ENDOMETRIAL ABLATION
Brenda L. Kehoe, M.D.
Minimally Invasive  Alternatives
to Hysterectomy
    Abnormal uterine bleeding
  1. 20-25% of women have abnormal uterine bleeding
  2. Greater than 7 days of bleeding is abnormal
  3. Greater than 80 cc (3 tablespoons) is abnormal
  4. Bleeding more frequently than every 21 days is abnormal
  5. Bleeding at an unexpected time may be reason for
    concern
  6. Bleeding after menopause may indicate disease
    Indications for endometrial ablation:
  1. Heavy menses
  2. Unable or not a candidate to manage medically
  3. Anemia due to blood loss
    Types of endometrial ablation

  1. First generation endometrial ablation
  • Loop electrode
  • Rollerball
  • Yag laser ablation
         
          2.  Second generation endometrial ablation
  • ThermaChoice
  • Her Option
  • HydroThermAblator
  • NovaSure
  • Microsulis
    Contraindications to endometrial ablation

  1. Pregnancy
  2. Planned pregnancy
  3. Active gonorrhea or chlamydia
  4. Pelvic inflammatory disease
  5. IUD in place
  6. Endometrial cancer
  7. Endometrial hyperplasia
  8. Uterine cavity measures more than 10 cm
  9. Major intrauterine pathology
    Risks of endometrial ablation

  • Infection
  • Bleeding
  • Perforation
  • Bowel or bladder injury
  • Anesthetic risks
  • Failure of the procedure
  • Return of heavy menses
  • Injury or burn to vagina
Device

ThermaChoice
HerOption
HydroThermAblator
NovaSure
Microsulis
Rollerball
    Method

    Hot water balloon
    Freezing
    Circulating hot water
    Bipolar radiofrequency
    Microwaves
    Electrical current
For more information, make an appointment with  
Everywoman's Health
503-284-5220
    Endometrial ablation is a relatively new procedure.  Some
    types are now available in our office setting.  Good candidates
    are women with heavy menses who no longer desire
    childbearing, who cannot tolerate or do not desire medicines
    for management, who do not have major anatomic
    abnormalities (massive fibroids, polyps, or other causes of
    heavy bleeding) and who want to avoid hysterectomy.  The
    procedure may not be successful in producing complete
    absence of menses, but may make menses more normal,
    prevent anemia from blood loss, and avoid hysterectomy.

    If desired or indicated, ablation may be carried out in the
    hospital or other outpatient setting.
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