Endometrial Ablation

We at Advanced Gynecology are happy to be able to offer some of the most advanced procedures for the treatment and care of abnormal uterine bleeding. Abnormal bleeding affects many women in the United States today. In the past the only surgical treatment for bleeding was either an abdominal or vaginal hysterectomy. Fortunately we now have much more to offer patients.

If it is determined that a surgical rather than a medical treatment for bleeding is needed, then endometrial ablation may be the procedure for you.

Bleeding comes from the endometrial lining. In a normal cycle this lining regenerates every month and when you are not pregnant you lose that lining and you have a period. This is what happens in the normal course of things. When this doesn’t happen normally for a variety of reasons, then it may be time to consider surgical treatment.

We recommend initially that any abnormalities of the uterus are ruled out. A procedure called SIS (saline infusion sonohystogram) is used to rule out any polyps or fibroids within the cavity of the uterus. This is a simple procedure in which saline is injected into your uterus and is viewed under ultrasound. If there are polyps or fibroids found, they need to be removed before the ablation can be done.  If there are not any than an ablation is an excellent choice.   

An endometrial ablation is simply a destruction of the lining of the uterus that is regulated every month. There are different kinds of ablations that work to destroy the lining. There is a heat technique in which a balloon of hot water is used to destroy the lining, a freezing technique in which a probe is used to freeze the lining, and there are several other techniques that we are presently not using.

Both of these procedures can be done in our office.

In the office setting the patient is given pre-op medications such as ibuprophen, darvocet and anti nausea medications. Once the procedure is begun the cervix is numbed with a Lidocain/Marcain mixture. This allows us to enter the cervix without difficulty. At this point either the balloon or the freezing probe is placed. The balloon procedure takes 8 minutes and the freezing takes approximately 16 minutes. There is very little difference other than the length of surgery. The freezing does seem to have less pain, but it takes longer and there seems to be a lot more discharge. You and your doctor will discuss which procedure may be best for you and whether having it done in the office is right for you.

The success rate for the ablation techniques are similar, approximately 40% of patients will never bleed again. (That’s correct: no period, nothing!). Another 40-50% of patients will be significantly better and probably will not have the problems of the past. About 10-20% will fail. Remember this procedure only affects the endometrial lining, so it has no effect on your hormones good or bad! There is no recovery time for the ablation as there are no incisions. You will have some bloody discharge for 1-3 weeks after the procedure. Intercourse is ok if you or he doesn’t mind the discharge.

Endometrial ablation is a great procedure for many women. Please contact us if you have other questions.