Endometrial Ablation

Endometrial Ablation (by hysteroscopy)

What is operative hysteroscopy? 
Operative hysteroscopy is a procedure in which the doctor can look into your uterus and guide a laser, electrocautery resectoscope, Thermachoice® or Novasure® instrument into the uterus. The doctor can use this procedure to remove or destroy the uterine lining. The uterus is a muscular organ at the top of the vagina where menstruation begins and babies grow.

When is it used? 
This operation may be performed when you have consistent bleeding from the uterus even after trying other procedures to control it. You may have excessive growth in the lining of your uterus, or your ovaries may not be working well.

Examples of alternatives are:

• having a D&C
• removing the uterus
• choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for a therapeutic hysteroscopy? 
Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. Avoid any over-the-counter herbs (especially those used for weight loss) 10-14 days prior to an anesthetic. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure? 
A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor dilates your cervix, then places a hysteroscope, a thin telescopelike tube with a light source, up through the cervix into the uterus. The uterus is then inflated with fluid or gas. This allows the doctor to view the inside of the uterus. The doctor uses a specially designed instrument to destroy or to remove the lining of the uterus.

What happens after the procedure? 
You may stay in the hospital about 2 hours after the procedure.

After the procedure you may:

• feel sleepy or groggy from the anesthetic
• have some cramps
• retain more urine than before
• have a watery discharge for 3 or 4 weeks afterwards.

After this operation you should not consider pregnancy. Discuss your concerns about this with your doctor.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure? 
Bleeding from the uterus should decrease or even stop because the lining of the uterus is removed. This happens without having to undergo the discomfort, hospitalization, expense, and longer recovery of a hysterectomy.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• Some of the blood vessels in the lining of the uterus may leak.
• The uterus could be punctured and need surgery to repair it.
• There is a risk of infection and bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor? 
Call the doctor immediately if:

• You start to bleed heavily.
• You develop a fever.
• You have a lot of pain in the lower abdomen.