The endometrium is the lining of the womb, which is normally responsible for nurturing a growing foetus in pregnancy, or a woman’s monthly periods at other times. Ablation means “removal of”. Microwave drying up or removing of the endometrium (Microwave Endometrial Ablation) can be an alternative to hysterectomy in some circumstances (e.g. heavy bleeding). Investigations by ultrasound scans and/or hysteroscopy will be performed before the procedure is considered.
There are several methods of endometrial ablation, which is normally a simple procedure. Two examples are:-
- The patient is given a general anaesthetic, and the cervix is dilated to allow a small instrument to be introduced into the uterus. At the end of this probe is a rolling ball, through which an electrical current is passed. The ball is moved around the inside of the uterus and the electrical current permanently destroys the endometrium.
- Under local anaesthetic, a thin wand is introduced into the uterus through the cervix. At the end of the wand is a gold mesh which opens like a triangular umbrella to completely cover the inside of the uterus. Radiofrequency energy is then passed through the gold mesh for about 90 seconds to destroy the endometrium, before the wand and mesh are withdrawn.
The woman can usually go home the same day, there may be some uterine cramps for a day or two and there may be a watery and bloody discharge for a few days, but most women can return to work in two or three days.
The main complication is infection, and to prevent this the patient should avoid swimming, baths and sex for about ten days after the procedure.
The procedure may not totally remove a woman’s symptoms, and up to a quarter of patients need to go on to have a full hysterectomy at a later date.