Endometrial ablation

Hello, I´m a woman, 67; my gynecologist recommends me to have an endometrial ablation, because my uterus has, since many years, a lime deposit + fills with mucus so I have to get a curettage every second year. But so far as I have read about endometrial ablation on the net it seems it´s mainly used when women suffer from difficult menstruations -- would it really be motivated in my case? Grateful for your answer, Britt Arenander

[Elaine Brown, MD]

Hi!
You have a very good question!
You are absolutely correct that endometrial ablation is used to cauterize the tissue that generates the uterine lining that sheds every month as the menstrual period.  As far as I know the only recommended use of ablation is for relieving heavy menstrual bleeding.

I am guessing that your gynecologist is thinking that an endometrial ablation would cause scarring of the lining and obliterate the cavity that fills with mucus.  That would be very nice if it works!  However, I would be a little nervous that the scarring might form in the wrong place and make it more difficult to access and drain the mucus when it does form. Also, I would be concerned that you would be at higher risk of complications (perforation of the uterus) due to the scarring that you already have.

I am just not sure whether it would work!  It seems to me that a D&C every few years is fairly minimally invasive, and I suppose if you wanted a guarantee you could go for a vaginal hysterectomy. I guess it mostly depends on your preference, and you are wise to make an INFORMED decision!

Good luck!

Dr B