Endometrial Ablation Surgery in Delhi, India

Endometrial ablation is a medical procedure used to treat heavy menstrual bleeding. It involves removing or destroying the lining of the uterus, known as the endometrium. This can help reduce or stop bleeding in women who have not found relief from other treatments. The procedure is usually done through various methods, like laser, heat, or freezing. It is recommended when other options have not worked and is considered less invasive than surgery.

Types of Endometrial Ablation

Endometrial ablation can be performed using various techniques. Each method uses different technology to achieve the same goal. Here are the types:

• Microwave: Microwave energy is directed into the uterine cavity through a specialised probe. This energy heats up the endometrial tissue to a temperature that destroys it.
• Radiowaves (radiofrequency): Radiofrequency energy is delivered through a thin electrode inserted into the uterus. This energy creates heat, which destroys the endometrial lining.
• Electricity (electrosurgery): Electrical currents are applied to the endometrial tissue through an electrode. The electrical energy heats up and destroys the lining.
• Heated fluid (hydrothermal): A flexible tube with a viewing lens is used to circulate heated fluid in the uterine cavity, allowing the doctor to observe the interior of your body. The fluid's high temperature destroys the endometrial lining.
• Heated balloon (balloon therapy): A balloon filled with heated fluid is inserted into the uterine cavity and inflated. The heat from the fluid ablates the endometrial lining.
• Cold (cryoablation): Extreme cold is applied to the uterine lining through a cryoprobe or similar device. The cold freezes and destroys the endometrial tissue.

Who Needs to Have Endometrial Ablation?

Endometrial ablation is advised for women suffering from significant menstrual bleeding who have not found relief through alternative therapies. This procedure is often considered when other methods have failed or are not suitable.

Why is Endometrial Ablation done?

Endometrial ablation is performed to address several issues related to abnormal uterine bleeding. Here are the main reasons:

• Heavy menstrual bleeding: The procedure can reduce or stop heavy menstrual bleeding, improving quality of life.
• Irregular periods: It helps in managing irregular menstrual cycles that disrupt daily activities.
• Bleeding disorders: Endometrial ablation addresses bleeding disorders when medication fails to control symptoms.

What Happens Before an Endometrial Ablation?

Preparing for endometrial ablation involves several steps to ensure the procedure is safe and effective:

• Pregnancy Test: Ensure you're not pregnant, as endometrial ablation cannot be performed during pregnancy.
• Biopsy: A biopsy may be done to check for abnormal cells and rule out cancer.
• Medication Review: Verify that you are not taking any medications, like blood thinners, that could complicate the procedure.
• Imaging: An MRI or ultrasound will be ordered to get a detailed view of your uterus.

What Happens During Endometrial Ablation?

The procedure is generally performed in an outpatient setting under local or general anaesthesia. Here's what occurs during the ablation:

• Insertion of instrument: A hysteroscope or other instrument is inserted through the vagina into the uterus to view the uterine lining.
• Ablation of uterine lining: Various methods are used to destroy or remove the lining of the uterus.
• Monitoring and completion: The doctor monitors the procedure to ensure complete ablation and then removes the instruments.

What Happens after Endometrial Ablation?

Post-procedure care is crucial for recovery and to ensure the effectiveness of endometrial ablation:

• Nausea: You may experience slight nausea after the procedure.
• Increased urination: Expect to urinate more frequently on the first day post-procedure.
• Cramping: Period-like cramps may occur for one to three days following the endometrial ablation.
• Bleeding/discharge: Light bleeding or pink discharge is normal for a few weeks, typically heaviest on days 2 and 3, as your body expels the uterine lining that was removed.

Advantages of Endometrial Ablation

Endometrial ablation offers several benefits for managing abnormal uterine bleeding:

• Reduction in menstrual flow: There is a significant reduction in the amount of menstrual bleeding for many women.
• Minimally invasive: Often performed using minimally invasive techniques, reducing recovery time.
• Improved quality of life: Reduces symptoms that affect daily activities and overall well-being.

Risks or Complications of Endometrial Ablation

Like any medical procedure, endometrial ablation carries some risks and potential complications:

• Infection: Risk of infection at the site of the procedure or within the uterus.
• Uterine perforation: There is a rare risk of perforating the uterine wall during the procedure.
• Abnormal bleeding: Some women may experience unusual bleeding or spotting after the procedure.

What is the Recovery Time After an Endometrial Ablation?

Recovery time varies, but most women can expect the following:

• Initial recovery: Cramping and light bleeding are common and typically resolve within a few days.
• Full recovery: Most women return to normal activities within 1-2 weeks. Follow-up visits are essential for monitoring recovery.

When To Call the Doctor?

Contact your doctor if you experience any of the following symptoms after the procedure:

• Severe bleeding: Excessive bleeding or prolonged bleeding beyond the expected duration.
• Severe pain: Intense or worsening abdominal pain not relieved by medication.
• Signs of infection: Fever, chills, or unusual discharge indicating a possible infection.

Conclusion

Endometrial ablation is a useful procedure for managing severe menstrual bleeding and related conditions. Understanding the procedure, its types, benefits, and risks can help in making an informed decision. Consult a healthcare provider to determine if endometrial ablation suits your condition.

Frequently Asked Questions

What are the side effects of endometrial ablation?

Common side effects include cramping, light bleeding, and discharge. It is important to consult a healthcare provider if one experiences more severe symptoms or complications.

Can I get pregnant after endometrial ablation?

Pregnancy is possible but not recommended after endometrial ablation due to the risks of complications and the reduced ability of the uterus to support a pregnancy.

What is the best age for endometrial ablation?

Endometrial ablation is often recommended for women in their 30s to 40s who are done with childbearing and have not found relief through other treatments.

How painful is a uterine ablation?

Pain levels vary; many women experience cramping similar to menstrual cramps. Pain management options are available and should be discussed with the healthcare provider.

Review 

Reviewed By Dr Anita K Sharma- Senior Director & Head - Obstetrics & Gynaecology on 28 Aug 2024.