Endometrial Ablation

Endometrial Ablation - Overview

This procedure is offered as a treatment for heavy periods. This treatment is only suitable for you if you have completed your family and do not wish for any future pregnancies.

A reliable form of contraception is important to be used following this procedure.

Before the procedure is started the doctor will prescribe you premedication in from of pain relief and anti-sickness medication.

What are the benefits of Local Anaesthetic?

• A safer procedure as it avoids general anaesthesia. It is especially suitable if you are at high risk for general anaesthesia.
• Recovery following the procedure is faster and less disruptive to your life.
• Shorter time to discharge from the hospital reduces risk of hospital acquired infection.
• Post-procedure pain relief requirement is 10 times less compared to patients who have the procedure under general anaesthesia.
• Avoid major surgery.

Risks of Endometrial Ablation

What are the side effects?

• Cramping/pelvic pain - post-treatment cramping can feel like a period type discomfort. This cramping will typically last a few hours and rarely continues beyond the first day following the procedure
• Nausea (you will be given anti sickness medicine routinely)
• Vaginal discharge / bleed

Serious complications (rare):

• Thermal injury to surrounding organs this may require additional surgery to repair complications but fortunately is a rare event.
• Perforation of the uterine wall, the procedure is stopped in this event and can be re-booked after 2 months (once the perforation has healed)
• Complications with pregnancy (Note: Pregnancy after this procedure can lead to serious complications.)
• Infection or sepsis which may require extra antibiotics and treatment.

How is the procedure carried out?

1. Examination and local anaesthesia to the neck of the womb to reduce discomfort during the procedure - following anaesthesia, the lining of the womb will be checked using a special telescope (hysteroscope) which is inserted through the neck of the womb.  

2. Insertion of the device to heat the lining of the womb - this approximately 90-120 seconds. It is likely you will experience period type cramps during this part of treatment.

3. Repeat check of the lining of the womb with the telescope to see the treatment has been carried out successfully you may wish to discuss having a Mirena IUS coil inserted for the additional advantage of reducing pain and bleeding and providing contraceptive cover after ablation.

Post Procedure Information:

How will I feel afterwards?

You may experience cramping and discomfort shortly after the procedure. Some patients can feel lightheaded soon afterwards. It is normal to get discharge which can be discoloured for 3-4 weeks and sometimes it can be heavy.

If you experience worsening of the lower abdominal pain associated with offensive discharge and fever, get in touch with your GP as you can sometimes develop infection (1 in 200 risk).

Can I still get pregnant following Endometrial Ablation?

The procedure can only be offered if you have completed your family.

It is important to know that, although the chances for pregnancy are reduced following an endometrial ablation procedure, it is still possible to become pregnant; you will be required to continue with some form of contraception to avoid pregnancy and subsequent complications.

The doctor will discuss insertion of Mirena hormone coil which may help with Gynaecological symptoms and provide contraception at the same time.

How effective is Endometrial Ablation?

The efficacy varies between 70 to 90 % depending on the patient factors.

Patients who have uterine fibroids, pelvic pain, larger uterine size, uterine shape and presence of polyps and fibroids can cause recurrence of symptoms requiring further treatment. Patients who have been sterilised in the past are also more likely to experience pelvic pain after the procedure.

Endometrial ablation can be more effective if a hormone coil like Mirena is also inserted at the same time.