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Endometrial Ablation with Gynecologist Dr. Maryann Prewitt
Endometrial Ablation with Gynecologist Dr. Maryann Prewitt
Published: 2014/08/04
Channel: Best Docs Network
Endometrial Ablation
Endometrial Ablation
Published: 2016/05/12
Channel: Danielle Lee
NovaSure Endometrial Ablation with Post-Op Bleeding
NovaSure Endometrial Ablation with Post-Op Bleeding
Published: 2014/07/17
Channel: trialfx .com
Hysteroscopic endometrial ablation
Hysteroscopic endometrial ablation
Published: 2013/09/21
Channel: Operative Gynecology
NovaSure Procedure
NovaSure Procedure
Published: 2015/11/13
Channel: Hologic
Endometrial Ablation Procedure For deep adenomyosis
Endometrial Ablation Procedure For deep adenomyosis
Published: 2013/09/21
Channel: Operative Gynecology
Demonstration on Endometrial ablation with Gynecare Thermachoice using a uterine model
Demonstration on Endometrial ablation with Gynecare Thermachoice using a uterine model
Published: 2011/08/09
Channel: drleesf
Novasure Procedure Performed on
Novasure Procedure Performed on 'The Doctors'
Published: 2009/04/28
Channel: The Doctors
Endometrial Ablation
Endometrial Ablation
Published: 2012/06/24
Channel: cartersvilleobgyn
Endometrial Ablation Surgery
Endometrial Ablation Surgery
Published: 2015/10/26
Channel: CutiesbyKelly
What is ENDOMETRIAL ABLATION? What does ENDOMETRIAL ABLATION mean?
What is ENDOMETRIAL ABLATION? What does ENDOMETRIAL ABLATION mean?
Published: 2017/08/03
Channel: The Audiopedia
Endometrial Ablation - Alternative to Hysterectomy
Endometrial Ablation - Alternative to Hysterectomy
Published: 2007/09/10
Channel: BroadcastMed Network
In-Office Endometrial Ablation - MyFlow™ Procedure
In-Office Endometrial Ablation - MyFlow™ Procedure
Published: 2015/12/18
Channel: Amy Brenner
NovaSure: My Experience
NovaSure: My Experience
Published: 2014/04/02
Channel: JackiePlus3Boys
Endometrial Ablation: Women Say Goodbye to Monthly Visitor
Endometrial Ablation: Women Say Goodbye to Monthly Visitor
Published: 2012/06/06
Channel: Lee Health Marketing
Genesys HTA™ Procedure Animation
Genesys HTA™ Procedure Animation
Published: 2012/06/28
Channel: Boston Scientific Gynecological Surgery
Novasure endometrial ablation operations
Novasure endometrial ablation operations
Published: 2015/11/05
Channel: Dr. Anna Burrows
Endometrial Biopsy – Side Effects and Endometriosis Symptoms for this Endometrial Ablation Disease
Endometrial Biopsy – Side Effects and Endometriosis Symptoms for this Endometrial Ablation Disease
Published: 2017/05/06
Channel: Sumon Info Point
Endometrial Ablation
Endometrial Ablation
Published: 2013/01/31
Channel: AHJReproductive
Endometriosis: laparoscopy+NovaSure endometrial ablation. My experience.
Endometriosis: laparoscopy+NovaSure endometrial ablation. My experience.
Published: 2016/01/21
Channel: Genie Liz
Should I get uterine ablation?
Should I get uterine ablation?
Published: 2016/10/31
Channel: Ladyboxrocks
Endometrial Ablation without Anesthesia by Promedical Inc.
Endometrial Ablation without Anesthesia by Promedical Inc.
Published: 2007/10/10
Channel: NuTrace Instrument Tracking
My Novasure Ablation Experience  Six Month Update
My Novasure Ablation Experience Six Month Update
Published: 2017/08/02
Channel: LesFam365
Ablation…Stopping Menstrual Flow
Ablation…Stopping Menstrual Flow
Published: 2014/09/02
Channel: Dr. Burt Webb
NovaSure 3D Procedure Animation and RF Controller Set-Up
NovaSure 3D Procedure Animation and RF Controller Set-Up
Published: 2016/01/12
Channel: River Hospital Education
Endometrial ablation
Endometrial ablation
Published: 2014/07/08
Channel: Askin Dogan
