Endometrial ablation is a quick outpatient treatment for heavy bleeding.
Endometrial ablation is the removal or destruction of the endometrium (lining of the uterus). It does not require hospitalization, and most women return to normal activities in a day or two. Ablation is an alternative to hysterectomy for many women with heavy uterine bleeding who are wish to avoid major surgery. After a successful endometrial ablation, most women will have little or no menstrual bleeding.
How is endometrial ablation done?
Prior to the ablation a biopsy is done to rule out uterine cancer. The ablation is done in conjunction with a hysteroscopy. Hysteroscopy is a small camera that is used to visualize the lining of the uterus. After visualization is performed, a variety of devices can be used to destroy the lining of the uterus. This procedure can be done in the office or as an out-patient procedure.
Recovery from endometrial ablation
Most women are able to go home within an hour after the an endometrial ablation. There may be mild cramping, which can usually be relieved by ibuprofen. Occasionally stronger medicine may be needed. It is normal to be tired for a few days, but most women are able to return to most normal activities in a day or two. Intercourse and very strenuous activity is usually restricted for 2 weeks. It is normal to have a increased discharge for 2 to 4 weeks afterward, as the lining is shedding. I normally do the first check-up 1 and then 4 weeks afterwards.
Who should consider endometrial ablation?
Women with heavy vaginal bleeding that impacts their life and do not have any other medical reasons for removal of their uterus should consider this procedure. This 5-10 minute procedure can often save a woman from a hysterectomy. You should not have this procedure done if you desire future fertility or have been diagnosed with uterine cancer.
Risks of endometrial ablation
As with any surgical procedure, there are risks, which should be compared to the risks of things we do in every day life. A number of things can be done to reduce these risks. Some of the risks of endometrial ablation procedures are perforation of the uterus, absorbing excess fluid, bleeding, infection, injury to organs within the abdomen and pelvis, and accumulation of blood within the uterus due to scarring. Another rare, but important, concern after any endometrial ablation procedure is that it might decrease your doctor's ability to make an early diagnosis of cancer of the endometrium. Abnormal bleeding should be evaluated whether or not you have had an ablation.
A small percentage of properly selected women having an ablation will still eventually need a hysterectomy, but the vast majority will not. Having done a large number of these minimally invasive procedure, Dr. Imtiaz can often identify women who will have a successful ablation and those who would be better off with other treatment.