Endothermal Ablation

What is Endometrial Ablation?

Endometrial ablation is a procedure in which the endometrium, or the uterine lining, is surgically removed. Endometrial ablation, which is performed to reduce bleeding during menstruation, may completely stop menstrual flow in some women.

No incision is made in the endometrial ablation procedure. Thin instruments are inserted through the passageway between the patient’s vagina and uterus. The instruments to be used may vary depending on the method to be preferred for removing the endometrium. In the endometrial ablation procedure, methods such as extreme cold application, heated liquids, microwave energy or high-energy radio frequencies can be used. When determining the method to be applied, various factors such as the size of the uterus and its current condition are evaluated for the patient.

In the endometrial ablation procedure, which is an effective treatment option for women experiencing excessive or irregular menstrual bleeding, the endometrium, or the inner lining of the uterus, is destroyed using heat or energy. Destroying the endometrium can reduce the frequency and amount of menstrual bleeding and increase the patient’s quality of life.

Why is Endometrial Ablation Performed?

Endometrial ablation is a treatment applied in case of excessive menstrual bleeding. There are many different reasons for endometrial ablation. The first of these is excessive menstrual bleeding.

Excessive menstrual bleeding is a condition characterized by more bleeding than normal during menstrual periods. Sometimes bleeding that requires changing pads or tampons every two hours or less is an indication that unusually heavy menstrual periods are experienced.

The amount and frequency of menstrual bleeding being higher than normal can also be listed among the reasons for endometrial ablation. In cases of bleeding lasting longer than eight days or anemia due to excessive blood loss, endometrial ablation may be considered.

Doctors usually start treatment with medication or intrauterine devices to reduce excessive menstrual bleeding. If these treatments are not effective or are not a suitable option for the person, endometrial ablation may be an option.

In addition to these;

Endometrial ablation can also be performed in cases of excessive bleeding between menstrual periods
Fibroid formation in the uterine wall
Endometriosis
Polyps or myomas in or on the uterine wall.

The following are the situations in which endometrial ablation is not recommended:

The individual is postmenopausal
The individual has certain anomalies in the uterus
The individual has uterine cancer or is in a high-risk group for uterine cancer
The individual has an active pelvic infection

How is Endometrial Ablation Performed?

Endometrial ablation is a procedure that is completed under general anesthesia in an average of 15 to 30 minutes. The opening in the patient’s cervix is ​​first widened to allow the passage of the instruments to be used in endometrial ablation. The cervix can be widened with medication or by inserting a series of rods of increasing diameter.

The endometrial ablation procedure may vary depending on which method will be used to remove the endometrium. The methods that can be used to remove the endometrium are listed below:

Electrosurgery

In this method, a thin scope is used to see the inside of the patient’s uterus. The electrosurgical procedure, in which a device that passes through the scope like a wire opens grooves in the endometrium, is performed under general anesthesia.

Cryoablation

Extreme cold is used to create two or three ice balls that freeze and destroy the endometrium. The doctor monitors the condition of the ice balls with real-time ultrasound. Each freezing cycle takes about six minutes, and the number of cycles required is determined by the size and shape of the patient’s uterus.

Free-Flowing Warm Fluid

In this method, heated saline fluid is circulated through the patient’s uterus for an average of 30 minutes. The most important advantage of this method is that it can also be used in women with abnormal tissue growths that deform the uterus.

Heated Balloon

In the heated balloon method, a balloon device is inserted through the patient’s cervix and inflated with heated fluid. The procedure can be completed in 2 to 10 minutes, depending on the type of balloon device.

Microwave

This method, in which a thin rod inserted through the cervix emits microwaves that heat the endometrial tissue, is usually completed in 3 to 5 minutes.

Radio Frequency

A special device used in this method delivers radiofrequency energy that will vaporize the endometrial tissue within 1 to 2 minutes. After this procedure, the device is removed from the uterus.

Preparation Before Endometrial Ablation

Before the endometrial ablation procedure, the patient is examined in detail. Her medical history, medications used and current health status are evaluated. Her general health status is checked and a pelvic examination is performed. Some blood tests, imaging tests and ultrasound may be performed before the procedure.

Endometrial ablation is not performed in the event of pregnancy. A thin catheter is inserted into the endometrium to test for cancer and a small sample is taken. Since endometrial ablation cannot be performed with an IUD, the IUD is removed.

Since some types of endometrial ablation are more successful when the uterine lining is thin, medication may be prescribed to thin the endometrium or dilation or curettage, a procedure in which excess tissue is scraped off, may be performed.

After Endometrial Ablation

After endometrial ablation, you may experience cramps similar to your period for a few days. Cramps can be relieved by using over-the-counter medications such as acetaminophen or ibuprofen. You may also experience a watery vaginal discharge mixed with blood for a few weeks. The discharge, which is usually at its heaviest for a few days after the procedure, gradually decreases.

Patients may feel the need to urinate more frequently in the first 24 hours after endometrial ablation. It is important to avoid heavy lifting and activities that may cause straining after endometrial ablation. Regular check-ups with your doctor after the procedure should also be considered.

Results of Endometrial Ablation

It may take several months to see the final results of endometrial ablation. However, endometrial ablation usually reduces the amount of bleeding during menstruation. After the procedure, most women experience lighter periods, and some may stop menstruating altogether.

Since it is possible to get pregnant after endometrial ablation, it is necessary to continue using birth control methods. Although pregnancy is possible after the procedure, the risk of a dangerous pregnancy and miscarriage should not be ignored.