Endometrial Ablation – When is This Procedure Appropriate?
Endometrial ablation is indicated for treatment of abnormal uterine bleeding or patient-perceived heavy menstrual bleeding in premenopausal women with normal endometrial cavities.
Evaluate for malignancy, hyperplasia, and to ensure the cavity configuration is appropriate for ablation
Prior to ablation: Endometrial biopsy, transvaginal ultrasound, saline infusion sonohysterography, hysteroscopy or a combination of these procedures
Endometrial cavity too large for the device parameters | Mullerian duct disorders (bicornuate/septate uterus) | Recent pregnancy | Active infection | Malignancy or hyperplasia
Relative contraindications include
Surgeries that may distort or weaken the myometrium such as classic cesarean section and transmural myomectomy
Consider ablation when patients have failed or have been intolerant of medical therapies
Determine your patient’s fertility plans
Pregnancies that occur after ablation have a high rate of malpresentation, prematurity and placenta accreta
Patients should be counseled to use effective contraception
Endometrial ablation is a minimally invasive surgical procedure to reduce menstrual flow and is designed to treat abnormal uterine bleeding in women who do not desire future fertility. A number of options are available including resectoscopic, thermal balloon, cryotherapy, heated free fluid, microwave and radiofrequency electricity. Endometrial thinning, either mechanical or by suppression/inhibition of ovarian function, has been used as an adjuvant to ablation.
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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