Benefits and Risks of Uterine Ablation Surgery

Uterine ablation is a surgical procedure that removes the lining of the uterus (endometrium) to treat uterine fibroids, heavy periods, or endometriosis. It has been shown to reduce menstrual flow, and some patients have also stopped having periods. 

In this article, we describe the benefits of uterine ablation, as well as side effects, what you can do after the procedure, and whether there is the possibility of pregnancy after ablation. 

What Are the Different Types of Ablation Procedures?

During the procedure, the physician has to widen (dilate) the opening of your cervix so they will be able to pass the instruments they will be using for ablation. They do this either with medication or rods that they insert inside the uterus to increase the diameter. 

Uterine ablation surgery takes about five minutes, and there are different methods that we can use. For example:

• Radiofrequency: The surgeon inserts a small probe into the uterine cavity and then uses radio waves to destroy tissue in the uterus.

• Heated fluids: The surgeon places heated fluids to remove the lining of the uterus. 

• Cold probe: The surgeon uses a cryogenic (very cold) probe to freeze the endometrium. 

• Balloon therapy: The doctor inserts a catheter with a special balloon at the end and inserts it into the patient’s uterus. Then, they fill the balloon with heated fluid, which then expands and destroys the endometrium.

• Electrical: Electric current destroys the uterine lining, but this is the least common method used during uterine ablation. 

What Are the Benefits of Uterine Ablation?

Some benefits of uterine ablation include the following:

The procedure can reduce or stop bleeding altogether. Every month, the uterus lining thickens to prepare the body for implantation, but menstrual bleeding occurs if there is no conception. That said, when we remove the lining of the uterus, the procedure halts or reduces menstrual flow.

The surgery can also reduce the risk of uterine infection and comes with a short recovery time so you can get back to your normal routine within a few days. This is because it doesn’t require any incisions, as we insert very thin tools through the passageway between the vagina and cervix. However, these tools vary as they depend on the method we use during surgery.

Is Uterus Ablation Surgery Right for Me?

Before the procedure, your doctor may do an endometrial biopsy, ultrasound, or hysteroscopy to check the shape and size of your uterus and if there are any abnormalities. 

They may also ask about your medical history and the medications and supplements that you are taking or whether you are on any birth control method. This helps determine whether you are the right candidate for uterine ablation surgery. 

The physician may ask you to stop any medications a week before your scheduled surgery. They may also prescribe medication that thins the endometrium or perform a dilation and curettage (D&C), to scrape out extra tissue. You should also stop smoking. 

Your doctor will also discuss the procedures available for uterus ablation surgery and those that require general anesthesia and conscious sedation. 

We do not recommend the removal of the uterus lining in postmenopausal women, those planning to get pregnant, or who have:

• Endometrial hyperplasia. 
• Uterine Cancer.
• Recently been pregnant. 
• A pelvic infection.

Can I Get Pregnant After Ablation?

Pregnancy after ablation is rare, but it can happen. We don’t recommend having your uterus lining removed if you plan on getting pregnant in the future. Women who undergo surgery should still use birth control methods. This is because complications can arise from pregnancy after ablation, as the endometrium would not support fetal development. This can also increase the risk of having a miscarriage.

Some women also choose to undergo sterilization after uterine ablation surgery. 

The next section discusses uterine ablation recovery. 

Uterine Ablation Recovery

You can get back to your normal routine within a few days, and you may experience pain and bleeding for a few days. Some patients also have watery or bloody discharge within the first three weeks and nausea for the first 24 hours. 

Your surgeon may recommend that you avoid having sex, douching, or using tampons for the first few days. If you are in pain, don’t take aspirin as it can cause bleeding. Let your healthcare provider know so they can suggest a different over-the-counter medication. 

We advise seeking medical help if you have:

• Fever.
• Chills.
• Stomach pain or intense cramping.
• Heavy bleeding.
• Trouble urinating.

Now that we have covered what you can expect during your uterine ablation recovery, we can move on to discuss the risks and complications of the procedure. 

What Are the Risks and Complications of Uterus Ablation?

Uterus ablation risks and complications are rare, but all surgical procedures carry some risks. Here is a list of some possible complications that patients can experience :

• Pain, bleeding, or infection.
• Complications related to anesthesia. 
• Heat or cold damage to nearby organs. 
• Uterine perforation. 
• Green vaginal discharge. 
• High fever. 
• Nausea and vomiting.
• Shortness of breath.

Additionally, people who have a history of painful periods or have undergone tubal sterilization may have a higher risk of developing worsening pain after uterine ablation surgery. 

They should also talk to their doctor if they smoke, drink or have diabetes or obesity as these can increase the risk for complications.

Is It Possible to Get Uterine Ablation Side Effects Years Later?

Some patients may start having heavier and longer periods again after a few years. This occurs when the uterus lining hasn’t been destroyed, and the patient may experience little relief during the first menstrual cycle after their procedure. 

An endometrial biopsy would be beneficial to determine the cause of abnormal uterine bleeding. Still, it would not be able to take place because of the scar tissue that develops from the initial ablation surgery.

They may also develop cyclic pelvic pain months or years after the procedure, which may be similar to labor pain. This happens because of a hematometra, which is a collection of blood that accumulates in the uterine cavity and can’t pass through the cervix. 

In addition, the healthcare provider may perform an ultrasound to detect a hematometra. It is easily detectable as the menstrual blood that accumulates in the uterine cavity appears as black dots 

We refer to these “side effects” as “late-onset endometrial ablation failure (LOEAF). 

LOEAF After Care

Patients that experience bleeding or cyclic pelvic pain months or years following ablation surgery may consider the following:

• A hysterectomy which involves the removal of the uterus or womb.
• Hormonal suppression to control symptoms such as birth control pills, norethindrone, or megestrol, among others. 
• Living with symptoms if they are manageable. 
• Doing an Ultrasound-Guided Reoperative Hysteroscopic Surgery (UGRHS).

Book Your Appointment Today

If you have uterine fibroids, heavy periods, or endometriosis, you can undergo uterine ablation surgery to treat your condition. Our team will discuss the different procedures available at our clinic and ask about your medical history to determine whether the procedure is the right option for you.

Call our reception desk to schedule your appointment. We look forward to meeting you at Women’s Healthcare of Boca Raton.