Uterine Ablation

What is uterine ablation?

Uterine ablation is the surgical removal of the endometrium or the lining of the uterus. The uterus is a pear-shaped organ located in the lower abdominal (pelvic) area where a baby grows during pregnancy. When pregnancy does not occur, the endometrium is shed each month through menstrual bleeding. Uterine ablation is a treatment for menorrhagia (abnormally heavy menstrual bleeding).

Uterine ablation is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available depending on your circumstances. You should consider getting a second opinion about all your treatment choices before having uterine ablation.

Types of uterine ablation

The types of uterine ablation procedures include:

• Balloon thermal ablation. Your doctor inserts a balloon into your uterus and fills it with heated liquid. The heat destroys your endometrium after approximately 10 minutes.
• Cryoablation or freezing. Your doctor inserts a small probe into your uterus. The tip of the probe cools to extremely low temperatures. It freezes your endometrium to destroy it.
• Electrosurgery. Your doctor inserts a special tool into your uterus that carries an electrical current. The electrical current destroys your endometrium. The tool can have a rollerball, wire loop, spiked ball, or triangular mesh tip. You will have this procedure done with general anesthesia in a hospital.
• Hydrothermal ablation. Your doctor instills and circulates heated fluid, usually saline, inside your uterus. The heat destroys your endometrium after approximately 10 minutes.
• Laser. Your doctor inserts a laser probe into your uterus. The laser light energy destroys your endometrium.
• Microwave. Your doctor inserts a probe into your uterus that uses microwave energy to destroy your endometrium.
• Radiofrequency. Your doctor inserts a probe into your uterus that uses radio wave energy to destroy your endometrium.

Why is uterine ablation performed?

Uterine ablation is a major surgical procedure that your doctor may recommend to treat menorrhagia, which is abnormally heavy menstrual bleeding. Your doctor may only consider uterine ablation for you if other treatment options with less risk of complications have failed. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Uterine ablation is an alternative to more invasive procedures, such as a hysterectomy. A hysterectomy is the surgical removal of a woman’s uterus. However, some women should not have a uterine ablation. This includes women with the following conditions:

• Being past menopause
• Current or recent infection of the uterus
• Desire to bear a child in the future
• Disorders of the uterus or endometrium
• Noncancerous or precancerous uterine growths
• Pregnancy or recent pregnancy
• Uterine cancer
• Uterine fibroids

How is uterine ablation performed?          

An obstetrician-gynecologist will lead the surgical team and perform your uterine ablation in a hospital, outpatient surgery center, or office setting. An obstetrician-gynecologist is a doctor who specializes in the medical and surgical treatment of the female reproductive system.

Surgical approaches to uterine ablation

Uterine ablation does not involve incisions or cutting. It may be performed using one of the following approaches:

• Hysteroscopic procedures are performed by inserting special instruments and a hysteroscope into your vagina, through your cervix (opening to the uterus), and into your uterus. A hysteroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your doctor as he or she performs the surgery.
• Nonhysteroscopic procedures use specialized probes that your doctor inserts into your vagina, through your cervix, and into your uterus. Your doctor may use ultrasound imaging to view the probe’s position inside your uterus.