ENDOMETRIAL ABLATION

What is endometrial ablation?

Endometrial ablation is a medical procedure in which endometrial lining of a uterus is remove (ablate) or destroy .In Endometrial ablation thin layer of tissue (endometrium) in the uterus is destroyed or removed  to stop or reduce heavy menstrual bleeding or abnormal uterine bleeding.The procedure for endometrial ablation is not surgery therefore no incisions are needed for endometrial ablation.Endometrial ablation must not be performed if women is pregnant or pregnancy is desired in the future.

Causes for which Endometrial Ablation is done -Why is endometrial ablation done?

• Endometrial Ablation is done only when other methods like medical or hormonal therapies is unable to control or stop the bleeding .
• Endometrial ablation is done to control or stop the abnormal ,prolonged and heavy vaginal bleeding .
• Endometrial ablation is done when you don't want to have hysterectomy to control bleeding  

Techniques and Methods used for Endometrial Ablation

Electricity,Laser beam, freezing, heating ,microwave energy or high-energy radio frequencies are all successfully used methods for endometrial ablation.

Electricity (electrical or electrocautery)

An electric current current is used in this method for Endometrial ablation this electric current travels through a wire loop or roller ball put on the uterus lining to destroy it.

Fluids (hydrothermal) for Endometrial Ablation 

What is the procedure for Endometrial Ablation ?

In Hydrothermal or fluids techniques or procedure heated fluid is used. This heated fluid is pumped into the uterus to destroy the lining.

Balloon therapy 

What is the procedure for Endometrial Ablation ?

In Balloon therapy/techniques for endometrial ablation doctor put a thin tube (catheter) into the uterus. The catheter has a balloon at the end. Doctor fills the balloon with fluid and heats it. The heated fluid destroys the uterine lining.

High-energy radio waves (radiofrequency ablation)

In radiofrequency ablation for Endometrial ablation  doctor puts an electrical mesh into the uterus. He or she expands it. Then doctor sends an electrical current made by radio waves to destroy the lining.

Cold (cryoablation)
In this method doctor uses a probe with very cold temperature to freeze the lining.

Microwaves (microwave ablation)
In microwave ablation for endometrial ablation doctor  sends microwave energy through a thin probe to destroy the lining.

Hysteroscope
Some endometrial ablations are done using tool called a hysteroscope.  It is a thin, lighted tube.This tool lets your provider see the inside of your uterus. It sends images of the inside of the womb to a video monitor.He or she can use a camera on the tool to record what is seen.

Transcervical resection of the endometrium (TCRE) -uses a hysteroscope equipped with a cauterization loop that avails for resection of the endometrium. It is a proven procedure being a day-care procedure with rapid recovery.

Risks of ENDOMETRIAL ABLATION

What are the risks and complications of endometrial ablation?

Risks due to Hysteroscopy

Risks of hysteroscopy include:

• Damage to the cervix Hole (perforation) in the wall of the womb
• Scarring of the lining of the womb
• Need for surgery to repair damage

Risks due to any pelvic surgery include:

• Damage to nearby organs or tissues
• Blood clots, which could travel to the lungs and be deadly (rare)

Risks due to anesthesia include:

• Breathing problems Nausea and vomiting
• Headache
• Dizziness
• Lung infection

Risks due to any surgery include:

• Bleeding 
• Infection

Deciding on endometrial ablation
There are pros and cons for endometrial ablation so before going to have endometrial ablation do proper research ,ask your doctor more about it,and after understanding clearly what are the advantages or disadvantages of endometrial ablation take your decision wisely Pros or cons of endometrial ablation includes :

What are the Pros of Endometrial ablation

• It can be effective at easing heavy periods – more so than treatment with medicines.
• The risk of complications is less with endometrial ablation compared to a hysterectomy.
• It take not more than 1 hour which means you can go home the same day.

What are the Cons of endometrial ablation 

endometrial ablation isn’t suitable as a treatment option if:

• You want to have children
• You have endometriosis
• You have large fibroids

Like many procedures, there are also some side-effects and complications of endometrial ablation, such as infection or damage to your womb. Also, for some women, endometrial ablation will make no difference to their heavy periods. 

What are the alternatives to endometrial ablation?

If you think Endometrial ablation is not right option for you then you can choose other options on doctors recommendations below are some option which can take as an alternative to endometrial ablation :
Intrauterine system (IUS) -This is a plastic T-shaped device, placed in your womb, which releases a hormone similar to progesterone. It works by thinning the lining of your womb and reducing the bleeding. 

Medicines: Such as the combined oral contraceptive pill or tranexamic acid.

These options may be recommended before endometrial ablation.

Hysterectomy:If all other treatment options have failed, you may be offered a hysterectomy to remove your womb. But this should be a final option because there is
 more risk of complications compared with endometrial ablation. 

Outlook (Prognosis)

What is the outlook after endometrial ablation?

The lining of your uterus heals by scarring. Women will most often have less menstrual bleeding after this procedure. Up to 30 to 50% of women will completely stop having periods. This result is more likely in older women.Failure was most likely to occur in women younger than 45 years and in women with 5 or more children, prior tubal ligation, and a history of painful menstrual cramps.

Alternative Names 

Hysteroscopy-endometrial ablation; Laser thermal ablation; Endometrial ablation-radiofrequency; Endometrial ablation-thermal balloon ablation; Rollerball ablation; Hydrothermal ablation; Novasure ablation