Hysteroscopic Endometrial Ablation

A hysteroscopic Endometrial Ablation is a surgical procedure where the lining of the uterus (endometrium) is removed or destroyed. It is most commonly used a successful treatment for women with heavy and/or irregular menstrual bleeding who no longer wish to have children. It is used as an alternative to a hysterectomy which was the traditional method of treatment for heavy periods. The procedure does not remove the uterus or the ovaries unlike certain types of hysterectomies, so patients do not need to take any hormone medication after their procedure.

Who is Suitable for Hysteroscopic Endometrial Ablation?

Hysteroscopic Endometrial Ablation can significantly reduce or eliminate heavy bleeding which affect your daily activities. If your heavy bleeding causes other health problems such as anaemia, then the procedure could also help. Approximately 50% of women who have undergone hysteroscopic endometrial ablation surgery do not have monthly bleeding at all, with the remaining 50% experiencing minimal bleeding.

Diagnosing Hysteroscopic Endometrial Ablation

Your doctor will take a full medical history from you, and will decide what investigations you may need. Ensure you inform your doctor about all medications you are taking, including over the counter medicines and herbal supplements. Investigations can include blood tests, along with an abdominal ultrasound to detect if you have any uterine fibroids.

You may also be recommended a hysteroscopy which allows the inside of your uterus to be examined before surgery has been decided. This allows the opportunity for the uterus size and shape to be estimated. It also allows for a small biopsy sample of the uterus lining to be taken to rule out any abnormal cells which may be present. A hysteroscopy is carried out as an outpatient procedure.

Preparing for your Procedure

If your doctor feels that surgery is the best option for you, they will discuss all aspects of the procedure with you ahead of time. This will give you the opportunity to ask any questions you may have to ensure you are happy with going ahead with surgery. There are a few things you should do in the days and weeks leading up to your surgery. These include:

• Removal of your IUD (coil)
• Taking a pregnancy test

Occasionally, if the lining of your uterus is particularly thick, your doctor may prescribe a medication to thin the lining prior to surgery.

How is the Procedure Performed?

Hysteroscopic Endometrial Ablation uses a hysteroscope which is a thin, lighted telescope-like device that is inserted through the vagina and into the uterus once the cervix has been dilated. Other tools are inserted through the hysteroscope to heat or freeze the uterine lining. The hysteroscope projects images of the uterus onto a monitor where the surgeon can see which areas of the uterus lining need to be removed or destroyed.

Surgery is usually performed under a general, spinal or epidural anaesthetic, meaning you may be asleep or awake throughout the procedure; however, you will not feel any pain regardless of the type of anaesthetic used. After the procedure, the uterus heals by scarring and there may be some period-like pain and bleeding, although this is entirely normal. In most cases, the patient can go home the same day.

Post-Operative Recovery

Recovery from surgery varies, depending on the type of ablation you had and the type of anaesthesia used. Once your blood pressure, pulse and breathing are stable and you feel alert, you will either be taken onto the ward if you need an overnight stay, or discharged home. You should plan to have someone drive you home.
It is advised that you wear a sanitary pad for a few days after your procedure as you will likely experience vaginal bleeding, along with a watery-bloody discharge for several weeks. This is entirely normal, but if symptoms persist beyond this time, speak to your doctor about it.

You may also experience nausea, vomiting, painful cramps or the need to urinate more frequently in the first few days following your procedure. These should disappear after this time, although cramping can last for longer. If they do persist, you can take over the counter painkillers such as paracetamol or ibuprofen to help. Avoid aspirin as this can increase the risk of bleeding.

Following your surgery, it is important that you do not have sexual intercourse, use tampons or douche. Your doctor will advise you on the appropriate length of time before you can resume these activities. Other activities you should avoid are heavy lifting and strenuous exercise.  

If you experience any of the below symptoms, you should contact your doctor immediately:

• Severe abdominal pain
• Fever or chills
• Foul smelling discharge from your vagina
• Trouble urinating
• Heavy bleeding that lasts for more than 2 days after surgery

Risks and Complications

There is a small risk of complications from hysteroscopic endometrial ablation surgery, including infection of the uterus. This will usually be present as an offensive vaginal discharge which will need treating with antibiotics.

It is recommended that you continue to use birth control post-surgery because if pregnancy does occur, it is more likely to result in miscarriage. The endometrial lining usually thickens in response to pregnancy, but without a thick lining following your procedure, an embryo cannot implant and grow successfully.

More serious risks, although rare can include:

• Infection or bleeding
• Damage to the vagina, vulva or bowel from the heating and freezing applications used during surgery
• Puncturing of the uterine wall or bowel
• Absorption of the fluid used during surgery into your bloodstream

Need Help?

At One Healthcare we can arrange for you to see a specialist Gynaecology surgeon for an initial consultation, usually within 48 hours.  The Hysteroscopic Endometrial Ablation procedure at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Hysteroscopic Endometrial Ablation treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

Contact us and find out more

If you live in and around the Kent area and would like to visit our One Ashford Hospital please click here

If you are based in and around Hertfordshire and would like to visit the One Hatfield Hospital please click here.