• Piedmont Women's Healthcare

Endometrial ablation is a procedure that uses a lighted viewing instrument (hysteroscope) and other instruments to destroy (ablate) the uterine lining or endometrium. Endometrial ablation can be performed by:

• Laser beam (laser thermal ablation).
• Heat (thermal ablation), using:
  • Radiofrequency.
  • A balloon filled with saline solution that has been heated to 85C.
  • Normal saline.
• 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.

What to expect after surgery
Endometrial ablation is usually performed in an outpatient facility or hospital. The procedure may be performed using a local or spinal anesthesia, although general anesthesia is sometimes used.

It takes a few days to two weeks to recover.

Why it is performed
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 have reduced menstrual flow following endometrial ablation and up to half will stop having periods.

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 either gonadotropin-releasing hormone analogues one to three months before the procedure. This decreases their production of estrogen and helps thin the lining of the uterus.

Risks
Problems that can happen during endometrial ablation include:

• Accidental puncture of the uterus.
• Burns to the uterus or the surface of the bowel.
• Buildup of fluid in the lungs.
• Sudden blockage of arterial blood flow within the lung.
• Tearing of the opening of the uterus.

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.