The uterus has 3 different layers of tissue, each one of them with different functions in the menstrual cycle and during pregnancy development. Endometrium, also called endometrial lining, is the layer that covers the interior of the uterus cavity.
The endometrium has many important functions. For example, during the pregnancy process, the endometrium receives the embryo during implantation and protects it during the entire pregnancy process. On the other hand, in the menstrual cycle, the endometrium suffers different changes induced by the sexual hormones and, if the implantation doesn't occur, it is shed and expulsed through the vagina, which produces the menstruation.
Certain conditions and diseases can affect the normal function of endometrium, which can cause an excessive bleeding during menstruation or between consecutive menstrual cycles. In those cases, an endometrial ablation might be indicated.
WHAT IS AN ENDOMETRIAL ABLATION?
An endometrial ablation is defined by the experts as the surgical procedure used to destroy the endometrium. It can be used to reduce, control or completely stop an abnormal menstrual bleeding.
WHY MUST I UNDERGO AN ENDOMETRIAL ABLATION?
The endometrial ablation is considered the best treatment for abnormal menstrual bleeding due to non-cancerous or benign conditions. Experts consider heavy menstrual bleeding as the one that lasts more than eight days and forces the woman to change the pad or tampon approximately every two hours, and that is so severe that it can cause anemia.
However, it is important to know that this procedure is not performed as the first-line of treatment for heavy bleeding. In fact, it is reserved for those women who do not respond appropriately to medical or hormonal therapies.
Although it is not recommended, an endometrial ablation can be used in certain cases of endometrial cancer, but if cancer cells have reached the deepest part of the tissues, the ablation might not reduce bleeding.
WHAT MUST I DO BEFORE AN ENDOMETRIAL ABLATION?
In the first place, the patient must visit a doctor (please follow the link to read more on Gynecology Consultation) to determine the cause of the excessive or abnormal bleeding. For that, the patient must undergo many blood tests, images studies and even an endometrium biopsy.
All those tests, besides helping to determine the cause of the menstrual alterations, will help to discard some conditions like uterine polyps, benign tumors and endometrium cancer. Likewise, the doctor will exclude the diagnose of pregnancy and will remove any intrauterine contraceptive devices (IUDs) before performing an endometrial ablation.
HOW IS AN ENDOMETRIAL ABLATION PERFORMED?
To perform an endometrial ablation, the doctor will produce the cervix dilation and will insert the instruments needed to perform the procedure through the vagina until the body of the uterus. In some cases, a lighted viewing instrument, called Hysteroscope, is used to improve the doctor's vision inside the uterus cavity during the procedure.
The tools that will be used during the procedure will vary according to the method used to perform the ablation per se. There are different techniques that can be used to produce the endometrial ablation. In general terms, they include using extreme cold, extreme heat, high-energy radio-frequency, laser beams, among others.
Some methods can be performed in the doctor's office while others must be performed as outpatient surgeries in an operating room. In all cases, endometrial ablation is considered a safe procedure.
The surgeon will recommend the best way of treatment to each patient according to different characteristics, including the size and shape of the uterus, the intake of certain medication before the procedure, the surgeon's experience and the type of anesthesia preferred by the patient.
WHAT MUST I EXPECT AFTER AN ENDOMETRIAL ABLATION?
Immediately after the procedure, the woman can experience menstrual-like cramps for a few days, watery vaginal discharge (that in some cases may be mixed with a little blood), frequent urination, among others. If these symptoms are severe or last more than a week, you must consult a doctor.
The patient also must know that, although pregnancy can occur after an endometrial ablation, the pregnancy may be riskier than a normal pregnancy. In fact, miscarriages are very frequent because the endometrium is in charge of allowing implantation and protecting the fetus during pregnancy development, and it has been damaged.
Likewise, after an endometrial ablation, ectopic pregnancy (outside the uterus) is also frequent. So, experts recommend avoiding pregnancy for a long period after the ablation or reserve the procedure for women who don't desire to get pregnant.
HOW MUCH DOES AN ENDOMETRIAL ABLATION COST?
The cost of an endometrial ablation can vary according to the technique that will be used to destroy the endometrium. Likewise, according to the amount of endometrium that will be removed and the patient's general health condition the cost of endometrial ablation can be higher or lower.
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