Why get an Endometrial Ablation?
The endometrium is shed each month during menstruation. Endometrial ablation is a treatment for excessive menstrual blood loss, characterized by:
- Unusually heavy periods most months
- Enough blood loss to soak through a pad or tampon every hour on the heaviest days
- Anemia from excessive blood loss.
While medications are typically the first line of treatment for heavy menstrual bleeding, endometrial ablation may be an option if medications don't help.
Endometrial ablation is not recommended for women who:
- Wish to become pregnant in the future
- Have significant cramping with menstrual periods
- Have cancer of the uterus
- Were recently pregnant
- Are past menopause
How is it done?
Endometrial ablation is a procedure to destroy the endometrium — the lining of your uterus. No incisions are needed for endometrial ablation. Your doctor will insert slender tools through your cervix — the doorway between your vagina and your uterus.
The tools vary, depending on the method used to destroy the endometrium. Some types of endometrial ablation use extreme cold, while other varieties depend on heated fluids, microwave energy or high-energy radiofrequencies.
Some types of endometrial ablation procedures can be done in your doctor's office, while others must be performed in an operating room. Factors such as the size and condition of your uterus will help determine which endometrial ablation method is most appropriate.
Endometrial ablation risks may include:
- Perforation of the uterine wall
- Heat or cold damage to nearby organs
- Pain, bleeding or infection
Many women stop having periods after endometrial ablation, but pregnancy is still possible in some women. However, these pregnancies usually end in miscarriage because the lining of the uterus has been damaged. Women who want to become pregnant in the future should not undergo endometrial ablation.
Types of Endometrial Ablation
There are several techniques used to perform endometrial ablation including the following:
- electrical or electrocautery - electric current travels through a wire loop or rollerball that is applied to the endometrial lining to cauterize the tissue
- hydrothermal - heated fluid is pumped into the uterus and destroys the endometrial lining with high temperature
- balloon therapy - a balloon at the end of a catheter is inserted into the uterus and filled with fluid, which is then heated to the point that the endometrial tissues are eroded away
- radiofrequency ablation - a triangular mesh electrode is expanded to fill the uterine cavity. The electrode delivers electrical current and destroys the endometrial lining.
- microwave ablation - microwave energy is delivered through a slender probe that has been inserted into the uterus and destroys the endometrial lining.
One type of endometrial ablation uses a balloon filled with hot fluid to destroy the endometrial lining of the uterus.
HTA – Hydrothermal Ablation
The cervix is slightly dilated to allow the introduction of a hysteroscope through the vagina, into the cervix and then into the uterus. This gives Dr Vered a view of the inside of your uterus to assure proper positioning. Then, the uterus is filled with room temperature saline solution to gently clean and flush the uterus. The fluid is gradually heated to 90º C and circulated in the uterus for ten minute.