Endometrial ablation is a procedure that destroys (ablates) the uterine lining, or endometrium. This procedure is used to treat dysfunctional or abnormal uterine bleeding. Sometimes a lighted viewing instrument (hysteroscope) is used to see inside the uterus.
The endometrium heals by scarring, which usually reduces or prevents uterine bleeding.
Endometrial ablation may be done in an outpatient facility or your doctor’s office. The procedure can take up to about 45 minutes. The procedure may be done using a local or spinal anesthesia. And general anesthesia is sometimes used. In most cases Dr. Corney will perform an Endometrial Biopsy to confirm the cause of the heavy bleeding before an Endometrial Ablation is considered.
Endometrial ablation can be done by:
- Laser beam (laser thermal ablation).
- Heat (thermal ablation), using:
- A balloon filled with
- saline solution that has been heated to 85°C (185°F) (thermal balloon ablation).
- Normal saline (heated free fluid)
- Electricity, using a resectoscope with a loop or rolling ball electrode.
The Endometrial Biopsy
Endometrial Biopsy is a procedure in which a tissue sample is taken from the lining of the uterus (endometrium), and is checked under a microscope for any abnormal cells or signs of cancer.
- How the Endometrial Ablation is done?
- How to Prepare?
- What to Expect After Biopsy?
- Why is it done?
- What do the results mean?
- What are the risks of Endometrial Biopsy?
Why is it done?
The test is done to find the cause of:
- Abnormal menstrual periods (heavy, prolonged, or irregular bleeding)
- Bleeding after menopause
- Bleeding from taking hormone therapy medications
- Thickened uterine lining seen on ultrasound
The test is usually done in women over age 35.
This test can also be used to test for endometrial cancer. Sometimes, it is used as part of the diagnosis in women who have been unable to become pregnant (see infertility).
What do the results mean?
Normal results mean the cells in the sample have no abnormalities.
Abnormal menstrual periods may be caused by:
- Endometrial cancer or precancer (hyperplasia)
- Uterine fibroids
- Uterine polyps
- Hormone imbalance
If the lining is being tested for infertility, the sample may determine if hormones are properly stimulating the lining so that the fertilized egg can implant.
Other conditions under which the test may be performed:
- Abnormal bleeding if a woman is taking the breast cancer medication, tamoxifen
- Anovulatory bleeding
Symptoms & Treatments
How the Endometrial biopsy is done
This procedure may be done with or without anesthesia. You will lie on your back with your feet in stirrups.The health care provider will do a pelvic examination, and will insert an instrument (speculum) into the vagina to hold it open and see the cervix.
The cervix is cleaned with an antiseptic liquid and then grasped with an instrument (tenaculum) to hold the uterus steady. A device called a cervical dilator may be needed to stretch the cervical canal if there is tightness (stenosis). Then a small, hollow plastic tube is gently passed into the uterine cavity.
Gentle suction removes a sample of the lining. The tissue sample and instruments are removed. A specialist called a pathologist examines the sample under a microscope.
How to prepare
There is no special preparation for the biopsy. You may want to take ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) 1 hour before the procedure to reduce cramping.
What to expect during the biopsy
The instruments may feel cold. You may feel some pain when the cervix is grasped. You may have some cramping as the instruments enter the uterus and the sample is collected.
What are the risks of the biopsy?
It is rare that there are negative side effects or consequences of this procedure. In those rare cases risks may include:
- Making a hole in (perforating) the uterus or tearing the cervix (rarely)
- Prolonged bleeding
- Slight spotting and mild cramping for a few days