Endometrial Ablation

 

Endometrial Ablation may be an alternative treatment option for pre-menopausal women with menorrhagia (excessive uterine bleeding) due to benign causes, for whom childbearing is complete. This condition is frequently treated by performing a hysterectomy. The Hydro ThermAblator® system (HTA® System) is designed to ablate the endometrial lining of the uterus without the need for surgery.

WHY IS ENDOMETRIAL ABLATION PERFORMED?

Endometrial ablation is an alternative to hysterectomy for the treatment of menorrhagia in women who wish to keep their uterus or avoid major surgery. Instead of removing the whole uterus, only the inner lining is gone. Menorrhagia is a condition in which a woman has extremely heavy or prolonged menstrual periods. Bleeding between periods is called abnormal uterine bleeding. In some cases, bleeding may be so severe and relentless that daily activities become interrupted and anemia develops.

In general, bleeding is considered excessive when a woman soaks through enough sanitary products (sanitary napkins or tampons) to require changing every hour. Bleeding is considered prolonged when a woman experiences a menstrual period that lasts longer than seven days.

Menorrhagia and abnormal uterine bleeding may be due to a hormone imbalance or disorder (particularly estrogen and progesterone), especially in women approaching menopause or after menopause. Other causes of abnormal bleeding include the presence of abnormal tissues such as fibroid tumors (benign tumors that develop in the uterus, also called myomas), polyps, or cancer of the endometrium or uterus.

Depending on the cause of the bleeding, endometrial ablation may be recommended to destroy the lining of the uterus. Because the endometrial lining is destroyed, it can no longer function normally, and bleeding is stopped or controlled. In most cases, a woman cannot become pregnant after endometrial ablation because the lining that nourishes a fetus has been removed. However, after ablation, a woman still has her reproductive organs.

There may be other reasons for your physician to recommend endometrial ablation.

WHO IS A GOOD CANDIDATE FOR ENDOMETRIAL ABLATION?

    • Women who are pre-menopausal

    • You limit your activities due to heavy bleeding

    • Heavy bleeding is causing you to be anemic or tired

    • Women who have finished having children and have no future fertility interest

    • Women who wish to retain their uterus

WHAT DOES AN ENDOMETRIAL ABLATION INVOLVE?

You will talk with your doctor and have a number of tests before the procedure is done. The tests may include:

    • Hysteroscopy

A slender, light-transmitting telescope, the hysteroscope, is used to view the inside of the uterus.

    • Ultrasound

Sound waves are used to view the pelvic organs.

    • Endometrial Biopsy

A small amount of the tissue lining the uterus is removed and viewed under a microscope.

Ablation is done as an outpatient procedure or it can be performed in the office. Surgery in most cases. This means you can go home the same day. After ablation, some women still have light bleeding or spotting and may experience some cramping in which ibuprofen is usually adequate to treat the pain.

A woman who has had ablation still has all her reproductive organs in place. Because of this, routine Pap tests and pelvic exams are still needed after ablation.

WHAT IS THE EFFECTIVENESS OF ENDOMETRIAL ABLATION?

Approximately 90% of women who undergo endometrial ablation will have reduced menstrual bleeding. Of those, approximately 45% will stop having a period altogether. A small percent of women will require additional treatment or a hysterectomy.

hydro thermablator® system (hta)

The Hydro ThermAblator® System uses heated fluid that is pumped into the uterus and destroys the endometrial lining with high temperature.

The HTA System is designed to offer:

    • A therapy that fully conforms to uterine lining by circulating heated saline.

    • A gravity flow system which is designed to:

Limit maximum fluid pressure < 52 mm Hg.

Prevent fluid escape through the fallopian tubes.

    • Treatment of a partial septate uterus.

    • Therapy in the presence of intramural uterine fibroids (≤4 cm).

    • Hysteroscopic visualization which promotes proper device placement throughout treatment cycle.

 

 

 

 

 

 

 

 

Source

  1. Boston Scientific: http://www.bostonscientific.com/Device.bsci?ge=HCP_Overview&navRelId=1000.1003&method=DevDetailHCP&id=10004911&pagedisclaimer=Disclaimer.ProductPage
  2. Johns Hopkins Medicine: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/endometrial_ablation_92,P07774/