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Endometrial Ablation

Endometrial ablation is a minimally invasive procedure used to treat small uterine fibroids and abnormal uterine bleeding by removing a thin layer of the inner lining of the uterus. Your doctor may recommend endometrial ablation if your condition did not respond to other treatments such as hormone therapy or an intrauterine device (IUD).

There are three kinds of endometrial ablation:

  • Radiofrequency ablation. During this procedure, the doctor inserts a probe with an expandable tip into the uterus through the vagina and cervix. The end of the probe carries a mesh-like device that opens inside the uterus and sends radiofrequency energy into the lining. The energy and heat destroy the endometrial tissue.
  • Heated balloon ablation. Heated balloon ablation uses a tool called a hysteroscope to place a balloon into the uterus. The doctor inserts the hysteroscope into the vagina and through the cervix into the uterus. A heated fluid is pumped into the balloon. As the balloon expands, its edges touch the uterine lining, destroying it with heat.
  • Microwave energy ablation. In this procedure, the doctor inserts a special probe into the uterus through the vagina and cervix. The tool applies microwave energy to the uterine lining, which destroys it.

Your doctor will remove any tissue that is destroyed during an ablation procedure through the vagina.

Endometrial ablation is a short treatment that takes about 45 minutes to perform and does not require a hospital stay. Some kinds of ablation are completed in outpatient centers while others can be administered in your doctor’s office.

Many women experience lighter menstrual bleeding after ablation. Between 30 and 50 percent of women stop having periods. This mostly occurs in older women.

If ablation does not control your uterine fibroid symptoms, you may need additional treatment or surgery.

Ablation is not used for women past menopause, and it is not recommended if you have certain conditions such as:

  • Uterine or endometrial disorders
  • Endometrial hyperplasia
  • Uterine cancer
  • Recent pregnancy
  • Uterine infections

Endometrial ablation is also not recommended for women who want to get pregnant. Pregnancy after ablation carries a high risk of miscarriage and other problems because the uterine lining is removed. For this reason, doctors recommend using birth control after ablation and until you complete menopause.

Additional risks include:

  • Infection
  • Bleeding
  • Damage to the uterine wall or bowel
  • Burns from electrosurgery
  • Leaking of fluid used to expand the uterus during the procedure into the bloodstream 

Because you retain your reproductive organs, you will still need routine Pap tests and pelvic exams after an endometrial ablation procedure.

How We Can Help

How We Can Help

Endometrial Ablation Treatment Information

What to Expect

Your doctor will check the size, shape and health of your uterus before performing an ablation. If you have an IUD, it must be removed before the procedure.

Your doctor will take a biopsy of the lining of your uterus before the procedure to make sure you do not have cancer. He or she may also perform other tests to check the size and shape of your uterus and make sure ablation is an appropriate treatment. Possible tests include:

Your doctor will talk with you about any medicines and supplements you take. You may need to stop taking medicines that reduce your blood’s ability to clot, including:

Talk with your doctor about the pain medicine that will be used during the ablation. You may receive general anesthesia or light sedation depending on which procedure you undergo.

Your cervix may be dilated before the procedure. Your doctor will use medicines or a series of rods to gradually increase its size. Talk with your doctor about what to expect.

Procedure

Follow instructions from your doctor the night before your procedure. If you will receive general anesthesia, you likely will not be able to eat or drink after midnight.

On the day of the procedure:

If you receive general anesthesia, you will be moved to a recovery room after the procedure. A nurse will monitor your vital signs as you wake up. If you receive light sedation, you will relax in the doctor’s office until the sedation wears off. Recovery takes about two hours depending on the type of pain relief used.

You can expect frequent urination for 24 hours after the procedure. You may also experience nausea. Before you go home, your doctor will talk with you about when you can exercise, have sex or use tampons.

Results

If the doctor took samples of uterine tissue during the ablation procedure, biopsy results will be available within one or two weeks.

Your doctor will share the results with you and talk to you about what they mean.

Recovery Time

Once you are home, you should expect some minor side effects such as:

Be sure to follow your doctor’s instructions about when you can exercise, have sex or use tampons. In most cases, you can return to work and your normal activities within a day or two.

Your regular menstrual bleeding should be much lighter after ablation, or menstruation may stop altogether.

Physician Follow-Up

Your doctor will schedule a follow-up visit about three months after the ablation procedure to check your progress. It can take several months to experience the full effects of ablation.


Endometrial Ablation Locations & Physicians

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