Endometrial Ablation
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What is endometrial ablation?
Endometrial ablation is the surgical destruction of the lining tissues of the
uterus, known as the
endometrium.
Endometrial ablation is one type of treatment for
abnormal uterine bleeding.
Why is endometrial ablation done?
Endometrial ablation is a treatment for abnormal bleeding of the uterus that
is due to a benign (non-cancerous)
condition. Endometrial ablation is not sufficient for treatment of bleeding due
to cancer of the uterus, since cancer
cells may have grown into the deeper tissues of the uterus and would not be
removed by the procedure.
Endometrial ablation is only performed on a
nonpregnant woman who does not plan to become pregnant in the future. It should
not be performed if the woman has an active
infection of the genital tract.
Endometrial ablation is not a first-line therapy for heavy bleeding and should only be considered when
medical and hormonal therapies have not been sufficient to control the bleeding.
How is endometrial ablation performed?
Prior to the procedure, a woman needs to have an
endometrial sampling (biopsy) performed to exclude the presence of cancer.
Imaging studies and/or direct visualization with a hysteroscope (a lighted
viewing instrument that is inserted to visualize the inside of the uterus) are
necessary to exclude the presence of
uterine polyps or benign tumors (fibroids)
beneath the lining tissues of the uterus. Polyps and fibroids are possible
causes of heavy bleeding that can be simply removed without the need for
ablation of the entire endometrium. Obviously, the possibility of
pregnancy must
be excluded, and intrauterine contraceptive devices (IUDs) must be removed prior to considering
endometrial ablation.
Hormonal therapy may be given in the weeks prior to the procedure
(particularly in younger women), in order to shrink the endometrium to an extent
whereby ablation therapy has the greatest likelihood of success; because the
thinner the endometrium, the greater the chances for successful ablation.
To begin the procedure, the cervical opening is dilated to allow passage of
the instruments into the uterine cavity. Different procedures have been used and
are all similarly effective for destroying the uterine lining tissue. These
include laser beam, electricity, freezing, heating, or microwave energy.
The
choice of procedure depends upon a number of factors, including
- the preference
and experience of the surgeon,
- the presence of fibroids, the size and shape of
the uterus,
- whether or not pretreatment medication is given, and
- the type of anesthesia desired by
the patient.
The type of anesthesia required depends upon the method used, and
some endometrial ablation procedures can be performed with minimal anesthesia
during an office visit. Others may be performed in an outpatient surgery
department.
Next: What are the risks and complications of endometrial ablation? »
- Hysterectomy - Learn about hysterectomy procedures and options available for women. There are many types of hysterectomy surgeries including a total, radical, laparoscopy assisted vaginal hysterectomy, supracervical, and oophorectomy. The type of hysterectomy procedure will depend upon the reason for the procedure.
- Uterine Cancer - Learn uterine cancer (cancer of the uterus, endometrial cancer) causes, diagnosis, symptoms, signs, stages, statistics and treatment: surgery, radiation, chemotherapy.
- Endometrial Biopsy - Read about endometrial biopsy, a procedure to help determine the cause of some medical diseases and conditions in women. Examples include infertility, abnormal uterine bleeding, or infections of the female reproductive system.
Latest Medical News
Womens Health RSS