Endometrial ablation is a surgical procedure in which the endometrium (or uterine lining) is removed permanently. The endometrium is the lining of the inside of the uterus, and its growth and subsequent shedding is what causes the bleeding of menstruation.
The burning away or removal of the endometrium is not exactly a permanent procedure, because the endometrium does grow back – especially in younger women. However, having more than one ablation is not advised.
Women who choose this procedure usually undergo it as a last resort. It is tantamount to sterilisation, especially in older women whose endometrium will not likely grow back.
Why is it done?
Some women have abnormally long or heavy menstrual periods, which could be caused by a host of factors including polycystic ovarian syndrome (PCOS) and fibroids. However, in a percentage of women, the causes of the bleeding is not known, this condition is called dysfunctional uterine bleeding (DUB).
Endometrial ablation is one method for treating DUB; the removal of the endometrium will cause the bleeding to cease.
It can also be a treatment for severe PMS and dysmenorrhoea (painful periods), albeit a rather fatalistic one. In fact, it should be approached as a last resort treatment because of its invasive process and the complications it can incur. In addition to that, women who still want children will have to find other methods for treating bleeding problems and painful periods.
Independent studies have shown that women who undergo the procedure are satisfied with the results; living a period and pain-free life can be liberating.
Types Of The Procedure
Endometrial resection: an instrument called a reteroscope and an electrode is used to destroy the endometrium in small sections. The surgery is specialised and can take up to an hour.
Non-reteroscopic ablation (or global ablation): This procedure is simpler and faster, and is gaining popularity. This method uses new devices like microwave endometrial ablation (MEA), Novasure and cryotherapy.
Success rate of endometrial ablation is up to 90%.
Cessation of menstrual periods in up to 50% of women, with light bleeding in 40%.
No need for further treatment for abnormal bleeds.
Painful periods are stopped.
As with every surgery, there are complications attached to this procedure. However, these are very rare, with those complications in 1/200 of patients.
Reaction to anaesthesia occurs in a small percentage of patients.
Some patients could have abnormal bleeding and haemorrhaging after the procedure.
In 10% of patients, the surgery does not take. These patients might have to have a hysterectomy.
Uterine perforation could occur in some women.
There is risk of infection.
Pregnancy is possible, but the chances are very narrow. These pregnancies are usually rife with complications and cannot be carried to full term.
The recovery time after the surgery is just about a week, as it is not a major surgery. Women who have had this procedure will still need to employ hormonal and barrier methods of contraception, as there is a slim chance of pregnancy afterwards.
You can make an appointment with Dr Kaur on (07) 3839 0552
This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.
This post was written by Dr Anu Kaur