Endometrial Ablation

Endometrial ablation is a general term for any technique that removes or destroys the endometrium (lining of the uterine cavity). There are many different techniques for performing endometrial ablation. Serving Greater Boston communities, the gynecologic surgeons at Newton-Wellesley Hospital’s MIGS center employ a variety of endometrial ablation techniques, depending on each individual patient's specific needs.

endometrial ablationExamples of such techniques include:

  • Rollerball endometrial ablation uses a heated ball to burn the endometrium under direct visualization with a hysteroscope. Other uterine lesions, such as polyps and fibroids can be removed during the same procedure using this technique.
  • NovaSure® endometrial ablation uses heat to remove the lining of the uterus. ThermaChoice® Balloon endometrial ablation uses hot water circulating through a balloon to destroy the lining of the uterus.
  • HTA Hydro ThermAblator® uses hot circulating water to destroy the lining of the uterus.
  • Her Option® endometrial ablation freezes and destroys the lining of the uterus.

If you would like to learn more about endometrial ablation continue reading. If you would like to discuss having a endometrial ablation at MIGS, contact us to arrange for a consultation.  

 

 

  • Why is an endometrial ablation performed?
  • Who is a good candidate for endometrial ablation?
  • What does an endometrial ablation involve?
  • What happens after the procedure?
  • How successful is an endometrial ablation in treating heavy bleeding?
  • Discharge Instructions

     

    Why is an endometrial ablation performed?
    Endometrial ablation, or destruction of the lining of the uterus, is a treatment for menorrhagia (heavy menstrual bleeding).  It is an alternative to hysterectomy for the treatment of menorrhagia in women who wish to keep their uterus or avoid major surgery.


    Who is a good candidate for endometrial ablation?
    Good candidates include women who:

    • are pre-menopausal
       
    • have heavy bleeding caused by a benign (non-cancerous) condition
       
    • have finished having children and are not interested in future fertility
       
    • wish to retain their uteruses

    What does an endometrial ablation involve?
    An endometrial ablation is an outpatient procedure with a short recovery.  It can either be performed in the office, or as an outpatient procedure in the operating room. A woman may experience some cramping after the procedure; ibuprofen is usually adequate to treat pain.  

    It is common to have a vaginal discharge for 2-4 weeks after the procedure. Most women are typically back to their normal activities in 1-2 days.  


    What happens after the procedure?
    The recovery process will vary depending upon the type of ablation performed and the type of anesthesia that was administered.

    If anesthesia was received in the operating room, the patient will be taken to the recovery room for observation. Once blood pressure, pulse and breathing are stable and the patient is alert, they are discharged home. Another person needs to drive the patient home.

    If an ablation was performed in the office, the patient can go home in about 30 minutes.

    Discharge Instructions for Endometrial Ablation (pdf)


    How successful is an endometrial ablation in treating heavy bleeding?
    Success rates vary depending on the technique used.  When combining all the different techniques:

    • About 40% of women will have no periods (amenorrhea) after an endometrial ablation.
    • About 85-90% of women have either no periods or decreased bleeding.  They are satisfied with the outcome of the ablation and do not need further treatment.
    • About 10-15% of women will require additional treatment, such as a hysterectomy.

    Myomectomy

    Myomectomy is a surgical procedure in which only the fibroids are removed, preserving the uterus. As an alternative to hysterectomy, one advantage of a myomectomy is that with the uterus in place, childbearing remains an option. A disadvantage of a myomectomy is that when the uterus remains in place, fibroids can recur, sometimes requiring additional surgery.

    Fibroids can be removed by hysteroscopic myomectomy, laparoscopic myomectomy or an open abdominal myomectomy.

    Serving Greater Boston communities, the gynecologic surgeons at Newton-Wellesley Hospital’s Minimally Invasive Gynecological Surgery center perform the following types of myomectomy:

    • Hysteroscopic myomectomy is a technique used to remove fibroids that are submucosal. A hysteroscope, a thin tube containing a video camera, is passed through the cervix and into the uterus. The fibroid is then removed by shaving it out. There are no incisions with a hysteroscopic myomectomy. It is a day surgery procedure (you typically leave the hospital 1 hour after the completion of the procedure) with a 1-day recovery period.
    • Laparoscopic myomectomy is a technique used to remove fibroids that are intramural (deep in the muscle of the uterine wall), subserosal or pedunculated (on the outside of the uterus).  This minimally invasive technique uses a laparoscopic technique to remove the fibroids through very small incisions. It is a day surgery procedure (you typically leave the hospital 1-2 hours after the completion of the procedure) with a 1-2 week recovery period.
    • Open myomectomy uses a traditional large abdominal incision to remove the fibroids. Most fibroids can be removed by minimally invasive techniques; the use of the open method is limited to women with specific situations where laparoscopic or hysteroscopic removal of fibroids is not appropriate.

    Open and Minimally Invasive Fibroid Removal (Myomectomy) Video  

     

     

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