Endometrial ablation is a procedure that destroys (ablates) the uterine lining, or endometrium. This procedure is used to treat dysfunctional or 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
- 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.
Why is it 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
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.
How well it works
Most women will have reduced menstrual flow following endometrial ablation. And up to half will stop having periods altogether.
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) between 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).
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.
