Endometrial ablation is a medical procedure that is used to remove (ablate) or destroy the endometrial lining of a woman's uterus. This technique is most often employed for women who suffer from excessive or prolonged bleeding during their menstrual cycle but can not or do not wish to undergo a hysterectomy. The procedure is most commonly done on an outpatient basis.

Procedure

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The procedure is done via hysteroscope, a lighted viewing instrument inserted into uterus through the vagina and cervix which allows the surgeon to examine the uterus. A second instrument is then used to perform the ablation:

• laser
• radiofrequency
• a saline-filled balloon heated to 85 °C (185 °F) thermal balloon ablation
• electrical current

The procedure is done while the patient is either under general or spinal anesthesia. The recovery period can be from a few days up to 2 weeks. After the procedure, the endometrial heals by scarring, reducing or removing the possibility of future uterine bleeding. The procedure will also render the patient sterile.

Effectiveness

Approximately 90% of women who undergo this procedure will have reduced menstrual bleeding. Of those, approximately 45% will stop having period altogether. However, a second procedure or a hysterectomy will be required in approximately 22% of cases.

Risks

Although uncommon, the procedure can have serious complications including:

• Perforation of the uterus
• Burns to the uterus (beyond the endometrial lining)
• Pulmonary edema or embolism

Sources

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• Palo Alto Medical Association
• Speroff L, Fritz MA. (2005). Dysfunctional uterine bleeding. In L Speroff, MA Fritz, eds., Clinical Gynecologic Endocrinology and Infertility, 7th ed., pp. 548–571. Philadelphia: Lippincott Williams and Wilkins.
• Georgia Reproductive Specialists
• Advanced Gynecology Solutions

Medical treatments