Key Points about Endometrial Ablation Procedure
Endometrial ablation is a surgical intervention targeting the removal of a portion of the uterine lining (endometrium) to address non-cancerous disorders causing abnormal uterine bleeding. This procedure involves the surgical destruction of the endometrial tissues and is a viable treatment option for benign conditions leading to abnormal uterine bleeding. Endometrial ablation is not recommended for women desiring future pregnancies, those with active genital tract infections, or as a first-line therapy for heavy bleeding. Various methods, including laser beams, electricity, freezing, and heating, are employed for endometrial ablation, with the choice depending on multiple factors. While most women experience a successful reduction in abnormal bleeding, some may require further surgery due to endometrial regrowth.
Understanding Endometrial Ablation
Endometrial ablation entails the surgical removal or destruction of the endometrial lining, specifically designed to address abnormal uterine bleeding resulting from benign conditions.
Indications for Endometrial Ablation
Endometrial ablation is performed to treat abnormal uterine bleeding caused by non-cancerous conditions. However, it is not suitable for cases involving uterine cancer, as cancer cells may extend beyond the reach of the procedure.
Considerations for Endometrial Ablation
This procedure is reserved for non-pregnant females without plans for future pregnancies and should not be performed during an active genital tract infection. It is considered only when medical and hormonal therapies prove insufficient in controlling bleeding.
The Endometrial Ablation Procedure
Before undergoing endometrial ablation, a woman must undergo an endometrial sampling to rule out cancer. Imaging studies and hysteroscopy may be conducted to identify any underlying issues like polyps or fibroids. Hormonal therapy may precede the procedure to shrink the endometrium, enhancing the success of ablation.
The actual procedure involves dilating the cervical opening to facilitate instrument passage into the uterine cavity. Different methods, such as laser beams, electricity, freezing, or heating, are employed based on factors like surgeon preference, uterine characteristics, and anesthesia preferences.
Risks and Complications
While complications are infrequent, they may include accidental perforation of the uterus, damage to the cervical opening, infection, bleeding, and, rarely, pulmonary edema. Some women may experience minor side effects like cramping, nausea, and frequent urination following the procedure.
Outlook After Endometrial Ablation
The majority of women report a successful reduction in abnormal bleeding after endometrial ablation. Up to half may cease having periods. However, studies indicate a failure rate of 16% to 30% at five years, with failure more likely in younger women and those with specific medical histories. Repeat ablations or other uterine-sparing procedures may be necessary in some cases.
It's crucial to note that although endometrial ablation typically results in infertility, it should not be considered a form of birth control. Pregnancy can still occur in remaining or regrown endometrial tissue, potentially leading to severe complications. Therefore, the procedure is contraindicated for women desiring future pregnancies.
