Endometrial ablation

Endometrial ablation
Schematic illustration of endometrial ablation
ICD-9-CM	68.23
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Endometrial ablation is a surgical procedure that is used to remove (ablate) or destroy the endometrial lining of the uterus. The goal of the procedure is to decrease the amount of blood loss during menstruation (periods). Endometrial ablation is most often employed in people with excessive menstrual bleeding following unsuccessful medical therapy.^[1] It is less effective than hysterectomy, but with a lower risk of adverse events.^[2]

Endometrial ablation is typically done in a minimally invasive manner with no external incisions. Slender tools are inserted through the vagina and into the uterus. In some forms of the procedure, one of these tools may be a camera (hysteroscope) to assist with visualization. Other tools include those that harness electricity, high-energy radio waves, heated fluids, or cold temperature to destroy the endometrial lining.^[3]

The procedure is almost always performed as an outpatient treatment, either at a hospital, ambulatory surgery center, or physician office. Patients will most commonly undergo local and/or light sedative anesthesia, or if necessary, general or spinal anesthesia.^[4]

After the procedure, the endometrium heals by scarring over, thus reducing or eliminating future uterine bleeding.^[5] The patient's hormonal functions will remain unaffected because the ovaries are left intact. Due to the uterine changes that take place after undergoing ablation, patients are unlikely to be able to become pregnant after the procedure, and of pregnancies that do occur, complication risk is high. To reduce the associated mortality risks, it is often recommended for patients to adhere to birth control methods after undergoing endometrial ablation.^[4]