Endometrial Ablation is defined as a procedure done to permanently remove a thin, superficial layer of the topmost inner lining of uterus-the endometrium. This procedure is done to treat excessive or abnormal bleeding from the uterus. Some doctors consider endometrium ablation as an alternative option to hysterectomy.
The uterus or womb is a hollow pear-shaped female genital organ located in the female’s lower abdomen in between the rectum and bladder. The innermost lining of uterus is endometrium and is shed off every month during menstruation except when a fertilized egg (ovum) gets implanted and pregnancy occurs.
Why is Endometrial Ablation Done?
Endometrial ablation is done in women who report heavy bleeding. In case the treatment with medications does not yield desired results, doctors take the route to endometrial ablation.
EA or endometrial ablation has been done as an effective alternative option to hysterectomy for treating dysfunctional uterine bleeding (DUB) when medical treatment is not giving good results.
What Should I Know Before I Go For Endometrial Ablation?
You should discuss your menstrual periods and other health issues before undergoing the procedure. Before doing the procedure, your doctor will seek your consent both verbal and written. You can clarify all pending doubts from the doctor. Inform the doctor whether you are pregnant or not. If you are allergic to any specific medicine, tape, anesthetic agent, etc make a point to notify the care giver. Also inform the doctor about any medicines or herbs that you might be taking. If you are taking any anticoagulants drugs, aspirin, etc. make sure you inform your doctor.
Who Should Not Have Endometrial Ablation?
The endometrial ablation is contraindicated for females with following conditions:
- Pelvic inflammatory disease
- Vaginal or cervical infections
- Recent pregnancy
- Cervical, endometrial, or uterine cancer
- Weak uterine muscle wall
- Intrauterine device (IUD)
- Past uterine surgery for fibroids
- Vertical or classical caesarean section
- Abnormal shape and structure of the uterus
- Narrowing of inner side of uterus
Health Issues After Endometrial Ablation
After EA or endometrial ablation, you might experience following health issues. Immediately consult your doctor if any of the conditions are seen.
- Foul-smelling discharge from your vagina
- Fever or chills
- Severe abdominal pain
- Excessive bleeding
- Difficulty urinating
Can I Get Pregnant After Having Endometrial Ablation?
Though the chances are low, yet you could get pregnant after having an endometrial ablation. Even though you have had a procedure of endometrial ablation, your reproductive organs are still there. However, pregnancy in such a case is rare, if not impossible. If you do happen to conceive, the chances of having a miscarriage and other complications run considerably high. Infact, if a woman wishes to bear a child, she should try not having this procedure. Until after you have menopause, you should take birth control pills or get yourself sterilized.
Pregnancy occurring subsequent to endometrial ablation is seen to be associated with complications and risks. Placenta increta is a major complication of ablation. Couple counseling should be done about contraceptive methods after endometrial ablation as conception after ablation can be life-threatening.
Techniques Used to Perform Endometrial Ablation
There are many ways to perform endometrial ablation such as:
- Electrical or electrocautery
This process is done by passing electric current through a roller ball or wire loop and is applied gently to the endometrial lining for tissue cauterization
- Hydrothermal ablation
In this process hot fluid is injected in the uterus and the endometrial lining of the uterus is destroyed due to high temperature
- Balloon therapy
In this technique, a balloon catheter is introduced in the uterus. The catheter is filled with fluid and is heated to a certain point so that the endometrial tissues are easily eroded away
- Radiofrequency ablation
In this type of ablation, a triangular mesh electrode is introduced in the uterine cavity which expands the cavity. The electric current from the electrode destroys the endometrial lining
- Cryoablation (freezing)
In this procedure very low temperature is used to destroy the endometrial lining. A probe is introduced in the uterine cavity. The temperature of the probe is extremely low
- Microwave ablation
The endometrial lining is destroyed by microwave energy by introducing a slender probe in the uterine cavity
Risks Associated With Endometrial Ablation
The complications associated with endometrial ablation are enlisted as under:
- Perforation of the uterus or bowel
- Overloading of fluid into the bloodstream
Endometrial ablation should never be done if the patient is pregnant as it can lead to miscarriage. A woman cannot conceive after endometrial ablation because ablation eliminates most of the endometrial tissue so the lining left is not adequate for the implantation of fetus and consequent nourishment.
After the procedure of endometrial ablation you might experience vomiting, nausea and strong cramps in lower abdomen. This is normal. But if these conditions persist for more than two days or their intensity is unbearable, immediately consult your doctor. Take rest for a week or 10 days and avoid lifting heavy weights. No strenuous activity should be done. Diet is very important. Make sure you take a well balanced diet to avoid fatigue.