What is a radiofrequency endometrial ablation?

A radiofrequency endometrial ablation is an operation that uses radiofrequency energy to thin the lining (endometrium) of your uterus (womb). After the operation most women have a noticeable reduction in their periods and, for some women, periods stop altogether.

What are the benefits of surgery?

The most common reason for having an endometrial ablation is to relieve the symptoms of heavy periods (abnormal uterine bleeding).

Most women will have much less bleeding when they have their period. Pain is usually significantly reduced, although for some women mild cramping may still happen.

Just under half of the women who have the operation will not have periods anymore.

Are there any alternatives to surgery?

Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications.

Other alternatives include an IUS (intra-uterine system — an implant containing a synthetic form of the hormone progesterone that fits in your womb) but these are usually tried before surgery is recommended.

What does the operation involve?

The operation can be performed under a local or general anaesthetic. The operation usually takes less than 20 minutes.

Your gynaecologist will place a radiofrequency probe into your womb. They will expand a mesh from the probe in your womb. Your gynaecologist will check that your womb is intact and then pass radiofrequency energy through the mesh. The radiofrequency energy will be delivered for about 90 seconds, thinning the lining of your womb.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• feeling or being sick
• bleeding or discharge
• infection
• allergic reaction to the equipment, materials or medication
• chest infection

Specific early complications

• failed procedure
• making a hole in your womb with possible damage to a nearby structure
• thermal burns

Specific late complications

• continued bleeding or pain needing another endometrial ablation or a hysterectomy
• haematometra, where blood and other menstrual fluid collect in pockets in your womb
• if you have been previously sterilised, tubal sterilisation syndrome
• pregnancy problems, if you become pregnant after an endometrial ablation

Consequences of this procedure

• pain

How soon will I recover?

You should be able to go home the same day.

You may get some cramps and mild bleeding similar to a period. Rest for 1 to 2 days and take painkillers if you need them.

You should be able to return to normal activities after 2 to 4 days. Most women are fit for work after about a week.

You should expect to have some bleeding or discharge for up to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The operation is not recommended for women who still want children.

Summary

An endometrial ablation is a common gynaecological operation. It helps relieve the symptoms of heavy periods. You should get less bleeding and pain.

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