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Hydrothermal Endometrial Ablation
What you need to know about hydrothermal endometrial ablation:
Endometrial ablation is a procedure to remove the endometrium (lining of your uterus). You may need this procedure if you have heavy or abnormal vaginal bleeding. Hydrothermal means heated fluid is used during the procedure. You will not be able to become pregnant after this procedure. Your healthcare provider will talk with you about this procedure to make sure you do not want to have children in the future.
How to prepare for the procedure:
Your healthcare provider will talk to you about how to prepare for the procedure. You may be told not to eat or drink anything after midnight on the day of your procedure. You will also be told what medicines to take or not take on the day of your procedure. You may need someone to drive you home after the procedure and stay with you to make sure you are okay.
What will happen during the procedure:
- You may be given local anesthesia to numb the area. You may instead be given general anesthesia to keep you asleep and free from pain during the procedure. Your healthcare provider will widen the opening of your cervix. A tool will be guided into your uterus. Heated liquid will be sent through the tool and into your uterus.
- The liquid will continue to flow until the lining is removed. This takes about 10 minutes. Your provider will control the heat and the pressure of the liquid. Liquid will not be allowed to move into your fallopian tubes or your abdomen. The system will automatically shut down if this happens.
What to expect after the procedure:
You may feel some discomfort for a few days. This is normal and should stop soon. Contact your healthcare provider if any of the following becomes severe or continues:
- Cramps, similar to menstrual cramps, for 1 to 2 days
- Watery, bloody discharge for 2 to 3 days that may become light and last a few weeks
- Frequent urination for 24 hours
Risks of hydrothermal endometrial ablation:
You may bleed more than expected or get an infection in your vagina, urinary tract, or uterus. Your cervix, uterus, or nearby organs may be burned or damaged. You may get a blood clot in your leg or arm. A blockage may form over months to years and cause blood to pool inside your uterus. This blockage may cause severe pain and you may need a hysterectomy. You may also need a hysterectomy if endometrial ablation does not work. Rarely, pregnancy can happen after hydrothermal endometrial ablation. Your risk for a miscarriage is much higher if you become pregnant after this procedure.
Call 911 if:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You feel dizzy, weak, and confused.
- You cannot stop vomiting.
- You have severe pain.
- You are not able to urinate.
Contact your healthcare provider if:
- You have a fever.
- You have vaginal bleeding and it is not time for your monthly period.
- The bleeding during your monthly period has not decreased.
- You have pain when you urinate or see blood in your urine.
- You have questions or concerns about your condition or care.
- Medicines can help decrease pain, calm your stomach, and control vomiting.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Ask when you can return to your usual activities. Do not have sex or use tampons or douches for 6 weeks after your procedure, or as directed.
You may still need to use birth control to prevent pregnancy. Pregnancy risks, such as a miscarriage and tubal pregnancy, are higher after this procedure. Talk to your healthcare provider about birth control or pregnancy after endometrial ablation.
Follow up with your doctor as directed:
Write down your questions so you remember to ask them during your visits.
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