Uterine Endometrial Ablation
Uterine Endometrial Ablation is one of the most effective options for persistent, prolonged, and heavy uterine bleeding/cramping, symptomatic small fibroids, and adenomyosis. The procedure is designed for patients that do not desire future fertility/pregnancies or surgery/operation. It is an excellent alternative to hysterectomy in appropriate candidates. There are no hormones or surgery involved. An endometrial ablation destroys the lining of the uterus by using either a freezing (cryoablation) or heat energy (thermal ablation) technique.
Cryoablation (Her Option®)
Cryoablation (Her Option®) is a minimally invasive, safe, in-office procedure that destroys the lining of the uterus via freezing. It is performed in the convenience of our office with minimal to no discomfort. It can accommodate different uterine sizes and shapes, and is highly effective with a patient satisfaction rating of greater than 90%. About one hour before the procedure, pain relief and relaxation medications (toradol and ativan) are administered. Local anesthesia is sometimes used if needed to numb the cervix just prior to the procedure. When anesthesia is adequate, a slender probe is inserted through the vagina into the uterine cavity, where it creates an ice ball that freezes the uterine lining and most of the uterine wall tissue creating a permanent effect. Cold temperatures have a natural pain relieving (analgesic) effect, reducing pain associated with the procedure. During the procedure, your doctor will monitor the progress of the treatment using an abdominal ultrasound. The procedure takes about 25-35 minutes, and the recovery time is less than one hour. Vaginal discharge is expected to last for about two weeks. Post-procedure discomfort is mild and usually adequately treated with using over the counter pain killers, such as advil, motrin, or tylenol. Patients usually return to work in 1-2 days.
After three months, patients’ periods are expected to be absent or lighter with shorter duration and significantly less cramping. This effect is typically permanent. This procedure is not a sterilization procedure and patients still need to use birth control after the procedure. If permanent birth control is desired, an In-office Tubal Occlusion (Essure®) Procedure can be performed at the same or later time.
Thermal Endometrial Ablation
Thermal Endometrial Ablation is similar to Uterine Cryoablation, but the uterine lining is destroyed with a device supplying heat energy instead of using a freezing probe. Sometimes this method is limited by the size and shape of the uterus. Patient satisfaction and therapeutic effects are similar. Usually this method is performed in an Outpatient Surgery Center under general anesthesia. There are some doctor’s offices that can perform this procedure under conscious sedation in the office with appropriate monitoring. On average, over a 5 year period, endometrial ablation techniques are about 85% effective. About 15% of patients will require additional treatment or hysterectomy.