Endometrial ablation – Glengarry Private Hospital, Perth
Endometrial ablation – Summary
A low impact operation to reduce menstrual bleeding
1. Endometrial ablation is a popular treatment that reduces and often completely stops periods.
2. Many women who have an ablation also experience a reduction in period pain.
3. A general anaesthetic is required. Significant complications are rare.
4. Ablation is usually performed as day case surgery at Glengarry Private Hospital in Perth.
5. Endometrial ablation is usually well tolerated by most women.
6. Afterwards, a few days to a week are needed to fully recover from the operation.
7. Your family must be complete, and contraception will still be needed. A sterilisation can be done at the same time.
8. Endometrial ablation is a usually effective option for women in their forties with heavy periods who have completed their family.
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 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) 6119 9160
Endometrial ablation – what is it?
Endometrial ablation is a usually well-tolerated procedure to reduce heavy periods. We regularly perform this procedure 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, the period 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 the ablation operation, and may require additional treatment, such as a further ablation or a hysterectomy.
What about hormones?
There are no effects on the ovaries, so the hormones will be unchanged. Sometimes the local pelvic “hormones” (eg. prostaglandins that are released during the period) can cause symptoms like bloating & water retention. Endometrial ablation can sometimes reduce these symptoms.
Who should have endometrial ablation?
Not all women who have heavy periods are suitable, and we will need to assess first. If you still want to have children, endometrial ablation is not an option since the uterine lining is removed during the treatment. Any pregnancy afterwards would usually end in disaster. If you have had a sterilisation or your partner has had a vasectomy, an ablation can be an excellent choice for treating heavy periods. A sterilisation can also be done at the same time as the ablation. Sometimes the womb can be simply too big for the ablation to work. Some abnormal uterine conditions (like fibroids or some variations in the shape of the womb) may make ablation less effective unless they are dealt with. If these issues exist, we can usually reshape the uterus just prior to ablation to improve the end result. 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 positioning is correct. 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 abolish your periods with Novasure compared with balloon ablation. Over 50% of women will have no further periods, and most of the rest will have minimal bleeding. Period pain is also often helped. Novasure is good for regular-shaped wombs. If there is a septum or a fibroid we can reshape at the time of the ablation, and results can still be excellent. Overall this Novasure method is the best method of ablation. Most of our endometrial ablations in Perth are done using Novasure.
2. Balloon endometrial ablation (Cavaterm/Thermachoice)
Thermachoice III used to be one of the best balloon methods of ablation until it was withdrawn. Cavaterm is now the balloon method that some clinicians use. About 80% of women are satisfied/very satisfied with balloon ablation and many see their period pain reduce afterwards.
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 quite 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 with electrical energy while fluid irrigates the womb and keeps the view clear. This is how we used to do endometrial ablation before the machine technology was perfected. These old “manual” methods take much longer, requires a lot more skill, are more expensive, and there are slightly more potential complications. The old methods are still used if the womb is very irregular inside, or we’re repeating the ablation to get a more comprehensive result. We probably use this technique monthly usually as an adjunct to Novasure to additionally treat missed areas. Re-do ablations also need to be done manually.
Can I try & get pregnant after endometrial ablation?
No. Endometrial ablation should never be used if you are undecided, or 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 one in ten 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, and perforation or rupture of the wall of the uterus. 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 and also have 20 years experience using the classic manual hysteroscopic ablation and hysteroscopic resection techniques. Please contact our clinic at Glengarry Private Hospital in Perth. You will need a referral from your GP.