Endrometrial Ablation necessary for polyp control???

[VickiStick]

I just had an ultra sound which showed endometrial thickening and a possible polyp behind the thickening.  Blood work shows that estrogen is within normal range. Age 49. Treatment so far has been using progestren to start period after skipping a few periods. Usually experience cramping, bloating and pelvic pain especially in side when miss periods.  I have no right ovary removed 19 years ago with diagnosis that endometrial tissue had taken over ovary.  Problem now is within the last 3 weeks of missing a period I have had ongoing pelvic pain especially in my left side (with rectum pain). Experienced similar pain in past during ovaluation, but subsided with completion of ovulation.  I have had four children. Dr. wants to do D & C, scrape endometrial lining (biopsy), hysterscopy, and an ablation.  Understand all procedures except ablation.  Read on-line that ablation mainly used for heavy periods--don't have.  Didn't  read that this was used to control polyps. Heard ablation wipes warning signs for edometrial cancer (no bleeding).  I have had a precancerous colon polyp removed 3 yrs. Colonoscopy was clear 2 yrs. ago. I don't think is related.  I have had pelvic and rectum pain during ovulation for years. Couldn't this pelvic pain be also due to traveling edometrial tissue that maybe has adhered to the colon stimulated by hormones?  Would endometrial ablation be a good course of action for someone who has the above symptoms.  What will the ablation do for me?  Please advise.  Thanks.

[Machelle Seibel, MD]

I apologize for the delay in responding. I somehow didn't see your note until just now. Usually, for a polyp, either a D&C and/or a Hysteroscopy is done. The hysterocsopy involves putting a telescope into the uterus for a direct look at the lining and if a polyp is there, to see it and remove it. Ablations are usually done for excessive bleeding and not for polyps.

It sounds like you have endometriosis - a condition where the uterine lining travels outside of the uterus and implants on other internal organs such as the ovary. It can also implant on the colon and though very different than a colon polyp, it can cause pain and rectal bleeding.

Usually the diagnosis is made with a combination of either a barium enema and xray or a laparoscopy (band-aid telescope incision under the belly button) to see and treat the problem. A colonoscopy can't see endometriosis because the problem is outside the colon on the outside tissue, not inside like a polyp.
Machelle M. Seibel, MD