Endometrial ablation

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Endometrial ablation
Intervention
Endometrial ablation 1.jpg
Hysteroscopic endometrial ablation
ICD-9-CM68.23
 
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Endometrial ablation
Intervention
Endometrial ablation 1.jpg
Hysteroscopic endometrial ablation
ICD-9-CM68.23

Endometrial ablation is a medical procedure that is used to remove (ablate) or destroy the endometrial lining of a uterus. This technique is most often employed for people who suffer from excessive or prolonged bleeding during their menstrual cycle but cannot or do not wish to undergo a hysterectomy. The procedure is most commonly done on an outpatient basis. Placenta accreta may occur if the patient becomes pregnant after endometrial ablation, so birth control is recommended. However, heavy menstrual bleeding is most commonly due to dysfunctional uterine bleeding or adenomyosis. If patient does not want hysterectomy or endometrial ablation, another option with norethisterone can be given.

Procedure[edit]

A number of competing procedures are available.[1]

Older methods utilize hysteroscopy to insert instruments into the uterus to destroy the lining under vision using laser or electrical current in a small loop. Another system introduces a radio-frequency rod that emits energy to destroy the uterine lining.

The procedure is done while the patient is either under local anesthesia, or, if necessary, general or spinal anesthesia. The recovery period can be from one day up to 2 weeks.

After the procedure, the endometrium heals by scarring, reducing or removing the possibility of future uterine bleeding. The patient may develop amenorrhea, however hormonal functioning will remain unaffected.

Effectiveness[edit]

Approximately 80% of those who undergo this procedure will have reduced menstrual bleeding. Of those, approximately 45% will stop having periods altogether. However, a second procedure or a hysterectomy will be required in approximately 22% of cases.[citation needed]

Risks[edit]

Although uncommon, the procedure can have serious complications including:

See also[edit]

References[edit]

  1. ^ http://www.bostonscientific.com/templatedata/imports/collateral/Gynecology/oth_articleCarver_The%20Female%20Patient_01_gy_us.pdf
  2. ^ Hysteroscopic Surgery, by King’s College Hospital. August 2013
  3. ^ Cooper, K. G.; Bain, C.; Parkin, D. E. (1999). "Comparison of microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss: A randomised trial". The Lancet 354 (9193): 1859–1863. doi:10.1016/S0140-6736(99)04101-X. PMID 10584722.  edit
  4. ^ Page 122 in Desai (January 2002). Gynecology Endoscopic Surgery: Current Concepts. Jaypee Brothers Publishers. ISBN 978-81-7179-937-4. 
  5. ^ Hydro ThermAblator System (HTA). Instructions for use. 2005 Boston Scientific Corporation.
  6. ^ NovaSure. Instructions for use. 2004 Cytec Corporation.
  7. ^ Gynecare Thermachoice III. Instructions for use. 2008 ETHICON, Inc. a Johnson & Johnson Company.