The introduction of non-resectoscopic ablation techniques has greatly increased the use of endometrial ablation as a therapeutic option for women with abnormal uterine bleeding. Non-resectoscopic endometrial ablation is performed with a device that is inserted into the uterine cavity and delivers energy to uniformly destroy the uterine lining. Non-resectoscopic techniques are also referred to as second generation ablation.
Resectoscopic endometrial ablation techniques, on the other hand, are performed under hysteroscopic visualization, using resectoscopic instruments to ablate or resect the endometrium. Non-resectoscopic endometrial ablation techniques are more widely practiced than resectoscopic ablation, since they require less specialized training and have a shorter operative time .
Non-resectoscopic techniques for endometrial ablation will be reviewed here. General principles (eg, indications, contraindications, preoperative and postoperative care) of endometrial ablation, techniques for resectoscopic endometrial ablation or resection, as well as other management options for abnormal uterine bleeding, are discussed separately. (See "An overview of endometrial ablation" and "Endometrial ablation or resection: Resectoscopic techniques" and "Chronic menorrhagia or anovulatory uterine bleeding".)
CURRENT NON-RESECTOSCOPIC ABLATION DEVICES
Current non-resectoscopic endometrial ablation technologies approved for use in the United States by the Food and Drug Association (FDA) are:
●bipolar radiofrequency (Novasure)