What is an endometrial ablation?

An endometrial ablation is an operation to prevent the lining (endometrium) of your uterus (womb) from growing, either completely or partially each cycle (month).

There are three common devices used to perform an endometrial ablation.

• radiofrequency
• thermal balloon
• microwave

Each device uses heat to treat the endometrium.

What are the benefits of surgery?

The most common reason for having an endometrial ablation is to relieve the symptoms of heavy periods (abnormal uterine bleeding).

Pain is usually significantly reduced, although for some women mild cramping may still happen.

About a third of women who have the operation will not have periods anymore.

Are there any alternatives to surgery?

Heavy periods can be treated using a variety of medical treatments. Some treatments contain hormones and some do not.

There are a number of alternative treatments.

• Oral (mouth) tablets.
• Injections.
• An implant (a small device which sits under the skin in your arm).
• An IUS (intra-uterine system — an implant containing a synthetic form of the hormone progesterone that fits in your womb).

What does the operation involve?

The operation can be performed under a local or general anaesthetic. The operation usually takes about 20 minutes.

Your gynaecologist will examine your vagina. They will pass a hysteroscope (telescope) through your vagina, across your cervix (neck of your womb) into your womb to look at the shape and size of your womb to check you are suitable for an endometrial ablation.

Your gynaecologist will place the endometrial ablation device into your uterus and treat the endometrium. Your gynaecologist will usually use the hysteroscope again afterwards to check the endometrium has been treated.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• feeling or being sick
• venous thromboembolism
• infection
• allergic reaction to the equipment, materials or medication
• chest infection

Specific early complications

• thermal burns
• making a hole in your womb with possible damage to a nearby structure

Specific late complications

• haematometra, where blood and other menstrual fluid collect in pockets in your womb
• continued bleeding or pain
• If you have been previously sterilised, post-ablation tubal sterilisation syndrome (PATSS), where menstrual fluid becomes trapped in the fallopian tubes, causing pain
• pregnancy problems

Consequences of this procedure

• pain
• bleeding or discharge, lasting up to 4 weeks

How soon will I recover?

You should be able to go home the same day.

You may get some cramps and mild bleeding similar to a period. Rest for 1 to 2 days and take painkillers if you need them.

You should be able to return to normal activities after 2 to 4 days. Most women are fit for work after 3 to 4 days.

You should expect to have some bleeding or discharge for up to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Summary

An endometrial ablation is a common gynaecological operation. It helps relieve the symptoms of heavy periods. You should get less bleeding and pain.

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