Endometrial ablation

Abstract

Endometrial ablation is a new procedure. Correct patient selection is essential in producing good results. Patients must be counseled carefully about the advantages, disadvantages, and potential complications of this approach to the management of menstrual disorders. Excessive uterine size, the presence of active pelvic infection, and evidence of malignant and premalignant endometrium are absolute contraindications. There are two approaches for endometrial ablation: hysteroscopic approach and nonhysteroscopic approach. Hysteroscopic ablation can be produced by electrosurgical resection, rollerball ablation and Nd-YAG laser ablation. However, several complications can occur including, uterine perforation, hemorrhage, and excessive fluid absorption. In skilled hands, hysteroscopic endometrial ablation can be a safe and effective treatment for menorrhagia. Hysteroscopic endometrial ablation has some practical limitations. Nonhysteroscopic endometrial ablation has been developed to minimize the complications and less training is required. Therefore, it has potential for clinical use and is very attractive.