One decade later, ND: YAG Laser was first introduced by Goldrath et al., as a method of vaporization of the endometrium. One of the oldest trials was conducted by Droegemueller et al., who treated 11 women with dysfunctional uterine bleeding using cryosurgery of the endometrium based on a Frigitronics nitrous oxide cryosurgical system. Although the term seems to be relatively recent, trials on endometrial destruction were initiated many decades ago. Endometrial ablation: An overviewĮA refers to a set of procedures that aim to destroy the endometrium beyond its natural capacity to regenerate. We also aim to explain the mechanisms by which these predictors may contribute to recurrence and to recommend strategies that could improve treatment outcomes and minimize the need for intervention. In this review, our objective is to present available evidence on predictors of long-term failure of EA. Because failure of EA doubles treatment burden in terms of morbidity and costs and because EA failure seems to vary widely among reports, identification of determinants of treatment success had become imperative to improve patient selection and counselling. Failure of EA reached up to 26% after 8 years of treatment. Treatment failure is time-dependent and accordingly, the incidence of reintervention has been increasingly recognizable while 2-3 decades passed since EA was introduced. Īlthough EA provides fewer complications and significantly costs less than hysterectomy, treatment failure, defined as recurrence of symptoms that necessitates reintervention, presents a major concern. Because second generation devices allow office-based treatment under local anaesthesia, EA has become widely acceptable by both patients and health care providers and has become the most common treatment of HMB in the United States. Second generation EA devices (also known as global EA) have been well-established in gynecologic care and are offered to all eligible women. ![]() Thereafter, evidence from the literature has supported EA as a second line treatment if medical treatment fails or is contraindicated. Endometrial ablation (EA) has been introduced as an alternative to radical treatment since late 80’s and early 90’s and has gained substantial popularity as a convenient procedure of less cost and high safety profile. For decades, hysterectomy had been the only treatment approach when medical treatment is contraindicated or ineffective. I also paid $20 for the co-pay for the office visit and everything else was covered by insurance.Heavy Menstrual Bleeding (HMB) is the most prevalent form of abnormal uterine bleeding, a complaint that affects approximately 14% of reproductive aged women and presents both a health and financial burden. I'm badly affected by anesthesia, so that and the gas from having my abdomen distended were by far the worst parts (referred gas pain is awful). For the rest, intensity and/or frequency are lessened. For 15-30% of patients, it makes no difference or improvement. The stats I was given were that for 25-35% of patients, an ablation would end their period. ![]() You will have to have a tubal in conjunction and I had to sign paperwork acknowledging that, should the tubal fail, and I got pregnant, an abortion would be required or the pregnancy would be life threatening. I now have cramps maybe one cycle out of the year, spotting maybe one or two cycles out of the year, nothing more than a pantiliner can handle. My surgical gynecologist actually suggested it during my consult for the tubal. I had one, in conjunction with a tubal, when I was 28 (now nearly 35). ![]() For me, getting off the hormonal birth control was the best choice. I know I was a good candidate that didn't have endometriosis or anything, so your mileage may very. If my period stays this light, I might just ride it out until menopause. Five years later and I have no side effects and essentially no periods. I also bled brown goop for about 3 weeks. They pump your abdomen full of gas and it can take days or weeks to get rid of, so you are farty and bloated for a while. The worst part, I think, was actually the bloating. Nothing that incapacitated me, but it didn't feel great. The pain I had was like really bad menstrual cramps. I had the procedure on a Friday and went back to work on Monday, left halfway throughout the day and worked from home on Tuesday. I didn't need heavy pain medication and just took Ibuprofen as necessary. I went in for surgery at 7am, was back at my house by 10am. ![]() My uterus is healing itself so five years later, I'm starting to have very light periods about 4 times a year. Like you, I was on Mirena and once it was time to change it, I decided full tilt no more and my doctor agreed that a tubal and ablation was a good option for me. I had a tubal and endometrial ablation and it was the best choice I've ever made.
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