We perform a wide range of investigations in our practice which may then lead onto surgical management to resolve the outstanding symptoms.

Smear Abnormalities

Urinary Incontinence

Prolapse

Menstrual Disorders

Pelvic Pain and Endometriosis

Hysterectomy

Infertility

Contraception

Endometrial Ablation

Non-Invasive Prenatal Testing

Endometrial Ablation

Endometrial ablation is becoming an increasingly popular treatment for the management of heavy periods because it is minimally invasive and a successful ablation avoids the long term use of medications.

Endometrial ablation is the surgical destruction of the lining of the uterine cavity. It is performed by inserting a device into the uterine cavity that delivers energy to destroy the uterine lining.

Patient Selection or Indication

Primary indication for endometrial ablation is treatment of menorrhagia (heavy periods).

Contraindications

The contraindications for endometrial ablation are:

  • Pregnancy.

  • Known or suspected endometrial cancer or pre-cancer.

  • Desire to preserve fertility.

  • Acute pelvic infection.

  • Intrauterine device in place.

  • A previous trans-myometrial uterine surgery.

  • Post-menopausal women.

  • Women with congenital uterine anomalies such as a bicornual uterus.

  • A woman with a uterine cavity of a length that is greater than 10-12cm or severe thinning of the muscle layer of the uterine cavity.

Women who are considering ablation

For women who are considering ablation it is important to know that a successful result is most likely to be a reduction in the volume of bleeding. Amenorrhoea (no periods), is not guaranteed.

Prior to having an ablation a clinical examination with smear and swabs, combined with an ultrasound scan is routine.

Anaesthesia

Ablations are usually performed under regional or light general anaesthetic.

Post-Operative

Most patients are administered non-steroidal anti-inflammatory drugs. A local anaesthetic is also injected around the area of the cervix to reduce post-operative pain.

Sterilisation

Laparoscopy tubal sterilisation can be performed at the same time as an ablation procedure.

Improvement in Bleeding Symptoms

Women may experience irregular bleeding following the ablation so success of the procedure cannot be determined until about six to 12 weeks postoperatively. Most women will have a reduction in blood flow, but not amenorrhoea. Patient satisfaction rates are high; they are usually reported as greater than 90%.

Subsequent Surgery

10% of women will require additional surgical treatment for abnormal uterine bleeding two-five years postoperatively. Women who are less than 35 years old at the time of the ablation may tend to have a higher risk of treatment failure than older women.

Complication Rates

Complication rates are extremely low. The most common complication is infection requiring treatment with antibiotics.

Post Procedure

Patients should be advised that the common post operative side effects of ablation are cramping and a vaginal discharge. Light vaginal bleeding or pink-tinged discharge is often present for two to three days and uterine cramping may persist for 24-72 hours. Most women can resume normal activities after one to two days.