Endometrial ablation is the removal of the endometrium, the thin layer of tissue lining the uterus. It is done to treat various conditions of heavy menstrual or vaginal bleeding such as menorrhagia, abnormal uterine bleeding and unusual bleeding between periods. Hormonal imbalance (oestrogen and progesterone) that happens most often in women nearing menopause or after menopause is the main cause for menorrhagia and abnormal bleeding. Other causes of abnormal bleeding may be the presence of fibroid tumours, polyps or cancer in the endometrium or uterus. Sometimes endometrial ablation may be performed as an alternative treatment option to hysterectomy (removal of uterus).
Endometrial ablation is not recommended in women of childbearing age who are planning to become pregnant, were pregnant recently, in post-menopausal women and in those with disorders of the uterus such as cancer, recent infection, and endometrial hyperplasia.
Endometrial ablation may be performed using one of the following techniques:
- Radiofrequency: In this technique, a special probe that emits the radiofrequency probe will be inserted into uterus through the cervix. A mesh-like arrangement at the tip of the probe emits the radiation to the walls of the uterus. The heat energy destroys the endometrium layer and the damaged tissue is then suctioned.
- Freezing: A thin probe will be advanced into the uterus under the guidance of ultrasound. The probe freezes the lining and removes the excessive endometrial tissue.
- Heated fluid: During this procedure, a fluid will be introduced into the uterus through a hysteroscope. The fluid is then heated and left in the uterus for 10 minutes. Heat energy destroys the excessive endometrial tissue.
- Heated balloon: In this technique, heated fluid is filled into a balloon which is then placed into the uterus with a hysteroscope. When the balloon expands, its edges transfer the heat to the uterine lining, destroying it.
- Microwave energy: In this technique microwave energy is applied to the endometrial tissue through a specially designed probe that destroys the lining.
- Electro surgery: This method is performed under general anaesthesia and is rarely done. A thin telescopic device called resectoscope which has an electrical wire loop, roller ball or spiked-ball tip is inserted to destroy the uterine lining.
You may expect some minor discomfort such as nausea, cramping, thin bloody discharge, and frequent urination following the procedure. These problems usually resolve within 2-3 days.
Talk to your gynaecologist to learn more about the procedure and your eligibility.