A quick guide to endometrial ablation
We are naturally scared by things we can’t see. It’s hard to imagine and can be difficult to accept what’s going on inside you, especially in a part of your body that feels so private and so delicate.
But endometrial ablation is a common procedure that tens of thousands of women in Canada have every year. Knowing this, at least, should make you feel a little more confident about what’s around the corner.
Why do I need it?
If your doctor has recommended endometrial ablation, then no doubt you’ll probably be tired of abnormal, prolonged – sometimes heavy – bleeding, and this is a way of hopefully stopping or at least minimizing this annoying problem.
However, the nature of this procedure means that it’s not for everyone. If you’ve already had a family, or don’t wish to have children, then this type of surgery is fine for you and your body. But because endometrial ablation removes the lining of the uterus – the environment a fetus needs to grow and develop – you shouldn’t be considering this option if you wish to become pregnant in the future.
What happens during the procedure?
As you’re about to discover, the idea of this procedure might sound a little unpleasant. But bear in mind that endometrial ablation is described by doctors as ‘minimally invasive’, meaning that it’s very simple, is over quickly and is very unlikely to cause further damage to your body. You’ll be in and out of hospital within a day. So relax.
So here’s the deal: the endometrial lining of your uterus – the tissue that’s bleeding – is burned away with a wand (not a magical one, I’m afraid) powered either by electricity or radio frequency.
The good news is that the wand can reach your uterus without making any incisions. Your cervix – the small opening between the uterus and vagina – is dilated to allow a scope with a tiny camera inside. It does help if the doctor can see what he or she is doing!
If your doctor uses an electric current which runs through a small metal loop or rollerball, the uterus will then be filled with fluid to allow room to maneuver. The heat of the current running through the ball or loop destroys the endometrial surface.
Your procedure might alternatively be done using radio waves – a system called Novasure. Your cervix will still need to be dilated, but rather than filling your uterus with fluid, a triangular wand made of mesh will expand to fit. A blast of radio frequency lasting a minute and a half destroys the lining.
How will I feel afterwards?
You’ll have anesthetic for this procedure and if you’ve had this before, you’ll know that afterwards you can feel a little nauseous, tired out and generally unwell. How it makes you feel depends on which type of sedation your doctor uses and whether it is a local anesthetic or a general anesthetic. The effects of each vary from person to person; some feel the effects less than others.
Many people can expect to be back to their best in around 12 hours and because you’ll only be in the hospital for a day, you can head home and sleep it off! If you’re a bit less lucky, you may experience menstrual-like cramps for one or two days, find you need to go to the toilet more often, or find watery discharge mixed with blood for up to a couple of weeks. These side effects are very common and even if you are unfortunate to experience all of them it’s still normal.
As is the case for any kind of surgery, however straightforward, there are risks involved. The main risk with endometrial ablation is perforation of the uterine wall or bowel during surgery. You may also experience blood loss, an infection, or you might need medication to control pain after the operation. As long as you’re aware of what the typical side effects are, as described above, you will be able to let your doctor know if you’re experiencing anything else that could be a problem.