Obstetrics and Gynaecology
Hysteroscopy Endometrial Ablation Treatment
Hysteroscopy Endometrial Ablation
Endometrial ablation is a procedure the doctor might consider if the patient bleed between her menstrual periods, have a heavy flow, or have periods that last a long time. If medicine doesn’t help, the doctor might suggest endometrial ablation. This procedure can curb the bleeding or stop it totally. The operation is generally performed under a general anesthetic and takes about 30 minutes.
Hysteroscopy and Endometrial Ablation
Endometrial ablation is a procedure the doctor might consider if the patient bleed between her menstrual periods, have a heavy flow, or have periods that last a long time. If medicine doesn’t help, the doctor might suggest endometrial ablation. This procedure can curb the bleeding or stop it totally. The operation is generally performed under a general anesthetic and takes about 30 minutes. Heavy menstrual bleeding can occur due to various reasons. Changing hormones might be one of the reasons or it could be fibroids and polyps growing in the uterus. Endometrial ablation removes the lining of the uterus called the endometrium. In most of the cases, this stops the patient from having periods. If it doesn’t completely stop the periods, the flow should return to normal or be very light.
Who Gets It?
Endometrial ablation can put an end to heavy bleeding that gets in the way of the patient’s day to day life. If the bleeding causes other health problems, like anemia, this procedure may be helpful.
However, endometrial ablation isn’t right for everyone. If the patient is post-menopausal, then they shouldn’t consider this. It’s also not a good idea if the patient has:
- Uterine, cervical, or endometrial cancer
- Pelvic inflammatory disease (PID)
- A vaginal or cervical infection
- A weak wall to your uterus
- An infection of the uterus
- A scar from a Caesarean section
- An intrauterine device (IUD)
- A disorder of the uterus or endometrium
Advantages of a minimally invasive hysteroscopy
With a minimally invasive hysteroscopy, no incisions are made on the body. Because of which, there is less blood loss, less scarring, and less post-operative pain. The recovery time is remarkably shorter than after traditional surgery. Ablation is performed when the uterine lining is treated with heat in for stop abnormal bleeding.
Advantages of minimally invasive endometrial ablation
With minimally invasive endometrial ablation, no incisions are made on the body. Due to which, there is less blood loss, less scarring, and less post-operative pain. The recovery time is much shorter than after traditional surgery.
Who should have minimally invasive endometrial ablation?
Women who have done their child-bearing and suffering from excessively heavy periods must consider this procedure.
Who should have a minimally invasive hysteroscopy?
Women, who have abnormally heavy periods or bleeding between periods often have abnormal growths of fibroids or polyps in the endometrial cavity. Endometrial cavity is the space inside the uterus from which periods come and where babies grow.
Are there any alternatives to surgery?
Heavy periods can be treated with the use of various oral medications. Other alternatives to surgery include a hormonal coil.
What complications can happen?
General complication
- Pain
- Feeling or being sick
- Bleeding or discharge
- Infection
- Blood clots
Specific complications
- There may be possible damage to a nearby structure due to the hole made in the womb
- Bleeding during the operation
- Fluid overload
- Failed procedure
- Haematometra
- Blood and fluid collecting in the patient’s fallopian tubes
- Continued bleeding or pain
What after this Procedure?
Endometrial ablation isn’t actually surgery; the doctor doesn’t make any incisions. Instead, the doctor will insert very thin tools through the vagina to reach the woman’s uterus. There are different types, but these depend on what kind of ablation she does.
The most common are:
Hydrothermal: The doctor gently pumps fluid into the patient’s uterus, and then heats it. After 10 minutes, this destroys women’s uterine lining.
Balloon therapy: The doctor guides a thin tube with a special balloon on the end into the patient’s uterus. Heated fluid fills the balloon, which expands and resulting in the breaking of the lining.
High-energy radio waves: The doctor puts electrical mesh into the women’s uterus and expands it. Then energy and heat are sent by strong radio wave which damages the lining, which is removed with the help of suction by the doctor.
Freezing: A thin probe with a very cold tip freezes the lining of the uterus. The doctor also calls this “cryoablation.”
Microwave: A special wand applies microwave energy to the uterine lining, which destroys the lining.
Electrical: The doctor can use an electric current to destroy the lining of the uterus, but this method is not very common as the others.
How soon will I recover?
The patient should be able to go their home the same day. The patient should be able to return to their normal activities after two to four days. Most women are fit to work after about a week. The patient may have some bleeding or discharge for up to six weeks after the operation. Regular exercise should help her to return to normal activities as soon as possible. Before starting exercising, the patient should ask a member of the healthcare team for advice. The operation is not required for women who still want children. However, even if her periods stop, there is still a risk of becoming pregnant.
What are the risks involved?
As with any medical procedure, there’s always a chance of infection or bleeding. The tools that the doctor uses for the ablation could also create a hole in the uterus and which results in burns, or causing any harm to their nearby organs. But these problems don’t occur very often. The chances that the patient gets hurt during an endometrial ablation are extremely low.
Future fertility
Pregnancy can occur after endometrial ablation, but these pregnancies produce a huge risk to mother and baby. As the lining of the uterus has been damaged, the pregnancy might end in miscarriage. Or the pregnancy might occur in the fallopian tubes or cervix instead of the uterus (ectopic pregnancy), which may be harmful to the mother and the baby. Some types of sterilization procedures can be performed at the time of endometrial ablation. If the patient has endometrial ablation, long-lasting contraception or sterilization may be required to prevent pregnancy.
Outlook
Endometrial ablation is a commonly-performed gynecological operation that relieves the symptoms of heavy periods in the women. If the operation is successful, the patient should have less bleeding and pain. Endometrial ablation isn't a sterilization procedure, so the patient must continue the use of contraception. Pregnancy might still be possible, but it will deadly to both the mother and her baby and may end up in miscarriage.
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