Endometrial Ablation
Endometrial ablation, put simply, is a procedure where the endometrium is destroyed. The endometrium is the innermost layer of the uterus and the part that thickens to either provide a place for a fertilized egg or be shed as a period. Obviously, this procedure greatly affects a person’s ability to successfully maintain a pregnancy; which is precisely the reason why it’s not well known.
So how is this procedure done?
Patients are under general anesthesia during it and no incisions are needed – it’s all done through a small instrument inserted into the vagina and into the uterus. There are a few ways that the endometrium can be destroyed:
Electrocautery
A wire loop or rolling ball with an electrical current is applied to the endometrium.
Hydrothermal:
Heated fluids are pumped into the uterus
Balloon:
A thin catheter with a balloon is inserted into the uterus and filled with heated fluids.
Radio-frequency:
Electrical mesh is inserted into the uterus and then expands.
Cryoablation:
A probe is used to freeze off the lining.
Microwave:
A probe sends microwave energy to destroy the lining.
NovaSure (radiofrequency):
A hysteroscope (camera) is inserted into the uterus. It measures the cavity and sends information to the doctor about the tissue and monitors it during the procedure as well as suctioning the destroyed tissue it destroys with radiofrequency.
Diagram of hysteroscopy
Why is it done?
The aim of this is to stop or decrease bleeding during periods, thus it’s most commonly done for:
Excessive blood loss
Anemia from heavy periods
Periods that worsen any existing conditions
Bleeding that lasts longer than 8 days
People with excessive bleeding may soak a regular or super tampon in 2 hours or less!
What can you expect from the ablation?
Prior to the ablation, you’ll need to consult with your OB/GYN to see if you’re a good candidate. Some abnormalities in your uterus, prior uterine conditions such as cancer, planning to become pregnant in the future, a current uterine infection, and others would make you a bad candidate for one.
If you are a good candidate for it, you’ll have a physical exam and a transvaginal ultrasound before scheduling the procedure. The day of, you’ll go through the outpatient surgery center of your hospital and prepare as you were having any other surgery. Then you’ll be put under general anesthesia, positioned in the stirrups. If you’re having the NovaSure (most common) ablation, the actual ablation will only take about 5 minutes! Most of the time I spent at the hospital was waiting for the OR and then waking up from it.
Waiting for the ablation
What’s the recovery like?
It’s common to have discharge that may look similar to a period and then be clear. Spotting, cramping, nausea, and vomiting are fairly common afterwards. Rarely, thermal injury, perforations, or infections can occur. Again, those are rare and uncommon.
What was your experience?
My recovery was very uneventful. I had spotting for a couple of days and then occasional clear discharge. I mostly felt tired from the anesthesia. I had a pelvic laparoscopy at the same time, which included incisions – unlike the ablation.
The biggest change I noticed came around 3 weeks after the procedure when I was bracing for another hellacious period – but there wasn’t one. Additionally, I’ve been able to treat the iron deficiency I’ve struggled with for 18 years! Not having the torture of my period has decreased my neuropathy and allowed my body to heal.
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