Pearl obstetrics | gynaecology

Would an endometrial ablation be right for me?

Endometrial ablation

What is endometrial ablation and how good is it?

It is a procedure to reduce excessive bleeding. The procedure destroys just the lining of the womb by the use of heat. In most cases, bleeding during your period will be reduced to moderate, light or no flow. Some women may experience spotting. Around 10% of patients may not reduce their periods enough and may require additional treatment.

Am I a candidate for this operation?

We must rule out abnormal uterine conditions like some fibroids, and your pap smears should be up to date.
If you will want to have children, endometrial ablation is not an option since the uterine lining is destroyed during therapy.

How does ThermaChoice endometrial ablation work?

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. When the treatment cycle is complete, all the fluid is withdrawn and the tube is removed.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 and will be lost like a period in the next 7-10 days.

Can I get pregnant after treatment?

This therapy should not be used if you ever want to have children – in fact, pregnancies after ablation can be dangerous for both baby and mother. Since there is a chance of pregnancy, contraception or sterilization should be used after treatment.

What will I feel after the procedure?

You may feel mild or moderate cramping like a period. We will give you a painkilling medication to make you feel more comfortable. After a few hours hours in hospital, you should be driven home where you can take it easy for the rest of the day.

What can I expect after I go home?

Most women can return to work and family commitments after a few days. Sexual activity can be resumed after your first check-up, usually 2 weeks. Most patients have a pinkish and watery discharge for about 2 weeks, sometimes as long as a month. In most cases, the first few periods after the procedure may continue to be heavy but 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 procedure may pose some 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. Collection of blood or tissue in the womb during the months afterwards is also possible and may require an outpatient procedure to correct the problem. All of these risks are extremely rare. As with any type of operation, there is the risk of infection, usually easily managed with oral antibiotic therapy. This risk is about 5%.

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.

Dr. Mark Sillender. Consultant obstetrician & gynaecologist