Endometrial ablation for heavy periods
Hysteroscopic
endometrial ablation for the treatment of abnormally heavy periods was first described
in 1981, and has since become an accepted alternative to long-term treatment with
drugs or hysterectomy for this common symptom. All ablation techniques aim to destroy
or excise (cut out) as much of the endometrium (lining of the womb) as possible,
thereby making periods much lighter or stopping them altogether.
As the treatment is generally very successful, many thousands of such procedures
are done each year in the UK.
There are several techniques for endometrial ablation, which can be broadly classified as "hysteroscopic" and "non-hysteroscopic" (although there is some over-lap). The hysterosopic techniques such as endometrial resection (TCRE), rollerball ablation and laser ablation have the advantage that the surgery is done under direct vision, and other common problems such as endometrial polyps (see Hysteroscopic polypectomy) and submucous fibroids (see Hysteroscopic myomectomy) can be dealt with at the same time. The "non-hysterosocopic" techniques are generally done blindly and involve the insertion of something very hot or very cold into the uterine cavity. The blind procedures are technically easier, but only hysteroscopic TCRE provides a thorough tissue sample for pathological examination for cancer (although this is an uncommon finding).
Unlike hysterectomy, all ablation procedures can be done as day-case surgery, and even under local anaesthesia if preferred.