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Endometrial Ablation

Endometrial Ablation

            Many women have long, heavy and painful periods.  This is known as abnormal uterine bleeding.  One treatment for this is uterine ablation.  This procedure involves destroying cells in the endometrium or lining of the uterus. 

 
Who should consider this treatment?

            Women who have heavy, long and/or painful periods.  Women who are finished with childbearing and no longer wanting pregnancy.

 
How Effective Is Ablation?

Ablation helps decrease the amount and length of your periods.  Most women see a significant decrease.  Some women may have very minimal to no period after ablation.  Additionally, some women may require a repeat ablation or further treatment.  Approximately 92% of women are satisfied with their ablation. 

 
What Tests Will I Need Before Ablation?

            Women considering ablation will need to have a sonohystogram and endometrial biopsy.  These tests allow us to see the lining of the uterus to check for causes of abnormal uterine bleeding such as polyps, fibroids, etc.  These tests are performed in out office.

 
Is Ablation Birth Control?

            No, although ablation destroys endometrial cells in the lining of the uterus, it does not prevent ovulation.  It may still be possible to become pregnant.  After ablation, it will still be necessary to use some type of birth control.

 
How Is Ablation Performed?

            Uterine ablation is performed vaginally.  There are no incisions necessary. 

 
What Are The Options For Ablation?

            Many offices offer more than one type of ablation:  Her Option and Novasure are common ablation procedures.  HerOption is cryoablation that involves freezing the endometrial cells with a wand.  It may be necessary to freeze several zones of the uterus.  This procedure is performed in our office.    Novasure is ablation that involves heating and burning the endometrial cells.  A gold mesh expands within the uterus, heats and is then retracted.  This procedure is performed in an outpatient surgical center.  The both Novasure and HerOption were approved by the in 2001.  A comparison of these 2 procedures is provided below. 

 

 

Her Option

Novasure

Type

Cryoablation

Thermalablation

Location

In office

Out patient surgery center

Ablation Occurs By

Freezing

Heat/Burning

How

A wand is placed in several position in the uterus and creates a freeze zone

A gold mesh expands and heats the endometium

Time of Procedure

20 minutes

90 sec

When

after your period

anytime

Pretreatment

Cytotec taken the night before and morning of procedure

 

Progesterone maybe used to help thin the lining

 

Preprocedure Medication

Ibuprofen

 

During Procedure

Toradol injection

IV sedation

Paracervical block

Paracervical block

After Procedure Meds

Ibuprofen and/or Percocet

Ibuprofen and/or Percocet

 

What Can I Expect After Ablation?

             Imediately after the procedure you may experience some cramping.  This discomfort may last up to 48 hours after the ablation and can be treated with mild analgesics like Ibuprofen.  Vaginal discharge is also common and may be watery or bloody.  This may last for several weeks.

What Risks Are There With Ablation?

             Risks include uterine perforation, bleeding infection and injury to other organs in the pelvis or abdomen.  Safety precautions are followed to minimize these risks.  Uterine ablation may also cause a delay in diagnosis of endometrial cancer since one of the warning signs of abnormal bleeding.

 

 For more information on these ablation procedures you can visit their websites at www.heroption.com and www.novasure.com

Cyndi Ayoub, WHNP
posted 5/1/09

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