Nonresectoscopic Endometrial Ablation

What you should know

  • Nonresectoscopic endometrial ablation (EA) is a procedure done to destroy the endometrium. The endometrium is the lining of your uterus (womb). During your menstrual cycle (monthly period), your uterus sheds its lining, along with blood and mucus. You may need an EA procedure if you have very heavy vaginal bleeding during your monthly period. Endometrial ablation also may help stop abnormal vaginal bleeding caused by a uterine polyp or myoma (lump).

  • There are many different procedures that can be done for a nonresectoscopic EA. You and your caregiver will decide which procedure will work best for you. During the procedure, a catheter (thin tube) or device is inserted into your uterus through your vagina and cervix. Your cervix is the lower end of your uterus. Heat, ice, or electrical energy will then 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 EA 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 skin burn from the heated probe. 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.

  • 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 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 (tissue lumps) 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 before your procedure:

  • Ibuprofen: You may need to take ibuprofen starting 24 hours before your procedure. This medicine may help decrease pain and inflammation (swelling). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

  • Ask caregivers about directions for eating and drinking.

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.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You will be taken to the room where your procedure will be done. You will lie on your back with your feet up in supports. You will be given medicine to keep you free from pain during the procedure. You will then have one of the following procedures done:

    • Cryotherapy: Your cervix may be widened with a special tool. A probe with a cooling device on the tip will then be put into your uterus. The probe tip will be cooled until an ice ball forms in your uterus and freezes the lining. The ice will be allowed to melt and then the icing and melting may be repeated again. An ultrasound will be used to help your caregiver see the probe and the ice form.

    • Heated free fluid: A scope or hollow tube will be put into your uterus so caregivers can monitor the procedure. Heated fluid will then be put through the scope and into your uterus. The heat from the fluid will destroy your uterine lining.

    • Thermal balloon: A catheter with a balloon at the end will be put into your uterus. Your caregiver will fill the balloon with water that is heated by a machine. The heat of the water will destroy the lining of your uterus.

    • Microwave energy: A probe that can measure the temperature of your tissue lining will be placed inside your uterus. A scope also will be used to check the placement of the probe. The probe uses electromagnetic energy to heat the lining of your uterus and destroy it. The probe will be moved across your whole uterus before it is removed.

    • Radiofrequency: A device will be placed inside your uterus. The device will get larger when it reaches your uterus. There is a mesh at the end of the device that uses electrical energy to destroy your uterine lining. There is also suction at the end of the device to remove any steam or tissue during the procedure.

After your procedure:

You will be taken to a room where you can 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 to you 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.

Learn more about Nonresectoscopic Endometrial Ablation (Precare)

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