Uterine Ablation

In-Office Hysteroscopy, D&C, and Uterine Ablation: A Personalized Approach to Empowering Your Health
Today, I'm thrilled to guide you through the transformative world of in-office hysteroscopy, dilation and curettage (D&C), and uterine ablation—procedures designed to enhance your well-being and alleviate heavy bleeding. (Note: Some physicians may only offer this procedure in a hospital under general anesthesia, with same-day discharge.)

Understanding the Why:
Uterine ablation is often recommended for heavy menstrual bleeding. It aims to significantly reduce or eliminate bleeding, providing you with relief. Evaluation by your physician is essential to determine candidacy, as this procedure may not be suitable for individuals with large uterine fibroids, postmenopausal women, those with uterine cell abnormalities, or women desiring future pregnancies.

Navigating the Journey:
Your comfort is our priority. We utilize pain management techniques such as misoprostol to prepare the cervix the day before, anxiety medications or nitrous oxide on the day, and a paracervical block. This allows us to perform the procedure in-office, with you remaining alert. The entire process typically takes under 30 minutes.

Procedure Steps:

• A speculum is inserted, and your cervix is visualized.
• With optimal pain management, instruments are used to dilate the cervix.
• We measure your uterine and cervical length.
• A thin camera is inserted through the cervix to examine the uterus for abnormalities and to treat any found.
• The camera is removed, and a uterine ablation device is inserted. Various ablation techniques (e.g., cryotherapy, hydrothermal, radiofrequency, electrocautery, or microwave) may be used. Ask your doctor which method they prefer.
• Post-ablation, the camera may be reinserted to check for effectiveness.
• The procedure, from start to finish, typically takes less than 30 minutes.

Sharing Considerations and Risks:
Uterine ablation can make future uterine biopsies more challenging, potentially impacting cancer detection. Regular screenings and monitoring are vital.

Charting the Path Forward: Contraception Post-Ablation:
Reliable contraception post-ablation is essential, as pregnancy poses significant risks after the procedure. This step safeguards your health.

Recovery, Resilience, and Renewal:
Recovery is generally swift, with cramping and spotting peaking over the first two days but possibly lasting up to two weeks. Most patients resume normal activities within one to two days. Follow post-procedure instructions for optimal recovery.

Restrictions:

• Avoid inserting anything into the vagina (no tampons, douching, intercourse).
• No tub baths, swimming, or strenuous activity for two weeks.

Author

Swor Women's Care Dr MIchael Swor is the founder and managing OBGYN physician at Swor Women's Care. Posts and blog updates are provided with the help of his partners, Dr Jenny Lichon and Dr KASH, as well as other healthcare providers and staff in the practice.