilkins.
Credits
ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Specialist Medical ReviewerKevin C. Kiley, MD - Obstetrics and Gynecology
Current as ofOctober 13, 2016
Fritz MA, Speroff L (2011). Abnormal uterine bleeding. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 591-620. Philadelphia: Lippincott Williams and Wilkins.