Endometrial Ablation

Endometrial Ablation – Treatment for Heavy Bleeding

Board-certified gynecologists Dr. Cindy Basinski and Dr. Rupal Juran offer endometrial ablation for patients who experience abnormal, painful, irregular and/or heavy bleeding. An Endometrial Ablation is a procedure that can be performed in the operating room or, less expensively, in the office, to control heavy, irregular, prolonged, painful or otherwise troublesome bleeding. An ablation usually takes 2-5 minutes and is completely non-hormonal and will therefore not add any of the risks associated with taking hormones or alter your own natural hormone levels.

After the procedure, 90-98% of women are reported to be satisfied with the results. Approximately 60-70% of women will have little to no bleeding after an ablation procedure with another 20-30% experiencing lighter periods that are markedly improved from pre-treatment. Approximately 10% of patients will “fail” an ablation procedure, meaning they will require further treatment in the future for continued bleeding or cramps. There are still many options with which we can treat patients who continue to have bleeding and/or pain after an ablation. Those options include medical treatment such as hormone therapy, attempting to perform another ablation or place a Mirena IUD, or treatment such as hysterectomy. In case you end up in the minority of women who do require further treatment, we will work with you to find a treatment suitable for you!

Treatment

Each month during a period, the uterine lining is shed and a new lining starts to grow.

Ablation uses energy, rather than hormones, to permanently remove the cells that grow the lining inside the uterus. By permanently removing these cells, we can prevent the regrowth of this uterine lining and try to stop periods permanently. An ablation procedure typically takes about 2 minutes for the ablation itself, with a few minutes before and after to prepare the uterus for the procedure and then to check the uterus afterwards. Prior to any ablation, hysteroscopy and D&C are performed to evaluate the lining of the uterus.

At Basinski & Juran, M.D.s we are committed to providing you the best experience possible by making available the option of IV medications for control of discomfort during your procedure without any additional out-of-pocket expenses. We use both oral medications such as Valium and IV medications during the ablation to achieve relaxation and assist with any cramping you may experience. Dr. Basinski and Dr. Juran and their nurses have obtained special certification to safely administer IV medications in an office setting, eliminating the need for an anesthesiologist and eliminating out-of-pocket anesthesia fees.

What can I expect after my ablation?

Following the procedure, you might have some moderate to intense uterine cramps that can last 4-6 hours. We ask that you take your prescription pain pills upon arriving home after your procedure to reduce discomfort and allow you to sleep comfortably. Most people find they sleep through a majority of the cramping and awake feeling little discomfort. For some fortunate women, they do not experience any cramping at all.

You may return to work the day following your procedure, but we ask that you avoid sexual intercourse for 4 weeks to avoid infection of the uterus. You may have a watery or bloody discharge for up to 6 weeks following your procedure until the uterine lining heals. If you are not happy with your bleeding pattern after 3-6 months, you may opt to try hormonal therapy, consider a repeat ablation, or consider a hysterectomy to control your abnormal bleeding.

What’s the difference between ablation and hysterectomy?

While both procedures may have the desired effect of no more bleeding or cramps, the ablation can be performed in-office, in a matter of minutes, without general anesthesia. In contrast, a hysterectomy must be performed in the Operating Room (OR) under general anesthesia and may take one hour or more. The downtime after an ablation is minimal; typically the only time off work a patient needs is the afternoon of the procedure. Recovery time and time off work after a hysterectomy is typically 2-4 weeks and sometimes even 6 weeks. For an ablation, no incisions are made in your abdomen, whereas a hysterectomy, even when performed laparoscopically or minimally invasively, may still require incisions on your abdomen.

Is ablation a form of birth control?

No. While ablations may stop your periods, ablations do not prevent pregnancy. Dr. Basinski and Dr. Juran encourage their patients to consider permanent birth control such as Essure, tubal ligation, or vasectomy prior to having an ablation procedure. A pregnancy that occurs after ablation can be high risk both to the baby and to the mother, as the lining of the uterus has now been altered and the pregnancy may not properly implant. This may lead to growth defects, bleeding, and possibly require emergency hysterectomy during pregnancy. The Essure procedure is a sterilization procedure that can be performed in-office prior to the ablation and is a popular permanent birth control option for many patients.