Endometrial ablation – Glengarry Private Hospital, Perth
Endometrial ablation – Summary
A low impact alternative to hysterectomy
1. Endometrial ablation is a treatment that often effectively reduces or stops periods.
2. Many women also see a reduction in period pain.
3. An ablation is often a good choice for women with heavy periods who have completed their family.
4. It is usually performed as day case surgery at Glengarry Private Hospital in Perth.
5. Endometrial ablation is overall well tolerated by most women.
6. Afterwards, a few days to a week are needed to fully recover.
7. Significant complications are rare.
8. Your family must be complete to have an ablation, and contraception is still needed.
Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.
Glengarry Private Hospital is a friendly medium-sized hospital in the Northern suburbs in Duncraig, very near to the freeway, midway between Joondalup and Osborne Park Hospital.
Call us to arrange a consultation • Perth (08) 9448 9822
Endometrial ablation – what is it?
Endometrial ablation is a well-tolerated procedure to reduce heavy periods, which we regularly do at Glengarry Private Hospital, Perth. The ablation operation treats the lining of the womb by the use of heat or energy. In the majority of cases, heavy or irregular periods will be stopped completely or reduced to light flow only. Period pain is often reduced. Some women may experience just spotting rather than a period after their endometrial ablation. Around 5% of patients may not be satisfied after this operation and may require additional treatment.
What about hormones?
There is no effect on the ovaries, so the hormones will be unchanged. Sometimes the local pelvic hormones (that are released during the period from all the bleeding) can give problems, and endometrial ablation can theoretically reduce these symptoms.
Who should have endometrial ablation?
Not all women with heavy periods are suitable. Sometimes the womb can be too big for ablation to work. Some abnormal uterine conditions (like fibroids or some shapes of womb) may make ablation more difficult. If so, we can often reshape the uterus at the time of ablation to improve the results. If you still want to have children, endometrial ablation is not an option since the uterine lining is removed during the treatment. If you have had a sterilisation or your partner has had a vasectomy, an ablation can be an ideal choice for treating heavy periods. In Perth, endometrial ablation has been growing in popularity, as women realise they can stop or reduce annoying heavy periods with (usually) a fast recovery from the procedure.
There are several different types of endometrial ablation
1. Novasure endometrial ablation
Novasure is radio-frequency energy controlled endometrial ablation. A fan-like device is inserted carefully into the womb after measuring it. The device has safety features so we can ensure the placement is fine. The device is then activated with a customised dose of energy. The RF energy removes the lining of the womb. It can get “into the corners” of the uterus better than the balloon types of ablation – as long as the womb is a normal size and shape. Overall, you’re more likely to completely get rid of your periods with Novasure compared with balloon ablation. Over 50% of women will have no further periods, and most of the rest will have very minimal bleeding. Period pain is also often helped. Novasure is good for regular-shaped wombs. If there is a septum or a fibroid that can be reshaped, results can be excellent. Most of our endometrial ablations in Perth are done using Novasure.
2. Balloon endometrial ablation (Cavaterm/Thermachoice)
Thermachoice used to be one of the best balloon methods of ablation until it was withdrawn. Cavaterm is now the balloon method used. About 80% of women are satisfied/very satisfied with balloon ablation and many see their period pain reduced at the same time.
First, a soft balloon attached to a thin tube is inserted into the vagina, through the cervix and placed into the uterus. Then the balloon is expanded with a sterile fluid which expands to fill your uterus. The fluid in the balloon is heated & maintained while the uterine lining is treated and the endometrial ablation completed. When the treatment cycle is complete, all the fluid is withdrawn and the tube is removed. Nothing stays in your uterus. Your womb lining has been treated by the heat and there is loss like a period in the next few days. After this you can get a clear discharge for a few weeks. Cavaterm is particularly good for large, irregular wombs.
3. Other types of endometrial ablation
The other types of ablation are performed using an operating hysteroscope. The lining is treated, or carved out (resected) and/or cauterised while fluid irrigates the womb and keeps the view clear. This is how endometrial ablation used to be done before the technology in balloon ablations or Novasure was perfected. These old methods take longer, requires a lot more skill, are more expensive, and there are slightly more potential complications. The methods can still be good if the womb is irregular, or we’re repeating the ablation to get a more comprehensive result.
Can I get pregnant after endometrial ablation?
No. Endometrial ablation should never be used if you ever want to have children. Pregnancies after ablation are rare, and can be very dangerous for both baby and mother. Since there is a chance of pregnancy, excellent contraception or, even better, male or female sterilisation should be in place before or after treatment. We will talk to you about this when you come to see us in our offices at Glengarry Private Hospital, Perth.
What will I feel after the endometrial ablation?
You will usually feel mild or moderate cramping like a period. We will give you simple painkillers to make you feel more comfortable. After a few hours in Glengarry Private Hospital here in Perth, you should be driven home where you can take it easy for the rest of the day. Occasionally there is no pain at all. Sometimes more severe pain caused by spasm can occur which needs stronger painkillers and an overnight stay.
What can I expect after I go home?
Most women can return to light work and family commitments a few days to a week after endometrial ablation. Sexual activity can be resumed when the discharge settles. Most patients have a pinkish and watery discharge for up to a month or so. In rare cases, the first period after the ablation is heavy, but this will begin to improve thereafter.
You should seek medical help if you develop a fever, pelvic pain not relieved by ibuprofen, vomiting, or a greenish discharge.
What are the risks with endometrial ablation?
The endometrial ablation is generally a safe procedure. The commonest risk is getting an infection afterwards which affects about 1/10 women. This is usually managed with a course of antibiotics. There are some very rare, but possible, risks including blood loss, burn of internal organs or cervix or vagina (if the fluid leaks), and perforation or rupture of the wall of the uterus. We’ve never seen any of these complications so far in our practice. Collection of blood or tissue in the womb during the months afterwards is also possible and may require another procedure to correct the problem. All of these risks are very rare.
We are accredited in all the standard methods: Novasure, Cavaterm, Thermachoice III, and also the classic hysteroscopic ablation and hysteroscopic resection techniques. Please contact our clinic at Glengarry Private Hospital in Perth. You will need a referral from your GP.