My daughter, now 38, visits me. She had undergone so called "ablation" overseas, of which I never knew. Some 11 years ago she gave a traumatic childbirth when her placenta would not come out so her obstetrician performed manual detachment. After that, 8 years ago she had undergone ablation for her heavy periods. Currently, she suffers lessened periods and lower back pain. Is there a cure for her reduced menstrual bleeding? Is that dangerous? 10x
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Endometrial Ablation
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Endometrial ablation is a rare procedure performed in drastic cases. And yes, next to 80% of those who undergo this procedure will have reduced menstrual bleeding. Endometrial lining can be ablated (removed) through different methods; yet, the aim of each method is the same - to burn (surgically destroy) the endometrium. This can be done under the general or regional (spinal) anesthesia and through:
- hydrothermal ablation (the saline fluid, filled in the uterus with the help of hysteroscope, is slowly heated and the inner lining of the uterus is burned)
- transcervical resection with cauterization loop
- NovaSure system (endometrium is burned with the help of electrically charged mesh placed in the cavity)
- Thermachoice balloon (burning with heated fluid filled in the balloon which is inserted into the cavity)
burning with laser or electric currents
- radio-frequency rod that emits energy to destroy the uterine lining
application of the iodine tincture in the uterine cavity.
Side effects may include myometrial burns and perforation, bowel burns ( a fatal condition), pulmonary edema or embolism (fatal again), post-ablation tubal sterilization, infertility, infections.
Recovery from the burns may last from one day up to 2 weeks. The endometrium heals by scarring. The procedure typically results in infertility, however it should not be considered as a reliable birth control method, because pregnancy can still occur in a small portion of the endometrial residue. If that happens, your daughter may have a delivery complication with placenta accreta (when chorionic villi are attached to the myometrium, instead of the decidua). If this happens, hysterectomy will be performed.
In 30% cases, the ablation fails. This mostly occurs in women younger than 45 years and who have 5 or more children, who had prior tubal ligation, and history of painful menstrual cramps.
Your daughter is 39, still in reproductive age. Therefore, the absence of endometrial phases (proliferation, secretion, menses) may alter the hypothalamic-pituitary axis, resultant in several conditions. She may need mammography, thyroid test (T3), and pap smear performed at least every 6 months. Her doctor may prescribe birth control pills (as hormonal treatment).
- hydrothermal ablation (the saline fluid, filled in the uterus with the help of hysteroscope, is slowly heated and the inner lining of the uterus is burned)
- transcervical resection with cauterization loop
- NovaSure system (endometrium is burned with the help of electrically charged mesh placed in the cavity)
- Thermachoice balloon (burning with heated fluid filled in the balloon which is inserted into the cavity)
burning with laser or electric currents
- radio-frequency rod that emits energy to destroy the uterine lining
application of the iodine tincture in the uterine cavity.
Side effects may include myometrial burns and perforation, bowel burns ( a fatal condition), pulmonary edema or embolism (fatal again), post-ablation tubal sterilization, infertility, infections.
Recovery from the burns may last from one day up to 2 weeks. The endometrium heals by scarring. The procedure typically results in infertility, however it should not be considered as a reliable birth control method, because pregnancy can still occur in a small portion of the endometrial residue. If that happens, your daughter may have a delivery complication with placenta accreta (when chorionic villi are attached to the myometrium, instead of the decidua). If this happens, hysterectomy will be performed.
In 30% cases, the ablation fails. This mostly occurs in women younger than 45 years and who have 5 or more children, who had prior tubal ligation, and history of painful menstrual cramps.
Your daughter is 39, still in reproductive age. Therefore, the absence of endometrial phases (proliferation, secretion, menses) may alter the hypothalamic-pituitary axis, resultant in several conditions. She may need mammography, thyroid test (T3), and pap smear performed at least every 6 months. Her doctor may prescribe birth control pills (as hormonal treatment).
There is no problem with less bleeding as the ablation is meant to treat heavy periods and reduce or stop the bleeding.
She needs to be seen by a gynecologist. An ultrasound and uterine (endometrial) biopsy should be considered. Blood tests may be helpful to evaluate hormones and other issues related to her periods. The back pain may (i.e., (pelvic floor dysfunction) or may not be related to her menstrual concerns and should be evaluated as well.