Endometrial Ablation
Endometrial Ablation
Published: 2010/01/07
Channel: William Parker
SURGERY DAY! | D&C, ENDOMETRIAL ABLATION, TUBAL LITIGATION | UPDATES!
SURGERY DAY! | D&C, ENDOMETRIAL ABLATION, TUBAL LITIGATION | UPDATES!
Published: 2016/06/18
Channel: emeriandkiddos
Uterine ablation- patient experience- Millennium Gynecology
Uterine ablation- patient experience- Millennium Gynecology
Published: 2014/03/17
Channel: Millennium Pregnancy and Gynecology
Hysteroscopy Endometrial Ablation
Hysteroscopy Endometrial Ablation
Published: 2017/02/04
Channel: Dr Gopalan Poovalingam
NovaSure Endometrial Ablation
NovaSure Endometrial Ablation
Published: 2016/01/12
Channel: River Hospital Education
Endometrial Ablation And Hysteroscopy Two Week Update
Endometrial Ablation And Hysteroscopy Two Week Update
Published: 2015/02/24
Channel: Thinking out side box
Novasure - Endometrial Ablation - Professional Brooklyn Gynecological Services - Brooklyn, NY
Novasure - Endometrial Ablation - Professional Brooklyn Gynecological Services - Brooklyn, NY
Published: 2015/02/11
Channel: PBGS Video
NovaSure Animation
NovaSure Animation
Published: 2011/03/07
Channel: NovaSureCentral
Hysteroscopic endometrial ablation with loop resection and rollerball diathermy A050.wmv
Hysteroscopic endometrial ablation with loop resection and rollerball diathermy A050.wmv
Published: 2012/05/22
Channel: drleesf
My Novasure Ablation Experience
My Novasure Ablation Experience
Published: 2017/02/06
Channel: LesFam365
Endometrial Ablation And Hysteroscopy  My Wife Had This Done
Endometrial Ablation And Hysteroscopy My Wife Had This Done
Published: 2015/02/11
Channel: Thinking out side box
What Are The Side Effects Of Endometrial Ablation?
What Are The Side Effects Of Endometrial Ablation?
Published: 2017/08/29
Channel: Another Question
post endometrial ablation syndrome
post endometrial ablation syndrome
Published: 2010/10/17
Channel: grettagrids
Permanent Birth Control & Endometrial Ablation
Permanent Birth Control & Endometrial Ablation
Published: 2013/05/05
Channel: FriendsofOCM
Endometrial Ablation Procedure
Endometrial Ablation Procedure
Published: 2011/07/26
Channel: CenturaHealth
Endometrial Ablation Surgery Video
Endometrial Ablation Surgery Video
Published: 2013/01/31
Channel: AHJReproductive
ROLLER BALL ENDOMETRIAL ABLASION
ROLLER BALL ENDOMETRIAL ABLASION
Published: 2014/01/26
Channel: Vinay More
Genesys HTA™ System Complete Procedure
Genesys HTA™ System Complete Procedure
Published: 2017/07/20
Channel: Boston Scientific Gynecological Surgery
Endometrial Ablation
Endometrial Ablation
Published: 2010/01/10
Channel: William Parker
I had my tubes tied & an ablation. My period was short last month & hasn
I had my tubes tied & an ablation. My period was short last month & hasn't come this month.
Published: 2013/09/14
Channel: IntermountainMoms
Who Should Not Have an Endometrial Ablation? - Renee Cotter, MD - Gynecology
Who Should Not Have an Endometrial Ablation? - Renee Cotter, MD - Gynecology
Published: 2015/12/11
Channel: West Hills Hospital & Medical Center
My Recovery: Breastfeeding, Hysteroscopy, D&C, & Uterine Ablation (Novasure)
My Recovery: Breastfeeding, Hysteroscopy, D&C, & Uterine Ablation (Novasure)
Published: 2016/02/14
Channel: The Kneady Homesteader
Endometrial Ablation - Dr. Scott Chatham
Endometrial Ablation - Dr. Scott Chatham
Published: 2009/10/06
Channel: CatawbaWomensCenter
Endometrial Ablation: Is Tubal Ligation a Risk Factor for Hysterectomy?
Endometrial Ablation: Is Tubal Ligation a Risk Factor for Hysterectomy?
Published: 2017/06/16
Channel: Hologic
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WIKIPEDIA ARTICLE

