The most common reason for a woman in her reproductive
years to see the gynecologist is because of abnormal vaginal bleeding.
Most often, this problem is caused by one of two abnormalities, either
altered hormonal function or a "mechanical disorder". By a mechanical
disorder, we mean some problem such as a fibroid or a polyp in the lining
of the uterus, which could cause the bleeding to occur. Hormonal
Irregularities can be caused by a myriad of problems but regulation
medically is usually successful.
After the diagnosis has been made, by sampling the
uterine lining and looking into the uterine cavity with a telescope
(hysteroscopy), the patient can choose a number of potential therapies
depending upon the diagnosis. If there is no overgrowth of the lining
(hyperplasia) and no evidence of large fibroids in the uterus causing the
bleeding, then one method of treatment may be endometrial ablation. Of
course medical treatment should first be tried but if these efforts fail
to correct the problem and if pain is not a significant part of the
patients symptoms then ablation can be performed.
Endometrial ablation s a simple procedure in
which the uterine lining (endometrium, not to be confused with
endometriosis) is removed either with the laser or electrosurgery while
looking through the hysteroscope. The procedure can be performed under
local anesthesia if the patient wishes or general anesthesia is available
if so desired. The recovery is very rapid and most patients are able to
leave the surgery facility in a few hours and are able to return to normal
activity by the following day. There is frequently a vaginal discharge for
several days but significant problems with recovery such as pain,
infection, or bleeding are rare. Today, because endometrial ablation seems
to be a very safe procedure, the procedure is beginning to be performed in
the physicians' office with new types of devices made especially for this
purpose. Cryotherapy (freezing) has now been used in this area to
successfully ablate the uterine lining.
It's important to realize that these
procedures are not guaranteed to produce ammenorrhea (cessation of
menses). Most studies including our own have shown that the rate of
absolute stoppage is 50%, while another 25% have very little bleeding, and
90% of the individuals are pleased with the result. Failures of the
procedure have been ascribed to adenomyosis in most cases and patients
with significant pain should be counseled against ablation.
Endometrial ablation gives today's women
another alternative to hysterectomy when abnormal bleeding occurs and is
persistent despite other treatments. This is a minimally invasive option,
which spares the patients anatomy, allowing acceptable results and rapid
recovery. If you have questions about abnormal bleeding, endometrial
ablation, or other solutions call the Endometriosis Care Center or the
Center for Women's Care & Reproductive Surgery.
Email the Center for Women's Care
Center for Women's Care &
Reproductive SurgeryŠ 2006
1140 Hammond Drive, Suite
Atlanta, Georgia 30328.
Toll Free 1 (888) 545-0400
Metro Atlanta (770) 352-0037
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