The medical procedure used to destroy or ablate the endometrial lining present inside the uterus, is known as endometrial ablation. In certain women there is excessive and prolonged bleeding during the menstrual periods or between two menstrual cycles, which leads to major discomfort and agony. Hysterectomy and endometrial ablation are two procedures employed to provide relief to such patients.
The Reasons for Performing Endometrial Ablation
Endometrial ablation is generally performed when it becomes difficult to identify a specific cause for the heavy bleeding from the uterus lining. The main reasons for the bleeding from the lining of the womb are connected to the development of polyps, which are non malignant growths that develop on the lining of the uterus and are prone to heavy bleeding.
The presence of hormonal problems or imbalances in the levels of hormones also lead to heavy bleeding. When the cause of the bleeding cannot be attributed to any specific cause, then endometrial ablation is performed to correct the problem.
The Procedure of Endometrial Ablation
Pre –Operative Stage
The doctors prescribe certain medications of injections for a period of two months before the endometrial ablation is performed. This is to decrease the thickness and density of the lining of the uterus, to prevent excessive blood loss during the operation and to increase the chances of success. The patients are also asked to quit smoking and bring their weight and blood pressure within the prescribed limits.
Endometrial ablation is an example of day surgery case where in the patient is released within a few hours of the operation. The entire process of endometrial ablation takes approximately 30-45 minutes and is performed after the administration of general anesthesia.
Once the patient is unconscious, a hysteroscopy is done, which enables the surgeon to have a look inside the womb through a specialized telescope connected to a monitor.The instruments used for performing endometrial ablation are inserted into the uterus through the vaginal opening. They are then made to pass through the cervix, which is located at the entrance of the uterus. The surgeons sometimes use special devices to widen the mouth of the cervix, to allow the telescope and other instruments to go through in an easy manner.
A special liquid is used to inflate the cavity of the uterus which lies collapsed under normal circumstances. This enables the surgeon to observe the inside of the womb clearly. The endometrial lining of the uterus that causes heavy bleeding in patients, is then destroyed by using special techniques. One of the most common methods used in endometrial ablation, is the burning of the tissues in the lining by using the wire loop connected to an electrocautery device.
One of the other common methods of destroying the lining of the womb is by inserting a triangular balloon, which is inflated to take the shape of the uterus. The balloon is then filled with a fluid which is heated to a particular temperature. This technique destroys the endometrial lining of the uterus.
Laser ablation, microwaves and freezing techniques are some other methods that have been used for endometrial ablation. These are guided by newer and more sophisticated technologies and are not very different from the traditional methods, as far as the advantages of the procedures are concerned.
Post Operative Stage
After the procedure of the endometrial ablation is complete, the patient is kept under observation for a few hours or overnight as required. A sanitary pad is placed to stop any post operative bleeding. The patient may be slightly heady or nauseous due to the after effects of the general anesthesia and rest is recommended during this stage. Certain painkillers or injections may be given to ward off any pain or discomfort.
Causes, Symptoms And Medicinal Treatment Of Heavy Menstruation
How To Stop Prolonged Period Bleeding
Top 7 Menstruation Problems
Irregular Menstrual Period Prolonged Periods
Causes Of Heavy Menstrual Bleeding
The Convalescing Period
The patient may have slight bleeding for a week after the operation. Contraceptive pills can be taken from the very next day of the endometrial ablation and normal sexual activity can be resumed after three weeks if there is no discharge or bleeding. The endometrial ablation reduces the chances of pregnancy, but it is important to use the right contraception to avoid any pregnancy after the operation. All other activities such as bathing, taking a shower , etc can be resumed soon after the operation.
Risks and Complications
The success rate of endometrial ablation is generally very high and most patients have no infections of complication after the same. According to the studies conducted on women who have had the procedure done, more than 85-90 percent of the patients had periods or very slight bleeding after the operation. The pre-operative measure and the general anesthesia prevent any damage to the heart or the lungs. Overall the endometrial ablation is a safe and routine procedure with negligible risks.
In some rare cases, the fluid inserted inside the womb may trigger off a reaction which may cause discomfort. The problem can be resolved with proper medication. There are also certain cases of infection inside the womb after the operation which spreads into the adjoining Fallopian tubes or the pelvic region. If the infection is very serious then the patient is administered antibiotics intravenously.
In extremely rare cases the instruments that are inserted for the operation may damage the organs, or the blood vessels around the uterus. A second operation is then performed to correct the damage. Post ablation tubal sterilization syndrome, bowel burns, burns to the uterus beyond the endometrial lining, perforation of the womb, pulmonary edema or embolism are some of the other risks involved with endometrial ablation.
Alternatives to Endometrial Ablation
Some patients do not want to treat the heavy bleeding through any interventions. Under the circumstances, they have to go through the excessive menstrual bleeding that affects their quality of life.
The only other alternative to endometrial ablation is removal of the uterus , through a process known as hysterectomy . This solves the problem completely, but is a more complicated and bigger operation as compared to endometrial ablation. It is recommended that that the patients undergo endometrial ablation and if the same does not sort out the problem , then they can go in for hysterectomy.
Avoidance of Endometrial Ablation
Endometrial ablation reduces the levels of fertility in women. If the patient desires to have children after sorting out the problem of heavy bleeding, then the procedure should be avoided.
If there is any suspicion regarding the presence of cancerous growth or a tumor in the uterus, then endometrial ablation cannot be recommended to the patient, as the treatment requires more radical and sophisticated methods.
Photo Credit: http://gebaermutterblutungen.de/language/