Laser And Resectoscopic Endometrial Ablation

What you should know

  • Laser and resectoscopic endometrial ablation (EA) is a procedure to destroy the lining of your uterus (womb). Your uterine lining is also called the endometrium. During your monthly period, your uterus sheds its lining along with blood and mucus. You may need EA if you have very heavy vaginal bleeding during your monthly period. An EA also may help stop heavy vaginal bleeding caused by a uterine polyp or myoma (lump).

  • During an EA procedure, your caregiver uses a tool called a resectoscope to help see inside your uterus. Your caregiver will put a heating device through the scope to destroy your uterine lining. This device may be a loop or metal rollerball that can be heated using an electric current. A laser also may be used to destroy the lining of your uterus. Having this procedure may decrease abdominal (stomach) pain and cramping during your period. The amount you bleed during your period may be decreased. In some cases, after your procedure, you may not have a period at all.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • During your procedure, you may get a tissue burn from the electrical current that is used. You may have damage to your cervix, uterus, or nearby organs such as your bowels. After your procedure, you may have abdominal pain. You may have worse abdominal pain if you have had your fallopian tubes tied to prevent pregnancy. You may have nausea (upset stomach), vomiting (throwing up), and abdominal cramping. You also may have vaginal discharge and bleeding after the procedure. A blockage may form causing blood to pool inside your uterus. You may get an infection in your vagina, urinary tract, or uterus. Your infection may lead to sepsis, which is a blood infection, and may be life-threatening.

  • After the procedure there may be a higher risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • Your body may absorb (take up) too much of the fluid used to widen your uterus. This may cause too much water to collect inside your body and decrease needed body chemicals. This may cause brain swelling and damage, and you may die. Without this procedure, you may continue to have heavy bleeding during your monthly period. Heavy bleeding may cause anemia (low red blood cell count), dizziness, and a feeling of constant tiredness. Talk to your caregiver about any questions or concerns you have about the procedure.

Getting Ready

Before your procedure:

  • Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin, prescribed, or other over-the-counter medicine before your procedure.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You will need to use a form of birth control to prevent pregnancy after your procedure. Pregnancy after EA can lead to problems such as a miscarriage. Talk to your caregiver about what form of birth control is right for you. If you have questions or concerns about having children after EA, talk to your caregiver.

  • You may need to have a transvaginal ultrasound to check the thickness of your uterine lining. The lining of your uterus may need to be thinned before your procedure. Your caregiver may do curettage (scraping) to thin the lining, or you may be given hormone medicine. If you have any polyps in your uterus, they may be removed before your procedure. A sample of your uterine lining may be taken and sent to a lab for tests. You may need a hysteroscopy or other imaging tests to check the size and shape of your uterus and cervix. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.

  • You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • Your caregiver may put medicine into your vagina to soften your cervix. This is done to prevent tears as the scope is passed through the opening of your cervix.

  • An anesthesiologist may talk to you before your procedure. This caregiver may give you medicine to make you sleepy before your procedure. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

  • Antibiotics: Antibiotics may be given before and during your procedure to prevent an infection caused by germs called bacteria.

Treatment

What will happen:

  • You will lie on your back with your buttocks on the edge of the table and your feet supported. You will get medicine to keep you free from pain during the procedure. A special tool may be put into your vagina to help widen the opening of your cervix. The scope will be put into your uterus through your vagina and cervix. Your uterus will be filled with a special fluid to widen it.

  • A heated loop, small metal rollerball, or laser will be put through the scope and into your uterus. The heated loop will cut and remove your lining in strips while flushing the area with fluid. The rollerball will be moved around your uterine lining while electrical energy destroys it. The laser works to destroy the lining of your uterus with a high-energy beam. Your caregiver may then put medicine into your uterus that helps decrease the amount of fluid you absorb. The scope will then be removed from your uterus and vagina.

After your procedure:

You will be taken to a room where you will rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are not having any problems, you may be able to go home. If you are staying in the hospital, you will be taken back to your room.

Contact a caregiver if

  • You cannot make it to your procedure.

  • You have a fever (high body temperature).

  • You think that you may be pregnant.

Seek Care Immediately if

  • You have increased blood loss during your monthly period.

  • You have new weakness or dizziness.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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