{"id":2099,"date":"2023-10-01T02:27:08","date_gmt":"2023-09-30T16:27:08","guid":{"rendered":"https:\/\/www.drseragyoussif.com.au\/?page_id=2099"},"modified":"2025-01-17T03:51:03","modified_gmt":"2025-01-16T17:51:03","slug":"endometrial-ablation","status":"publish","type":"page","link":"https:\/\/www.drseragyoussif.com.au\/?page_id=2099","title":{"rendered":"Endometrial Ablation"},"content":{"rendered":"
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Endometrial Ablation<\/span><\/h2>\n<\/div>\n<\/div>\n<\/div>\n
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Early Discharge after Hysterectomy for Benign Diseases by Mini-Laparotomy <\/span><\/h3>\n

Author:<\/strong> S. N. M. Youssif<\/span><\/h4>\n<\/div>\n<\/div>\n<\/div>\n
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Is a procedure that aims to destroy or remove the lining of the uterus \/ womb, to reduce or stop menstrual bleeding \/ periods. <\/span><\/p>\n

To suppress menstrual bleeding effectively, it is necessary to remove the full thickness of the endometrial lining as well as the superficial muscle layer (myometrium). <\/span><\/p>\n

Endometrial ablation techniques can be used in women with menorrhagia in whom medical therapy causes intolerable side-effects or is contraindicated. <\/span><\/p>\n

Endometrial ablation offers an alternative to hysterectomy, enabling preservation of the uterus. <\/span><\/p>\n

You may need endometrial ablation if:<\/span><\/p>\n

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  • You use more than nine pads or tampons (or both pads and tampons) on your heaviest days<\/span><\/li>\n
  • You have to wear both a tampon and a pad<\/span><\/li>\n
  • Your period lasts more than six days<\/span><\/li>\n
  • You have to get up at night to change your protection<\/span><\/li>\n
  • You pass blood clots<\/span><\/li>\n
  • You stain your bedding or clothes despite wearing tampons and pads<\/span><\/li>\n
  • You have period flooding <\/span><\/li>\n
  • You stay at home or take time off work during your period<\/span><\/li>\n
  • Endometrial ablation methods are termed first-generation or second-generation. <\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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    First generation techniques include <\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n
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    Transcervical resection of the endometrium with an electrosurgical loop (TCRE) <\/span><\/p>\n

    Rollerball endometrial ablation (RB)<\/span><\/p>\n

    TCRE\/RB Combined<\/span><\/p>\n

    Neodymium:yttriumaluminium garnet laser endometrial ablation (Nd:YAG) <\/span><\/p>\n

    All the above use a hysteroscope and fluid medium, and require a high level of technical skill.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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    Second-generation techniques include<\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n
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    Microwave endometrial ablation (MEA) <\/span><\/p>\n

    Fluid Filled Thermal balloon endometrial ablation (TBEA) <\/span><\/p>\n

    Radiofrequency electrosurgery <\/span><\/p>\n

    Hydrothermal ablation <\/span><\/p>\n

    Cryoablation <\/span><\/p>\n

    Endometrial thermal intrauterine thermotherapy<\/span><\/p>\n

    Second-generation EA techniques also include<\/span><\/p>\n

    Radiofrequency (thermoregulated) balloon EA, <\/span><\/p>\n

    Diode laser hyperthermy, and <\/span><\/p>\n

    Photodynamic therapy.<\/span><\/p>\n

     <\/span><\/p>\n

    All the above are newer techniques which are usually do not require use of hysteroscope, do not require a fluid medium and require less training to perform. <\/span><\/p>\n

    The newer techniques may be safer. For example the risk of bleeding may be lower, even though the surgeon can\u2019t see what is happening in the womb during the operation.<\/span><\/p>\n

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    Criteria that should be noted before considering endometrial ablation (first and second generation);<\/span><\/p>\n

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    • There are no cancerous or precancerous lesions of the endometrium or cervix<\/span><\/li>\n
    • Completion of childbearing <\/span><\/li>\n
    • No acute genital tract infection <\/span><\/li>\n
    • Uterine size less than the equivalent of 12 weeks gestation or uterine cavity length less than 12 cm <\/span><\/li>\n
    • No fibroids greater than 5 cm in diameter <\/span><\/li>\n
    • No absolute desire for cessation of periods (amenorrhoea) <\/span><\/li>\n
    • Adenomyosis (endometriosis in uterine muscles) may limit the effectiveness of endometrial ablation and may be a relative contraindication<\/span><\/li>\n
    • Repeated anovulation may limit the effectiveness of endometrial ablation procedures and may be relative contraindications. <\/span><\/li>\n
    • Resection of uterine submucous fibroids ( <5 cm ) should be considered prior to endometrial ablation. <\/span><\/li>\n<\/ul>\n

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      Success of endometrial ablation is less likely in women with a large uterus or if there is uterine myomas or adenomyosis.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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      How can this operation help me?<\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n
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      Periods are lighter for around 8 in 10 women who have their womb lining removed. <\/span><\/p>\n

      Periods stop completely for over a third of women. <\/span><\/p>\n

      Nearly three-quarters of women are satisfied after endometrial ablation using diathermy. <\/span><\/p>\n

      In one study, 8 in 10 women said they would recommend the treatment to their best friend.<\/span><\/p>\n

      After rollerball ablation to remove their womb lining, women in one study said they had improvements in<\/span><\/p>\n

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      • Pelvic pain (pain in the tummy and back): Nearly three-quarters of the women said they had less pain<\/span><\/li>\n
      • Premenstrual symptoms: Over two-thirds of the women had fewer symptoms, such as bloating and feeling irritable, before their period<\/span><\/li>\n
      • Their sex life: Almost all the women said their sex life got better after the operation<\/span><\/li>\n
      • Ability to do usual activities: All women could return to normal work and 8 in 10 found housework easier <\/span><\/li>\n<\/ul>\n

        But endometrial ablation doesn\u2019t work for everyone. Up to a quarter of women who have this operation still have heavy periods. The operation seems to work less well in women under 40.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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        What are the risks of Endometrial Ablation?<\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n
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        All operations have risks but serious problems seem to be rare with endometrial ablation.<\/span><\/p>\n

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        Your gynaecologist should tell you about the risks with this operation before you have it. It\u2019s important to tell the doctor if you have any allergies.<\/span><\/p>\n

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        Anaesthia can have side effects. For example, you may feel sick afterwards. It is also possible, but rare, to have an allergic reaction to the anaesthetic. Your blood pressure, heartbeat, body temperature and breathing will be closely monitored during the operation. <\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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        Complications or Problems that can happen during or immediately after surgery<\/strong><\/h3>\n<\/div>\n<\/div>\n<\/div>\n
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        One in 30 women had complications from endometrial ablation<\/span><\/p>\n