Endometrial Ablation for the control of heavy bleeding.
This is a procedure that can be performed either in the operating room or, less expensively, in the office. Both are performed in the same manner. This procedure is used to treat heavy bleeding. After the procedure, 80% of women will be satisfied with the results. Approximately 50% will no longer have any more periods or bleeding. Another 30% will have very light periods in which they bleed very lightly, only using a pantiliner throughout the period. Approximately, 20% will fail the procedure and wish to go onto a hysterectomy or hormonal therapy.
Prior to any ablation, hysteroscopy and D&C are performed to evaluate the lining of the uterus. I then use a device (such as Novasure) to burn the lining of the uterus. This can take approx 90 seconds. I do use IV and oral medications in the office. Most women experience menstrual type cramping during the procedure.
Following the ablation procedure you might have some intense cramping that can last up to 4 hours. We ask that you stay ahead of the pain and go ahead and take a pain pill following the procedure and go home and sleep. Most people find that they sleep through the pain and feel fine when they wake up. Not everyone will experience this pain.
You may return to work the day following your procedure, but I ask you to avoid sexual intercourse for 4 weeks to avoid infection. You may have a discharge or slight bleeding for up to 6 weeks until the uterus heals. I like to tell my patients that this discharge is a result of the healing burn within the uterus, much like a blister after you burn your skin. If you are not happy with your bleeding pattern 6 months after surgery, then hysterectomy may be your next option for treatment. I would not repeat this procedure.
It is also very important to understand that you should not become pregnant after this procedure. I encourage you to have a sterilization procedure in conjunction with an ablation. Ablation is not meant to be a procedure that prevents pregnancy.