In-Office Endometrial Ablation
Some women are held hostage by their menstrual
cycles. They have such long, painful, heavy periods that
they lose a week or more of every month where they
can't do what they want to do. If you are at the point
that you are ready to do something about it, you have
three basic options to choose from:
HORMONE THERAPY. This can be birth control pills
or Depo Provera. If this is adequate, it is often the least
invasive and most inexpensive option. Some women
do great on hormones. Some women don't.
HYSTERECTOMY. Almost always the uterus can be
removed vaginally, and recovery is fairly rapid. For some
women it is the best option, but it is the most expensive
and invasive.
ENDOMETRIAL ABLATION. This procedure is ideal for
those women who are through with childbearing, who
have life altering cycles but no other significant GYN
problems. There are pro's and con's to the procedure:
PRO's:
Much less expensive, with or without insurance
Faster recovery time. You can literally go about your normal
activities that same say or the next.
Over 90% of women are satisfied with the outcome. About
50% of women no longer have any bleeding, and about 40%
still will cycle, though considerably less than before.
CON's:
Half of women who get it still have some bleeding, and 10% fail
the procedure and need to have a hysterectomy. For
women who NEVER want to menstruate again, it is not
the best option.
It does not prevent pregnancy, though it would be very
unlikely. Some other sort of backup contraception is needed.
For women who also want to have a tubal done, we do the
ablation in the hospital where we can do both at once.
Here are the basic instructions we give our patient pre-op, to
give you a feel for what to expect:
Preparation
•Place one Cytotec® 200mcg tablet deep into your vagina
@ bedtime. Afterwards you may experience cramping or light
vaginal bleeding (Take ibuprofen (Motrin®) 600 mg [3 over the
counter 200 mg tablets] every 6 hours as needed for cramps).
•At about 7 am, take 500 mg of Cipro (an antibiotic) and eat
a light breakfast.
•Place 2 tablets of Halcion® (Triazolam) 0.25 mg under your
tongue 30 minutes before your appointment and take one tablet
of Norco (a narcotic pain medication). The combination of these
may make you a little drowsy. You should NOT drive yourself to
or from our office.
The Procedure
•When you arrive, one of the nurses will take your vitals.
•She will then give you an injection of Toradol in your hip.
Toradol is a very effective pain medication that will help with
any cramping you may have after the procedure. It does not
make you sleepy or drowsy.
•Dr. Lynn will then inject some local anesthetic into the cervix
and also will place some via a small tube directly inside the uterus.
Typically this is minimally uncomfortable.
•After a 10 minute wait, Dr. Lynn will use a series of dilators
to allow passage of the Novasure device, and then do the
ablation procedure. These last steps usually take anywhere
from 3-5 minutes to do. You may experience a crampy
sensation during the ablation but it is typically minimal.
•After the procedure, you will be observed for 20-30 minutes
and then allowed to be driven home.
Post Procedure Care
•Do not drive, operate potentially dangerous machinery, sign
legal documents or make critical decisions the day of the
procedure. You may resume regular activities the following day.
•Take ibuprofen (Motrin®) 600 mg [3 over the counter 200
mg tablets] every 6 hours around the clock on day of treatment.
Thereafter as needed for cramps.
•Additional pain medication such as Vicodin® or Norco® will
be prescribed. If necessary, take 1 2 tablets every 3 to 4 hours
as needed for discomfort.
•A heating pad placed on your lower abdomen can also help
reduce cramping.
•Continue to take ciprofloxacin XR 500 mg once a day to complete 3
day course of antibiotics.
•Expect vaginal discharge beginning soon after the procedure – it will
continue for 2 to 3 weeks
•You may bathe or shower as you wish without restrictions
•Do not place anything in your vagina (e.g. Tampon, intercourse) for
two weeks.
•Follow up is on an as-needed basis. We will call you in a few days
to check on you, and you should call us if you have any questions or
concerns.
•Report any unusual symptoms. Call if temperature is over 101
degrees, if bleeding heavier than normal period occurs, or if you develop
unusual pelvic pain or discomfort.
•Be aware that you will not know final results for at least 3 or 4 months,
so don’t be concerned over some spotting or cycles until then.
The NovaSure Company has a very nice website, full of useful information.
If, after considering all of the above, you feel that an endometrial
ablation is right for you, your next step is to contact Dr. Lynn to discuss
your situation, answer your questions, and make sure it is right for you.
Our office staff will help you with any insurance concerns at that time also.
Good luck. It's always good to know you have options, and now you have
one more to choose from.
