Definition An endometrial ablation is the removal or destruction of the lining of the uterus, called the endometrium. The purpose of this procedure is to end or reduce the menstrual flow. It is done when a woman has heavy menstrual periods but no evidence of cancer of the uterus. The procedure provides an alternative to hysterectomy, or complete removal of the uterus. For 60% of women who have the procedure, monthly periods stop completely. Flow is reduced for another 30%.
Who is a candidate for the procedure? Women may be considered for this procedure if they:
have heavy monthly periods that severely interfere with their activities
How is the procedure performed? This operation is done in a same day surgery setting. Either general anaesthesia or regional anaesthesia can be used. General anaesthesia means the person is put to sleep with medications. Regional anaesthesia means the person will be awake, but numb below the waist. A medication may be given to make the person drowsy.
A tool called a hysteroscope is inserted into the vagina. This contains a camera and light source. The device is then advanced through the cervix and into the uterus. This allows the doctor to view the inside of the uterus on a television screen. The endometrium and some of the underlying tissue is scraped off. The wall of the uterus is then cauterised to stop bleeding. Cauterization destroys the tissue with an electric current.
A newer method, called balloon ablation, has been used since 1998. In this procedure, a specially constructed balloon is placed within the uterus and a sterile fluid, heated to 87 degrees Celsius, is pumped through the balloon. The heated fluid destroys the lining of the uterus without affecting the rest of the uterus or other pelvic organs.
What happens right after the procedure? After the surgery, the woman is taken to the surgery recovery room. There she is watched closely for a short time. Her temperature, blood pressure, pulse, and breathing are checked often. The woman may have some cramps in her lower abdomen for the first 24 hours. Analgesics such as paracetamol can be used for the cramps. She may also have a small amount of vaginal bleeding. The woman may have some nausea from the anaesthesia, as well.
What happens later at home? A woman should rest for the first day or two after the procedure. She can usually go back to her normal schedule within 4 to7 days. It is important that she not insert anything into her vagina for 2 weeks. This means she should not use tampons, douche, or have intercourse. During this time, pain relief may be taken for cramps. Vaginal bleeding should stop after a few days.
What are the potential complications after the procedure? Complications can include bleeding, infection, and allergic reactions to the medications used for anaesthesia. Rarely, uterine wall is punctured during the procedure.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
