OBGYN Idaho Falls - Patient Education Article.

Endometrial Ablation

What is it?

This is an outpatient surgical procedure used to treat abnormal uterine bleeding.

Who qualifies?

Anyone who is done with child bearing and has had the necessary work up to rule out other causes for abnormal uterine bleeding such as:

  1. Uterine pre-cancerous changes
  2. Fibroids
  3. Enlarged uterus
  4. Pregnancy

Other more common causes of abnormal bleeding that can be treated with this procedure include:

  1. Uterine polyps
  2. Hormonal effects
  3. Unknown

Your physician may choose to use hormonal methods to pre-treat the endometrial lining of the uterus to “shrink it” prior to surgery.

What is the benefit?

The procedure is similar to a D&C, an out-patient procedure, which cleans the lining of the uterus. With endometrial ablation the lining of the uterus is burned. The procedure takes 20-60 minutes and most patients experience minimal cramps post-operatively. Recovery time is 2-3 hours. Most patients are back to their routine that very evening. The cost is less than a hysterectomy.

For abnormal uterine bleeding with no other problems, this might be a better procedure than a hysterectomy for many patients.

Risks/Expectations

It is not a sterilization procedure and other birth control methods are recommended. Frequently a tubal ligation can be done at the same time. A bloody, yellowish discharge may be noted for 3-6 weeks after the procedure. Bleeding after the surgery is variable.

Medical literature states:

  • 65-70% have no periods at all
  • 20-25% have slight cyclic spotting 1-2 days each month
  • 5% have normal periods with normal 3-5 day flow
  • Less than 5% have minimal change in bleeding pattern, these are those with the fibroids or severe adenomyosis.

The procedure does not trigger menopause and patients still require yearly exams and PAP smears. Risks are minimal. A recent in-house survey of patients undergoing this procedure indicate a better outcome with 90% having no periods at all and 5 – 8% with 1-2 days of light spotting each month. They all indicated delight in their expectations of the procedure and most only wished that they had the procedure done sooner.