The percentage of women suffering from severe or prolonged periods is constantly growing. Also, many women are forced to be treated for polyposis and other pathologies of proliferation of the uterine mucosa - endometriosis . Causes of illness in women can be hormonal disorders, poor blood coagulability, infectious diseases and neoplasms. Treatment-diagnostic curettage, which is shown with such ailments, does not always give a positive and lasting effect. An alternative way to get rid of massive bleeding is ablation of the endometrium.
What is ablation of the uterus?
Ablation of the endometrium is a procedure that is aimed at destroying the entire thickness of the uterine mucosa. The procedure is carried out as an alternative method of uterine removal (hysterectomy or uterine ex- traction ) with minor fibroids or endometriosis of the uterus.
The internal mucosa of the uterine body - the endometrium - refers to tissues that directly depend on the hormones in the body of a woman. Throughout the menstrual cycle, the endometrium undergoes transformation. For example, in the second phase of the menstrual cycle, it reaches its maximum thickness due to the fact that the blood supply to the mucous membrane of the uterus increases and the level of progesterone increases. All these changes take place in order that the uterine cavity is ready for conceivable conception, in the case of not onset of pregnancy, the endometrium begins to be rejected, what is called menstruation. If a woman's periods are too abundant and include blood clots, ablation of the endometrium of the uterus can permanently rid the woman of this unpleasant symptom.
What are the indications for ablation of the endometrium?
Not all patients are recommended by the doctor for ablation of the endometrium, accurate measurements are needed to perform the operation. Patients older than 35 years who suffer from prolonged and profuse bleeding, and who do not experience improvement after conservative treatment, ablation is recommended. Also, postmenopausal women, who can not be treated with hormone therapy, are among the patients who undergo ablation of the endometrium.
Before the procedure, the doctor must explain to the woman that after the operation she loses her fertility, so most often ablation is recommended for women at the pre-menopausal age.
The procedure is not performed for women who suffer from heavy menstruation (more than 150 ml), which are a consequence of cancer.
How does the endometrial ablation work?
The procedure is performed under intravenous anesthesia or epidural anesthesia. A small probe is inserted into the uterine cavity, which has a special nozzle for examining the walls of the uterus and the mouth of the fallopian tubes. Endometrial ablation can be performed in several ways by:
- laser radiation;
- hot liquid;
- a microwave nozzle;
- radio frequency method;
- cryodestruction;
- electrosurgery.
The most often performed hysteroscopic ablation of the endometrium, in which the internal mucosa of the uterus is cauterized
The advantages of ablation of the endometrium, in comparison with scraping and hormone therapy, include high efficiency, good tolerability, fewer consequences, faster recovery.
Very rarely, but sometimes, the effects of endometrial ablation may include bleeding, inflammation, heat injury to the vagina or vulva, and damage to the uterus. Pain after surgery can be directly related to the ablation complications listed above.