Endometrial Ablation
Heavy uterine bleeding is a very common gynecologic problem. In some women this problem can be severe enough to cause painful cramps, anemia and chronic fatigue. In many, this can be a disrupting and debilitating factor in their life.
There are a variety of causes for the bleeding such as hormonal disturbance, uterine fibroid, uterine polyp, endometrial hyperplasia, or cancer. Treatment of the condition is dependent on the cause. For large fibroids or endometrial cancer, for example, the indicated treatment is hysterectomy.
For hormonal disturbances such as hyperthyroidism, correcting the hormonal imbalance usually correct the abnormal bleeding. In women who are unresponsive to hormonal control either because they are unable to tolerate the medication or because the medication is ineffective in controlling the bleeding, endometrial ablation is a good alternative to hysterectomy.
The procedure is performed in an outpatient setting under local or light general anesthesia. A hysteroscopy, dilation and curettage is first performed. A balloon is then placed in the endometrial cavity through the cervix. This balloon is then filled with water which is heated to 87 degree Celsius for 8 minutes. This heating destroys most of the endometrial lining which is the source of the bleeding. The fluid is then removed from the balloon and the device removed.
The entire procedure takes about twenty minutes. The patient is discharged home after a brief recovery a few hours later. Post operative pain is minimal and can be easily controlled with ibuprofen. Patient is able to return to normal activity in one to two days.
Complication of this procedure is extremely rare but may include uterine perforation, hemorrhage, and bowel injury. This procedure is not indicated for women who desires future fertility or have suspected uterine malignancy. Most women experience normal or light menstrual flow after the procedure. Some will not have any cycle at all.