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Endometrial ablation
Endometrial ablation 1.jpg
Hysteroscopic endometrial ablation
ICD-9-CM 68.23

Endometrial ablation is an outpatient medical procedure that is used to remove (ablate) or destroy the endometrial lining of the uterus in women who have heavy menstrual bleeding. Endometrial ablation should never be performed on women who wish to have children.[1]

Endometrial ablation is most often employed in women who suffer from excessive menstrual bleeding, who have failed medical therapy and do not wish to undergo a hysterectomy. Heavy menstrual bleeding is most commonly due to dysfunctional uterine bleeding or adenomyosis. The procedure is almost always performed as an outpatient treatment, either at the hospital, ambulatory surgery center, or physician office. The Endometrial Ablation procedure is primarily performed while patients are under local and/or light sedative anesthesia, or if necessary, general or spinal anesthesia. Patients normally leave the treatment facility within one hour following the procedure and generally spend one day resting at home, before returning to the activities of daily living.

After the procedure, the endometrium heals by scarring over, thus reducing or eliminating future uterine bleeding. The patient's hormonal functions will remain unaffected because the ovaries are left intact. Placenta accreta may occur if the patient becomes pregnant after endometrial ablation, so birth control is necessary.

Depending on the treatment that is chosen, endometrial ablation is sometimes conducted after treatment with hormones, such as norethisterone or Lupron to reduce the thickness of the endometrium.[2]

Risks[edit]

Although rare, the procedure can have serious complications including:

Sterilization[edit]

Women who wish to become pregnant should not undergo endometrial ablation; pregnancy is rare (less than 2 percent) and can have mortal risks for the mother and child.[1]

Effectiveness[edit]

The U.S. Food and Drug Administration (FDA) approves and audits clinical studies to test and evaluate the effectiveness of all endometrial ablation treatments. Two patient effectiveness outcomes are measured at one year following treatment: 1.) Success Rate = the % of women who have their bleeding reduced to a normal period level or less, and 2.) Amenorrhea Rate = the % of women that have their bleeding completely eliminated. According to the results of the Randomized Controlled Trials performed for the FDA approval of the different treatment options, effectiveness Success Rates range from a high of 93% to a low of 67%, and the Amenorrhea Rates range from a high of 72% to a low of 22%. [3]

Treatment Options[edit]

A number of treatment options are available. They all work by destroying (ablating) the endometrium, the lining of the uterine cavity. [4]

