An endometrial ablation is the removal or destruction of the lining of the uterus, called the endometrium. The purpose of this procedure is to end the menstrual flow. It is done when a woman has heavy menstrual periods but no evidence of cancer of the uterus. The procedure provides an alternative to hysterectomy, or complete removal of the uterus. For 60% of women who have the procedure, monthly periods stop completely. Flow is reduced for another 30%.
Who is a candidate for the procedure?
Women may be considered for this procedure if they:
have heavy monthly periods that severely interfere with their activities
have had a dilatation and curettage, or D&C that has not been successful in decreasing menstrual flow
have been unsuccessfully treated with hormone replacement therapy
do not desire further pregnancies
How is the procedure performed?
This operation is done in a same day surgery setting. Either general anesthesia or regional anesthesia can be used. General anesthesia means the person is put to sleep with medications. Regional anesthesia means the person will be awake, but numb below the waist. A medication may be given to make the person drowsy.
A tool called a hysteroscope is inserted into the vagina. This contains a camera and light source. The device is then advanced through the cervix and into the uterus. This allows the doctor to view the inside of the uterus on a television screen. The endometrium and some of the underlying tissue is scraped off. The wall of the uterus is then cauterized to stop bleeding. Cauterization destroys the tissue with an electric current.
A newer method, called balloon ablation, has been used since 1998. In this procedure, a specially constructed balloon is placed within the uterus and a sterile fluid, heated to 188 degrees F, is pumped through the balloon. The heated fluid destroys the lining of the uterus without affecting the rest of the uterus or other pelvic organs.