Procedure
A number of competing procedures are available.
The HTA System uses a small telescope-like device called a hysteroscope which is inserted into the uterus through the cervix, to help doctors safely confirm proper probe placement and to see the area they are treating. This device circulates heated saline which burns the lining of the uterus. This procedure will stop, or significantly decrease, menstrual bleeding. 94% of patients who have undergone this procedure reported a satisfactory decrease in menstrual flow.
With the Novasure system a mesh is introduced into the cavity and the lining is destroyed by applying electrical energy to the mesh that will thermally damage the adjacent endometrium. 87% of patients have a successful reduction in bleeding down to normal levels.
An alternative is the Thermachoice III balloon that is filled with heated fluid to destroy the uterine lining. The fluid is safely contained in a flexible and non-allergenic material that conforms to most uterine shapes and sizes with no reduction of efficacy. Novasure® was compared with ThermaChoice® balloon ablation in a randomized trial of 126 women. There were no operative complications in either group. At five-year follow-up, the Novasure® versus ThermaChoice® groups had no significant differences in the frequency of amenorrhea (48 versus 32 percent), repeat ablation (one woman in each group), or hysterectomy (10 versus 13 percent). < Older methods utilize hysteroscopy to insert instruments into the uterus to destroy the lining under vision using laser or electrical current in a small loop. Another system introduces a radio-frequency rod that emits energy to destroy the uterine lining.
The procedure is done while the patient is either under local anesthesia, or, if necessary, general or spinal anesthesia. The recovery period can be from one day up to 2 weeks.
After the procedure, the endometrium heals by scarring, reducing or removing the possibility of future uterine bleeding. The patient may develop amenorrhea, however hormonal functioning will remain unaffected.
Read more about this topic: Endometrial Ablation