Endometrial Ablation

Endometrial ablation is the process used to destroy the endometrium or the lining of the uterus. This procedure is generally used for treating the abnormal uterine bleeding. This procedure is done using a hysteroscope which is an instrument with a light and a camera so that the inner part of the uterus can be viewed by the surgeon with the help of the hysteroscope. Endometrial ablation is usually carried out using any of the techniques mentioned below.
1) Thermal ablation
2) Laser beam ablation using radio frequency
3) Saline solution heated up to 85⁰ Contained in a balloon
4) With the help of a rolling ball electrode
5) Microwave
6) Freezing

Circumstances that necessitates endometrial ablation

1) When vaginal bleeding does not respond to other treatment options
2) The patient does not prefer hysterectomy to be performed
3) In patients who have completed the process of child bearing.
4) Other medical problems which prevents hysterectomy

Effectiveness of endometrial ablation

1) Menstrual flow has considerably reduced in most women after endometrial ablation.
2) Response to endometrial ablation in younger women is poor compared to older women. They usually continue to have regular period and may require repeated procedures for achieving the desired result.
3) Younger women may be allowed to take gonadotrophin releasing hormone analogues for three months prior to endometrial ablation. This will help thinning the lining of the uterus as the production of estrogen is reduced by this method.

Risk factors

i) The process of endometrial ablation may lead to puncture and perforations of the uterus
ii) Nearby organs may be damaged by the application of heat or cold accompanying this procedure.
iii) Bleeding, pain and other infection are other possible risk factors accompanying this procedure.

Preparations

Your surgeon may take a small sample of the endometrium for biopsy purpose. If cancer is detected you will have to undergo a hysteroscopy which is a procedure followed for removing the uterus.
Your surgical removal endometrium will be successful only if your endometrium is thin.
Thinning of endometrium can be achieved by medication or a D&C in which the doctor removes the extra tissue by scraping it out. Endometrial ablation is usually done under general anesthesia. So you will be asleep when the procedure is carried out and will not know any pain at all. But you have to confirm your medical fitness for this before general anesthesia is administered. If you are not suitable other similar procedures which are done under sedation has to be opted for.