Endometrial ablation/biopsy

Endometrial ablation is a procedure performed to permanently remove a thin tissue from the endometrium (lining of the uterus). Endometrial ablation is done as a treatment for abnormal or heavy uterine bleeding (menorrhagia). Before the endometrial ablation procedure, it is vital to ensure that the bleeding is not related to cancer. An endometrial biopsy can usually confirm this.

There are various ways of performing endometrial ablation, including:

• Freezing this is a procedure where a thin probe with an extremely cold tip is used to freeze the lining of the uterus
• Microwaves it is when a special wand is applied on the lining of the uterine to apply microwave energy
• Electrical is when the gynaecologist uses an electric current to destroy the lining of the uterus
• Heat this is thermal ablation, with either saline, radiofrequency or a balloon filled with fluid
• Saline

Dr Kwabena Essel may recommend an endometrial ablation if:

• You have abnormal or heavy uterine bleeding that is not related to cancer.
• You have no desire to bear children later.
• You do not have an active infection.
• You have a normal endometrial cavity.
• You would like to preserve your uterus.
• You have medical problems that make hysterectomy risky.

Endometrial ablation is a process that takes around 10 – 15 minutes, but the hospital stay can be longer. Recovery from an endometrial ablation procedure usually takes a few days to a few weeks. Endometrial ablation is rapid for most patients with most patients having very little discomfort the following day.

To thin the endometrial lining and increase the potential effectiveness of the procedure, Dr Essel may recommend administering birth control pills, Lupron Depot injection or progesterone.

The risks involved in the endometrial ablation procedure include uterine perforation, bleeding, infection, damage to the bladder, blood vessels, nerves or bowel, but are less than 1%. Endometrial ablation is not meant to prevent women from having children, but it is not advised for those who wish to bear children later since it may cause sterility. Potential side effects include fatigue and stomach or pelvic cramping. Others experience vaginal discharge or bleeding afterwards. However, these side effects last for a few days.

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