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[Hysteroscopic
Sterilization]
Menstrual Ablation is a surgical procedure to remove
the menstrual lining permanently. This procedure is
indicated to stop menstrual bleeding and/or
cramping. The main purpose of this procedure is to be
an alternative to hysterectomy. Only women done
having children should do this procedure.
A
small telescope is inserted through the vagina and
cervix to view the inside of the uterus. This is called
hysteroscopy. Then surgical instruments are inserted to remove the lining. Removal of the menstrual
endometrial lining is called ablation. Anesthesia in
the operating room is necessary. The patient may either
be asleep as in general anesthesia, or awake, as in
spinal or epidural anesthesia.
BENEFITS
OVER HYSTERECTOMY
-
There
are no incisions.
-
Minimal
recovery of one to two days.
-
No
negative hormonal changes.
-
Does
not cause menopause of the ovaries.
-
Frequently
improves premenstrual syndrome (irritability,
headaches).
RISKS OF
MENSTRUAL ABLATION
-
Approximately 5-10% of patients will have minimal
periods,
but rarely will menses be heavy again.
-
Risk of
infection, bleeding, injury to the uterus, or other
complications would be uncommon.
-
Ablation will not correct other problems such as
large uterine tumors or weakness of the bladder or
uterine prolapse.
-
Excess
irrigation fluid absorption, causing internal
swelling.
OPTIONS
-
No
treatment if bleeding is not heavy or interfering
with the lifestyle.
-
Medical
therapy such as hormones.
-
Abdominal, vaginal or laparoscopic hysterectomy.
Menstrual ablation is an excellent procedure for women
who have heavy menstrual bleeding that interferes with
their lifestyle and is an important alternative to other
current therapies.
NOTE: Menstrual
ablation is not considered a form of birth control. See
Hysteroscopic Sterilization for more information.
Hysteroscopic sterilization
Tubal ligation with no abdominal incisions became
available in 2002-2003. This procedure is done similar
to the ablation procedure with a telescope through the
vagina. A typical form of this is called Essure with
springs that cause scarring over three months. Dr.
MacFarlane does a direct cauterization of the tubal
entrance into the uterus in conjunction with the
ablation procedure. As these procedures are fairly new,
confirmation of the effectiveness is done after three
months. At this time the radiologist does a pap smear
type exam and places xray contrast fluid into the
uterus. An xray determines if the iodine contrast leaks
out the tube. Exact numbers are still unclear but
approximately 95% of hysteroscopic sterilizations by Dr.
MacFarlane are confirmed by xray as blocked tubes. The
other 5% that are not confirmed as blocked have many
choices including no treatment if no periods are seen
after 3-6 months.
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