The abnormal bleeding may be due to a non-cancerous (benign) condition. However, endometrial ablation surgery does not suffice as a treatment of bleeding due to cancer of the uterus, since the cancerous cells may have grown deeper into the tissue which cannot be removed by the procedure. It is very important to know that endometrial ablation can only be performed on non-pregnant women who do not plan to get pregnant in future. This treatment should not be the first resort and should be considered when medical and hormonal therapies have been insufficient.
The endometrial ablation procedure requires a biopsy before the surgery to determine the presence of cancer, if any. The thinner the endometrium, the higher is the chance for successful ablation and hence, hormonal therapy is given in the weeks before the procedure to shrink the endometrium. The procedure is then begun by dilating the cervical opening to make space in the uterine cavity and the uterine lining is destroyed by laser beam, electricity, freezing, heating, or microwave energy.
Endometrial ablation procedure varies on the technique employed. One technique includes inserting a small telescope like device called hysteroscope, into the uterus through the cervix and it circulates heated saline which burns the lining of the uterus.
Thermal balloon is the alternative method filled with heated fluid to destroy the uterine lining. There is also another option wherein a mesh is introduced in the uterus cavity and electrical energy is applied to the mesh to thermally damage the lining.
There are also other methods like hysteroscopy wherein instrument is inserted to destroy the lining under vision using laser or electrical current in a small loop. Another system introduces a radiofrequency rod that emits energy to destroy the uterine lining.
The endometrial ablation surgery is always done using local anesthesia or if need be, a general or spinal anesthesia. The recovery could be ranging from one day to 2 weeks. The healing procedure is by scarring, reduced or removal of future uterine bleeding possibility. The patient may develop amenorrhea, however hormonal functioning will remain unaffected.
The endometrial ablation procedure includes rare but serious complications like accidental perforation of the uterus, tears or damage to the cervical opening (the opening to the uterus), and infection, bleeding, and burn injuries to the uterus or intestines, bowel burn or post-ablation tubal sterilization syndrome. Some women may experience re-growth of the endometrium and need further surgery.
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