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Endometrial ablation is a procedure to remove a thin layer of tissue (endometrium) in the uterus. It is done to stop or reduce heavy menstrual bleeding. But it is only done on women who do not plan to have any children in the future.
The procedure is not surgery, so you will not have any cut (incision). Instead your healthcare provider puts small tools through your vagina to reach your uterus. Your provider has several ways to do the procedure. He or she can use:
Some endometrial ablations are done using tool called a hysteroscope. This tool lets your provider see the inside of your uterus. He or she can use a camera on the tool to record what is seen.
You may have endometrial ablation if you have heavy or long periods. You may also have it for bleeding between periods (abnormal uterine bleeding). In some cases, the bleeding may be so heavy that affects your daily activities. You may have a low blood count (anemia) because of it.
Heavy bleeding means enough bleeding that you have to change sanitary pads or tampons every hour. Long periods are those that last longer than 7 days.
Menstrual bleeding problems may be caused by hormone problems. This is especially true for women nearing menopause or after menopause. Other causes include abnormal tissues such as fibroids, polyps, or cancer of the endometrium or uterus.
Endometrial ablation lessens menstrual bleeding or stops it completely. You may not be able to get pregnant after endometrial ablation. This is because the lining that helps a fetus grow has been removed. But you will still have your reproductive organs.
Your healthcare provider may have other reasons to suggest endometrial ablation.
Possible complications of endometrial ablation include:
Tell your healthcare provider if you are:
You may have other risks based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
You may not be able to have an endometrial ablation if you have:
Certain things can make it harder to do certain types of endometrial ablation. These include:
You may have an endometrial ablation in your healthcare provider's office, as an outpatient, or during a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.
The type of anesthesia will depend on the procedure being done. It may be done while you are asleep under general anesthesia. Or it may be done while you are awake under spinal or epidural anesthesia. If spinal or epidural anesthesia is used, you will have no feeling from your waist down. The anesthesiologist will watch your heart rate, blood pressure, breathing, and blood oxygen level during the procedure.
Generally, an endometrial ablation follows this process:
The recovery process will vary, depending on what type of ablation you had and the type of anesthesia used.
If you had spinal, epidural or general anesthesia, you will be taken to the recovery room. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or sent home. If you had the procedure as an outpatient, plan to have someone else drive you home.
If you did not get anesthesia, you will need to rest for about 2 hours before going home.
You may want to wear a sanitary pad for bleeding. It is normal to have vaginal bleeding for a few days after the procedure. You may also have a watery-bloody discharge for several weeks.
You may have strong cramping, nausea, vomiting, or the need to urinate often for the first few days after the procedure. Cramping may continue for a longer time.
Do not to douche, use tampons, or have sex for 2 to 3 days after an endometrial ablation, or as advised by your health care provider.
You may also have other limits on your activity. These may include no strenuous activity or heavy lifting.
You may go back to your normal diet unless your healthcare provider tells you otherwise.
Take a pain reliever for cramping or soreness as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.
Your healthcare provider will tell you when to return for more treatment or care.
Tell your healthcare provider if any of these occur:
Your healthcare provider may give you other instructions after the procedure, based on your situation.
Before you agree to the test or the procedure make sure you know:
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