Endometrial ablation

INTRODUCTION

Women with abnormal uterine bleeding known to be unrelated to malignancy can choose from a variety of therapeutic options: watchful waiting, medical therapy, or surgical therapy. Surgical therapy is usually considered for women who fail medical therapy. (See "Menorrhagia", section on 'Medical therapy'.) Hysterectomy is the definitive surgical procedure. Endometrial ablation/resection is a more conservative surgical approach in which only the lining of the uterus is destroyed or removed.

Endometrial ablation is not intended to replace hysterectomy, but to offer women another choice for treatment of abnormal uterine bleeding. Women who want permanent cessation of menses can choose hysterectomy. Those who are more concerned about preserving the uterus or desire an outpatient procedure with minimal morbidity may find that endometrial ablation is the better choice. Women who participate in this decision making process are more likely to be satisfied with their treatment outcome.

INDICATIONS AND CONTRAINDICATIONS

Overview — The indication for endometrial ablation is treatment of abnormal uterine bleeding known to be unrelated to malignancy.

Candidates for endometrial ablation should meet all of the following criteria:

  • Abnormal uterine bleeding due to benign disease
  • Nonpregnant and no plans for future childbearing
  • A desire to retain their uterus
  • No locally active infection
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