DefinitionThis procedure involves the surgical removal of the lining of the uterus (womb). It may involve using heat, cold temperatures, microwave energy, or other methods.
Reasons for ProcedureEndometrial ablation will likely make menstrual flow lighter. In some cases, it stops menstrual flow completely. The procedure is used to treat menorrhagia —recurrent heavy periods not controlled by medication. Talk to your doctor about your plans for having a baby. This procedure decreases your chance of pregnancy.
Possible ComplicationsComplications are rare, but no procedure is completely free of risk. If you are planning to have endometrial ablation, your doctor will review a list of possible complications, which may include:
- Complications related to anesthesia
- Uterine perforation or organ injury
- Edema (swelling) due to fluid leakage and absorption
- Thermal (heat) injury to the vagina, vulva, or bowel
- Chronic disease such as diabetes or obesity
- Pregnancy or possible pregnancy—procedure should not be done if there is a chance that you are pregnant
- History of pelvic inflammatory disease (PID)—may trigger a recurrence of PID
- Inflammation of the cervix
What to Expect
Prior to ProcedurePrior to the procedure, your doctor will likely:
- Do an endometrial biopsy , ultrasound , or hysteroscopy of your uterus to check for abnormalities and understand the shape and size of your uterus.
- Ask about:
- Your medical history
- Medications or herbs and supplements you take
- Any allergies you have
- Whether you are pregnant or trying to get pregnant
- If you have an intrauterine device (IUD)
- Ask your doctor about your options. There are many types of endometrial ablation.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Take medication to thin the lining of the uterus.
- Arrange for someone to drive you home from the care center. You may also need help at home.
- Avoid smoking .
- Have a light dinner.
- The night before, do not eat or drink anything after midnight.
AnesthesiaThere are three anesthesia options for ablation:
- General anesthesia —blocks pain and keeps you asleep through the procedure
- Regional anesthesia —blocks pain in the area, but you stay awake through the procedure; given as an injection
- Local anesthesia—just the area that is being operated on is numbed; given as an injection
Description of the ProcedureThere are many different ways for the doctor to do this procedure. A simple ablation procedure is short. It can often be done in a care center. Other procedures take longer and need to be done in a hospital.During the procedure, the doctor will not make any incisions to access the uterus. A tiny probe will be inserted through the vagina and into the uterine cavity through the cervix. Depending on the method, the tip of the probe will expand to deliver:
- Radiofrequency—heat and energy
- Cryoablation—freezing temperature
- Heated fluid
- Heated balloon
- Microwave energy
- Electrosurgery—uses electrical current and a heated rollerball or spiked ball); may require general anesthesia
How Long Will It Take?This depends on the type of method. It can take 15-45 minutes or longer.
How Much Will It Hurt?You may feel cramping and discomfort. Your doctor will give you pain medication.
Average Hospital StayThis is usually done on an outpatient basis. You may need to stay there for 1-2 hours. Some methods may require an overnight hospital stay.
Post-procedure CareAt the Care Center or HospitalWhile recovering, the hospital staff may:
- Check blood pressure, heart rate, and breathing
- Check on your fluid status and the electrolytes in your blood
- Washing their hands
- Wearing gloves or masks
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Talk to your doctor about how your fertility has been affected by the procedure. Discuss family planning options.
- Have routine Pap tests.
- Have pelvic exams.