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An overview of endometrial ablation

Howard T Sharp, MD
Section Editor
Tommaso Falcone, MD, FRCSC, FACOG
Deputy Editor
Sandy J Falk, MD, FACOG


Women with abnormal uterine bleeding have a variety of therapeutic options. Endometrial ablation has become an increasingly popular treatment, since it is minimally invasive and successful ablation avoids chronic use of medications. In a national study in England from 2003 to 2006, 60 percent of all surgical procedures performed for menorrhagia were endometrial ablations [1].

Endometrial ablation is the surgical destruction of the uterine lining. This can be accomplished under hysteroscopic visualization, using resectoscopic instruments to ablate or resect the endometrium. It can also be performed with a non-resectoscopic ablation device, which is inserted into the uterine cavity and delivers energy to uniformly destroy the uterine lining. Non-resectoscopic endometrial ablation techniques are more widely practiced than resectoscopic ablation, since they require less specialized training and often have a shorter operative time [2]. Endometrial ablation is not appropriate for women with endometrial hyperplasia or cancer, or those who wish to preserve their fertility.

This topic review will provide an overview of endometrial ablation. Techniques for non-resectoscopic endometrial ablation and resectoscopic endometrial ablation or resection, as well as other management options for abnormal uterine bleeding, are discussed separately. (See "Endometrial ablation: Non-resectoscopic techniques" and "Endometrial ablation or resection: Resectoscopic techniques" and "Management of abnormal uterine bleeding".)


Terminology used to describe endometrial ablation varies. In this topic review, the following terms will be used:

Endometrial ablation – Surgical destruction of the endometrium. The endometrium must be destroyed or resected to the level of the basalis (figure 1), which is approximately 4 to 6 mm deep, depending upon the stage of the menstrual cycle. In this topic review, endometrial ablation will refer to either non-resectoscopic ablation or resectoscopic ablation, or resection of the endometrium.

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Literature review current through: Oct 2017. | This topic last updated: Oct 12, 2017.
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