Endometrial ablation

Surgery Overview

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Endometrial ablation is a procedure that uses a lighted viewing instrument (hysteroscope) and other instruments to destroy (ablate) the uterine lining, or endometrium. Endometrial ablation can be done by:

• Laser beam (laser thermal ablation).
• Heat (thermal ablation), using:
  • Radiofrequency.
  • A balloon filled with saline solution that has been heated to (thermal balloon ablation).
• Electricity, using a resectoscope with a loop or rolling ball electrode.
• Freezing.

The endometrium heals by scarring, which usually reduces or prevents uterine bleeding.

What To Expect After Surgery

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Endometrial ablation is usually done in an outpatient facility or hospital. The procedure may be done using a local or spinal anesthesia, although general anesthesia is sometimes used.

Recovery requires from a few days to 2 weeks.

Why It Is Done

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Endometrial ablation is used to control heavy, prolonged menstrual bleeding when:

• Bleeding has not responded to other treatments.
• Childbearing is completed.
• You prefer not to have a hysterectomy to control bleeding.
• Other medical problems prevent a hysterectomy.

How Well It Works

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Approximately 90% of women will have reduced menstrual flow following endometrial ablation, and up to half will stop having periods.

Younger women are less likely than older women to respond to endometrial ablation. After an endometrial ablation, younger women are more likely to continue to have periods and need a repeat procedure.

Young women may be treated with either gonadotropin-releasing hormone analogues (GnRH-As) 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).

Risks

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Complications of endometrial ablation are uncommon but can be quite severe. They can include:

• Accidental puncture (perforation) of the uterus.
• Burns (thermal injury) to the uterus or the surface of the bowel.
• Buildup of fluid in the lungs (pulmonary edema).
• Sudden blockage of arterial blood flow within the lung (pulmonary embolism).
• Tearing of the opening of the uterus (cervical laceration).

What To Think About

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Endometrial ablation is not recommended if you have a high risk for endometrial cancer. Regrowth of the endometrium may occur.

Do not consider this procedure if you plan to become pregnant in the future.

Although this surgery usually causes sterility by destroying the lining of the uterus, pregnancy may still be possible if a small part of the endometrium is left in place. Birth control of some form is required if you have not completed menopause and do not wish to become pregnant.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Credits

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Author	Merrill Hayden
Editor	Kathleen M. Ariss, MS
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Last Updated	February 22, 2006