Endometrial ablation

Endometrial ablation
Intervention
Hysteroscopic endometrial ablation
ICD-9-CM	68.23
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Endometrial ablation is an outpatient medical procedure that is used to remove (ablate) or destroy the endometrial lining of the uterus in women who have heavy menstrual bleeding. Endometrial ablation should never be performed on women who wish to have children.

Endometrial ablation is most often employed in women who suffer from excessive menstrual bleeding, who have failed medical therapy and do not wish to undergo a hysterectomy. Heavy menstrual bleeding is most commonly due to dysfunctional uterine bleeding or adenomyosis. The procedure is almost always performed as an outpatient treatment, either at the hospital, ambulatory surgery center, or physician office. The Endometrial Ablation procedure is primarily performed while patients are under local and/or light sedative anesthesia, or if necessary, general or spinal anesthesia. Patients normally leave the treatment facility within one hour following the procedure and generally spend one day resting at home, before returning to the activities of daily living.

After the procedure, the endometrium heals by scarring over, thus reducing or eliminating future uterine bleeding. The patient's hormonal functions will remain unaffected because the ovaries are left intact. Placenta accreta may occur if the patient becomes pregnant after endometrial ablation, so birth control is necessary.

Depending on the treatment that is chosen, endometrial ablation is sometimes conducted after treatment with hormones, such as norethisterone or Lupron to reduce the thickness of the endometrium.

Although rare, the procedure can have serious complications including:

Women who wish to become pregnant should not undergo endometrial ablation; pregnancy is rare (less than 2 percent) and can have mortal risks for the mother and child.

The U.S. Food and Drug Administration (FDA) approves and audits clinical studies to test and evaluate the effectiveness of all endometrial ablation treatments. Two patient effectiveness outcomes are measured at one year following treatment: 1.) Success Rate = the % of women who have their bleeding reduced to a normal period level or less, and 2.) Amenorrhea Rate = the % of women that have their bleeding completely eliminated. According to the results of the Randomized Controlled Trials performed for the FDA approval of the different treatment options, effectiveness Success Rates range from a high of 93% to a low of 67%, and the Amenorrhea Rates range from a high of 72% to a low of 22%.