Endometrial ablation

Question 1

What is endometrial ablation?

Answer 1

Outpatient procedure to remove or destroy endometrial layers (can prevent periods / heavy bleeding)

Question 2

What are the indications for endometrial ablation?

Answer 2

o Menorrhagia in premenopausal or perimenopausal women with normal endometrial cavities

o Postmenopausal bleeding of unknown origin

o Anovulatory bleeding and bleeding secondary to fibroids (intramural or submucosal <2cm for GEA, microwave ablation for submucosal up to 3cm) – higher risk of failure as does not remove fibroids

o No desire for future fertility but desire to retain uterus or avoid hysterectomy

Question 3

What are the complications of endometrial ablation?

Answer 3

o General = infection, bleeding, failure, damage to local structures (i.e. cervical os, uterus lining)

o Minor SE = cramping, nausea, frequent urination, watery discharge mixed with blood

o Rarely = pulmonary oedema due to fluid used to expand uterus being absorbed into blood stream