  • The Minerva - Endometrial Ablation System (Minerva Surgical), FDA approved in July 2015, is the first new FDA-approved surgical treatment for heavy menstrual bleeding in over 15 years. Minerva works by generating heat from plasma energy that is created and contained inside a leak-proof ablation array that takes the shape of the uterine cavity. The hot membrane surface of the array ablates (destroys) the endometrium. The Minerva procedure is the fastest FDA approved treatment, average procedure time is 3.1 minutes from device insertion to removal, and is usually performed under local and/or conscious sedation anesthesia. Most patients leave the treatment center within one hour of treatment. In the Minerva Randomized Controlled Trial for FDA approval, the Success Rate was 93% (bleeding reduced to a normal or less level) and Amenorrhea Rate was 72% (bleeding completely eliminated). In addition, 95% of the Minerva patients, "Would recommend Minerva to a family member or friend") and 92% of the patients were Satisfied.
  • The NovaSure - Endometrial Ablation System (Hologic), FDA approved in 2001, utilizes a metallized mesh electrode array that is introduced into the uterine cavity, applying bipolar electrical energy that creates heat to ablate (destroy) the endometrium. The Novasure average procedure time is 5 minutes from device insertion to removal and is usually performed under local and/or conscious sedation anesthesia. Most patients leave the treatment center within one hour of treatment. In the Novasure Randomized Controlled Trial for FDA approval, the Success Rate was 78% (bleeding reduced to a normal or less level) and Amenorrhea Rate was 36% (bleeding completely eliminated). In addition, 92% of the Novasure patients were Satisfied.
  • The Genesys HTA - Hydro-Thermal Ablation System (Boston Scientific), FDA approved in 2001, uses a hysteroscope device which is inserted into the uterus through the cervical canal, to help doctors safely confirm proper probe placement and to see the area they are treating. In this procedure, the doctor looks at the inside of the uterus with the hysteroscope and then fills the uterus with saline fluid. The fluid is then slowly heated and the lining of the uterus is burned so that menstrual bleeding periods become less heavy and, in some cases, even stops. The fluid is then cooled and removed by special tubing to protect the external areas of the body from any burns. The average procedure time is 26 minutes. In the HTA Randomized Controlled Trial for FDA approval, the Success Rate was 68% (normal or less bleeding) and Amenorrhea Rate was 35% (bleeding completely eliminated). 94% of the HTA patients were Satisfied. [5]
  • The Her Option - Endometrial Ablation System (Cooper Surgical), FDA approved in 2001, is a treatment that creates sub-zero temperatures to freeze and ablate the endometrium. Following the application of local anesthetic around the cervix, a physician uses ultrasound to guide the placement of a cryoprobe to the right uterine horn (cornua). The cryoprobe is activated, reducing its temperature to minus 60°C. The cryoprobe is kept in place while ice is formed in the uterine cavity, under ultrasound observation. Once the appropriate time has passed and/or the appropriate depth of ice has been achieved, the cryoprobe is warmed to 37°C. The cryoprobe is then repositioned to the untreated left uterine horn and the procedure is repeated. Finally, the cryoprobe is warmed and removed. In the Her Option Randomized Controlled Trial for FDA approval, the Success Rate was 67% (bleeding reduced to a normal or less level) and Amenorrhea Rate was 22% (bleeding completely eliminated). In addition, 86% of the Her Option patients were Satisfied.
  • Transcervical Resection of the Endometrium (TCRE) or Loop Resection with Rollerball Ablation as it is commonly called, utilizes a hysteroscope, through which a bi-polar radio frequency electrocautery cutting loop is deployed to resect (remove) the superficial endometrium, followed by a bi-polar radio frequency rollerball tool to ablate the remaining underlying endometrium via cauterization.[6] It is a proven procedure,[7] being a day-care procedure with rapid recovery.[8]
  • The 'Thermachoice III '- balloon (Johnson and Johnson), FDA approved in 1997, was taken off the market in December 2015. This system utilized a heated saline filled balloon which was inserted into the uterine cavity to ablate the endometrium. The fluid was safely contained in a flexible and non-allergenic Silastic membrane that conformed to most uterine cavity shapes and sizes.

Older methods utilize hysteroscopy to insert instruments into the uterus to destroy the lining under visualization using a laser, or microwave probe.

See also[edit]

References[edit]

  1. ^ a b [Serious and deadly complications from pregnancy after endometrial ablation: Two case reports and review of the literature, P.-Y. Laberge, Department of Obstetrics and Gynaecology, CHUL, Laval University, 2705, boulevard Laurier, S-768 Quebec City, G1V 4G2 Quebec, Canada http://www.em-consulte.com/en/article/256077]
  2. ^ [Endometrial Ablation, Website of Johns Hopkins University https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/endometrial_ablation_92,P07774/]
  3. ^ "FDA letter to Endometrial Ablation Industry" (PDF). 
  4. ^ http://www.bostonscientific.com/templatedata/imports/collateral/Gynecology/oth_articleCarver_The%20Female%20Patient_01_gy_us.pdf
  5. ^ "HTA Ablation". Centre for Women's Health - Wichita. Retrieved 15 September 2014. 
  6. ^ Hysteroscopic Surgery, by King’s College Hospital. August 2013
  7. ^ Cooper, K. G.; Bain, C.; Parkin, D. E. (1999). "Comparison of microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss: A randomised trial". The Lancet. 354 (9193): 1859–1863. PMID 10584722. doi:10.1016/S0140-6736(99)04101-X. 
  8. ^ Page 122 in Desai (January 2002). Gynecology Endoscopic Surgery: Current Concepts. Jaypee Brothers Publishers. ISBN 978-81-7179-937-4. 

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