More than 2 million women in the United States each year seek help from their gynecologists for excessive uterine bleeding, a condition called menorrhagia. For long-term relief, women historically had one option — hysterectomy; but today there is a new and less invasive procedure called endometrial ablation.
The procedure is intended to destroy all or most of the tissue responsible for menstrual bleeding. But this minimally invasive procedure keeps the uterus intact, sparing a woman from the hormonal side effects that come with hysterectomy.
There are several causes of menorrhagia — defined as a total blood loss of more than 80 ml per menstrual cycle or prolonged bleeding of more than 7 days. It is often a symptom of irregular anatomy, hormonal imbalance, or systemic disease such as von Willebrand’s disease, a disorder where blood clotting is extremely slow.
More common causes of menorrhagia are disorders of the uterus itself, such as fibroids or polyps, or endometrial cancer — though less common. Excessive uterine bleeding can also follow miscarriage, or it may be a side effect of taking hormone replacements after menopause, or the result of retained tissue after childbirth.
Of the 600,000 hysterectomies performed in the United States, it is estimated that more than 150,000 are performed for the relief of menorrhagia from benign causes. Many of these could have been treated with less-invasive alternatives.
One of those less-invasive choices is the Hydro ThermAblator System made by Boston Scientific (Editor's note: Boston Scientific is a corporate underwriter for this site). It is indicated for the relief of excessive uterine bleeding in women who have finished childbearing.
The system circulates heated saline around the uterine cavity and ablates, or virtually melts away the endometrium. During the procedure the surgeon inserts a probe into the uterus that includes a tiny telescope for viewing the lining of the uterus. Meanwhile, room temperature saline is circulating throughout the cavity. The fluid is gradually heated until it reaches the temperature necessary for ablation. After the 10-minute treatment phase, cool saline solution replaces the heated fluid in the uterus and the probe is removed.
Patients usually go home the same day of the procedure, and can expect cramping, which subsides after about 24 hours. A bloody discharge is typical for anywhere from a few days to a few weeks, and eventually becomes more watery.
Because the procedure involves flushing the uterus with fluid, the Hydro ThermAblator has the unique ability to treat even those women whose uterine cavities have unusual shapes, as well as those with fibroids.
To learn if you are a candidate for endometrial ablation or for more information about the procedure or other treatment options for menorrhagia, it is best to talk with your gynecologist.