Endometrial ablation/ resection for the treatment of heavy menstrual bleeding
The procedure involves destruction or removal of the lining of the lining of the womb. It is a surgical method of treating abnormal heavy periods negating the need to have a hysterectomy.
In the olden days women used to have the so called D&C but this was found not to have any effect on the heaviness of bleeding.
to have effect it was found that removal of the "deeper" muscle layer of the womb was required. This has been shown to be effective in treating heavy menstrual bleeding.
The first endometrial ablation was performed in way back in 1948, however the modern technique was developed in 1981 with the first transcervical resection of endometrium was performed in 1983, where a loop was used to remove the lining of the womb. Subsequent to this Laser was used but instruments were too cumbersome and expensive.
Some of the problems with the technique were:
Difficulty in training doctors in the technique due to the amount of skill required performing the procedure safely.
Complications such as
Though the studies that looked at the complications were in a way flawed, technology has been developed to lower the complexity of the procedure,
so it can be learned by more doctors, to theoretically reduce the risk of complications, making the procedure available to more women, and to allow the procedure to be performed under local anaesthesia in the day case setting.
Different types of procedures include:
all these technologies manage to treat heavy menstrual bleeding with varying techniques, and different levels of eff
On a whole the procedures are cost effective as the procedures are done as day cases and women are able to return to normal activities much quicker than they would if they had a hysterectomy.
On average 70-90% of women who have the procedure will have relief from symptoms of heavy bleeding.
Between 30-40% of women will stop having periods altogether
30% of women may need to have an additional procedure if the symptoms persist.
It is more successful in women over 45 years
Whatever type of ablation is performed CONTRACEPTION in still required as women have been known to fall pregnant after endometrial ablation and such pregnancies are usually plagued with difficulties with an increased risk of miscarriage
Small babies
Very adherent placentas
The procedure involves destruction or removal of the lining of the lining of the womb. It is a surgical method of treating abnormal heavy periods negating the need to have a hysterectomy.
In the olden days women used to have the so called D&C but this was found not to have any effect on the heaviness of bleeding.
to have effect it was found that removal of the "deeper" muscle layer of the womb was required. This has been shown to be effective in treating heavy menstrual bleeding.
The first endometrial ablation was performed in way back in 1948, however the modern technique was developed in 1981 with the first transcervical resection of endometrium was performed in 1983, where a loop was used to remove the lining of the womb. Subsequent to this Laser was used but instruments were too cumbersome and expensive.
Some of the problems with the technique were:
Difficulty in training doctors in the technique due to the amount of skill required performing the procedure safely.
Complications such as
- Perforation of the womb with damage to
- Bladder and or
- Bowel.
- Problems with absorption of fluid used to perform the procedure
- Bleeding requiring hysterectomy.
Though the studies that looked at the complications were in a way flawed, technology has been developed to lower the complexity of the procedure,
so it can be learned by more doctors, to theoretically reduce the risk of complications, making the procedure available to more women, and to allow the procedure to be performed under local anaesthesia in the day case setting.
Different types of procedures include:
- Balloon ablation (CavatermTM, ThearmachoiceTM)
- Novasure
- HydrothermalAblation,
- Cryoablation,
- Microwave ablation,
- Radiofrequency,
- VersapointTM. (bipolar)
- Photodynamic therapy.
all these technologies manage to treat heavy menstrual bleeding with varying techniques, and different levels of eff
On a whole the procedures are cost effective as the procedures are done as day cases and women are able to return to normal activities much quicker than they would if they had a hysterectomy.
On average 70-90% of women who have the procedure will have relief from symptoms of heavy bleeding.
Between 30-40% of women will stop having periods altogether
30% of women may need to have an additional procedure if the symptoms persist.
It is more successful in women over 45 years
Whatever type of ablation is performed CONTRACEPTION in still required as women have been known to fall pregnant after endometrial ablation and such pregnancies are usually plagued with difficulties with an increased risk of miscarriage
Small babies
Very adherent placentas
Educational Video of actual surgery. Showing Trancervical resection of endometrium for treating heavy periods
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