Hysteroscopic Endometrial Ablation

An endometrial resection is an operation to remove the lining (endometrium) of your uterus (womb).

The most common reason for having an endometrial resection is to relieve the symptoms of heavy periods (abnormal uterine bleeding).

About a third of women who have the operation will not have periods anymore.

Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications.

Other alternatives include an IUS (intra-uterine system – an implant containing a synthetic form of the hormone progesterone that fits in your womb) but these are usually tried before surgery is recommended.

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes about 30 minutes.

Your gynaecologist will examine your vagina. They will pass a small telescope (operating hysteroscope or resectoscope) through your vagina, across your cervix (neck of your womb) into your womb.

Your gynaecologist will pass fluid through the telescope to distend (swell) your womb. They will use a diathermy resecting loop (a loop of wire heated by electricity) to remove the lining of your womb and any polyps or small fibroids they find.

You should be able to go home the same day.

You should be able to return to normal activities after 2 to 4 days. Most women are fit for work after about a week.

You should expect to have some bleeding or discharge for up to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The operation is not recommended for women who still want children.

Even if your periods stop, there is still a risk of becoming pregnant.

Some of these can be serious and can even cause death.

General complications of any operation

• Pain
• Feeling or being sick
• Bleeding or discharge
• Infection
• Blood clot in your leg
• Blood clot in your lung

Specific early complications

• Making a hole in your womb with possible damage to a nearby structure
• Bleeding during the operation
• Fluid overload
• Failed procedure

Specific late complications

• Haematometra, where blood and other menstrual fluid collect in pockets in your womb
• Blood and fluid collecting in your fallopian tubes
• Continued bleeding or pain