There are no incisions (cuts) involved in ablation. Recovery takes about 2 hours, depending on the type of pain relief used. The type of pain relief used depends on the type of ablation procedure, where it is done, and your wishes. Discuss your options with your doctor before you have the procedure.
The following methods are those most commonly used to perform endometrial ablation:
- Radiofrequency—A probe is inserted into the uterus through the cervix. The tip of the probe expands into a mesh-like device that sends radiofrequency energy into the lining. The energy and heat destroy the endometrial tissue, while suction is applied to remove it.
- Freezing—A thin probe is inserted into the uterus. The tip of the probe freezes the uterine lining. Ultrasound is used to help guide the doctor during the procedure.
- Heated fluid—Fluid is inserted into the uterus through a hysteroscope. The fluid is heated and stays in the uterus for about 10 minutes. The heat destroys the lining.
- Heated balloon—A balloon is placed in the uterus with a hysteroscope. Heated fluid is put into the balloon. The balloon expands until its edges touch the uterine lining. The heat destroys the endometrium.
- Microwave energy—A special probe is inserted into the uterus through the cervix. The probe applies microwave energy to the uterine lining, which destroys it.
- Electrosurgery—Electrosurgery is done with a resectoscope. A resectoscope is a slender telescopic device that is inserted into the uterus. It has an electrical wire loop, roller-ball, or spiked-ball tip that destroys the uterine lining. This method usually is done in an operating room with general anesthesia. It is not as frequently used as the other methods.
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After the Procedure
Some minor side effects are common after endometrial ablation:
- Cramping, like menstrual cramps, for 1–2 days
- Thin, watery discharge mixed with blood, which can last a few weeks. The discharge may be heavy for 2–3 days after the procedure.
- Frequent urination for 24 hours
- Nausea
Ask your doctor about when you can exercise, have sex, or use tampons. In most cases, you can expect to go back to work or to your normal activities within a day or two.
Your doctor will arrange follow-up visits to check your progress. It may take several months before you experience the full effects of ablation.
Risks
The ablation procedure has certain risks. There is a small risk of infection and bleeding. The device used may pass through the uterine wall or bowel. With some methods, there is a risk of burns to the vagina, vulva, and bowel. Rarely, the fluid used to expand your uterus during electrosurgery may be absorbed into your bloodstream. This condition can be serious. To prevent this problem, the amount of fluid used is carefully checked throughout the procedure.
Finally...
Endometrial ablation works well for many women who have heavy bleeding. Endometrial ablation may be an option for a woman who does not wish to become pregnant. If you are thinking about getting endometrial ablation, talk to your health care provider about the risks and benefits.
Glossary
Cervix: The lower, narrow end of the uterus that extends into the vagina.
Dilation: Widening the opening of the cervix.
Endometrial Biopsy: A test in which a small amount of the tissue lining the uterus is removed and examined under a microscope.
Endometrial Hyperplasia: A condition in which the lining of the uterus grows too much; if left untreated for a long time, it may lead to cancer.
General Anesthesia: The use of drugs that produce a sleep-like state to prevent pain during surgery.
Hormone: Substance produced by the body to control the functions of various organs.
Hysteroscopy: A surgical procedure in which a slender, light-transmitting device, the hysteroscope, is used to view the inside of the uterus or perform surgery.
Intrauterine Device (IUD): A small device that is inserted and left inside the uterus to prevent pregnancy.
Menopause: The process in a woman’s life when ovaries stop functioning and menstruation stops.
Menstruation: The monthly discharge of blood and tissue from the uterus that occurs in the absence of pregnancy.
Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.
Pelvic Exam: A manual internal and external examination of a woman’s reproductive organs.
Sterilization: An operation that prevents a woman from becoming pregnant or a man from fathering a child.
Ultrasonography: A test in which sound waves are used to examine internal structures. During pregnancy, it can be used to examine the fetus.
Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.
Vulva: The external female genital area.
This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be
appropriate.
Copyright © March 2009 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
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The lining of the uterus—the endometrium—is shed by bleeding each month during menstruation. Some women have heavy bleeding or bleeding that lasts longer than normal. For them, endometrial ablation may be a good treatment option. This procedure treats the lining of the uterus to control or stop bleeding. It does not involve removal of the uterus and it does not affect a woman’s hormone levels.
