تعريف

This procedure involves the surgical removal of the lining of the uterus (womb). It may involve using heat, cold temperatures, microwave energy, or other methods.

أسباب هذا الإجراء

Endometrial ablation will likely make menstrual flow lighter. In some cases, it stops menstrual flow completely. The procedure is used to treat menorrhagia (recurrent heavy periods not controlled by medicine).

Talk to your doctor about your plans for having a baby. This procedure decreases your chance of pregnancy.

المضاعفات المحتملة

Complications are rare, but no procedure is completely free of risk. If you are planning to have endometrial ablation, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:

  • العدوى
  • نزيف
  • Complications related to anesthesia
  • Uterine perforation or organ injury
  • Edema (swelling) due to fluid leakage and absorption
  • Thermal (heat) injury to the vagina, vulva, or bowel

بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:

  • Pregnancy or possible pregnancy—procedure should not be done if there is a chance that you are pregnant
  • History of pelvic inflammatory disease (PID)—may trigger a recurrence of PID
  • Inflammation of the cervix
  • Being overweight or obese
  • التدخين

تأكد من مناقشة هذه المخاطر مع طبيبك قبل الإجراء.

ما يمكن توقعه

قبل الإجراء

Prior to the procedure, your doctor will likely:

  • Do an endometrial biopsy, ultrasound, or hysteroscopy of your uterus to check for abnormalities and understand the shape and size of your uterus.
  • Ask about:
    • تاريخك الطبي
    • Medicines or herbs and supplements you take
    • Any allergies you have
    • سواء كنت حاملا أو تحاولين الحمل
    • If you have an intrauterine device (IUD)

Before the procedure, you may need to:

  • Ask your doctor about your options. There are many types of endometrial ablation.
  • التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
    • الأدوية المضادة للالتهابات (مثل الأسبرين)
    • سيولة الدم, مثل كلوبيدوجريل (بلافيكس) أو الوارفارين (الكومادين)
  • Take medicine to thin the lining of the uterus.
  • Arrange for someone to drive you home from the care center. You may also need help at home.
  • Try to quit smoking.

The day before the procedure:

  • Have a light dinner.
  • The night before, do not eat or drink anything after midnight.

التخدير

There are three anesthesia options for ablation:

  • General anesthesia —blocks pain and keeps you asleep through the procedure
  • Regional anesthesia —blocks pain in an area of the body but you stay awake through the procedure, given as an injection
  • Local anesthesia—just the area that is being operated on is numbed, given as an injection

Your doctor will help you decide which one is right for you.

وصف الإجراء

There are many different ways for the doctor to do this procedure. A simple ablation procedure is short. It can often be done in a care center. Other procedures take longer and need to be done in a hospital.

During the procedure, the doctor will not make any incisions to access the uterus. A tiny probe will be inserted through the vagina and into the uterine cavity through the cervix. Depending on the method, the tip of the probe will expand to deliver:

  • Radiofrequency (heat and energy)
  • Cryoablation (freezing temperature)
  • Heated fluid
  • Heated balloon
  • Microwave energy
  • Electrosurgery (uses electrical current and a heated rollerball or spiked ball)—may require general anesthesia

These methods will destroy the cells lining the uterine cavity. You will not feel pain. Often, ultrasound is used to help guide the doctor. Suction will be used to remove the tissue that has been destroyed.

كم من الوقت سيستغرق ؟

This depends on the type of method. It can take 15-45 minutes or longer.

كم هو مؤلم ؟

You may feel cramping and discomfort. Your doctor will give you pain medicine.

متوسط ​​الإقامة في المستشفى

This is usually done on an outpatient basis. You may need to stay there for 1-2 hours. Some methods may require an overnight hospital stay.

رعاية ما بعد العملية

At the Care Center or Hospital

While recovering, you may receive the following care:

  • Check blood pressure, heart rate, and breathing
  • Check on your fluid status and the electrolytes in your blood

Your doctor will ask you how you feel and make sure you are well enough to go home.

في البيت

After the procedure, you may:

  • Feel cramping for 1-2 days
  • Have a heavy discharge for 2-3 days
  • Have a watery, bloody discharge for a few weeks
  • Need to go to the bathroom a lot for the first day and have some nausea

When you return home, do the following to help ensure a smooth recovery:

  • Make sure you have a supply of sanitary pads at home.
  • You should be able to return to normal activities within a day or two. Ask your doctor when you can:
    • Exercise
    • Resume sexual activity
    • Use tampons
    • Shower, bathe, or soak in water
  • Since you still have your sexual organs, you will need to:
    • Use birth control to prevent pregnancy
    • Have routine Pap tests
    • Have pelvic exams

استدعاء الطبيب

بعد مغادرة المستشفى ، اتصل بطبيبك في حالة حدوث أي مما يلي:

  • Heavy vaginal bleeding
  • Severe abdominal cramping and pelvic pain
  • Severe pain during الجنس
  • Severe low ألم في الظهر
  • Pain during bowel movements or urination
  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • استفراغ و غثيان
  • Cough, chest pain, or shortness of breath
  • الدوخة أو الدوار
  • Pain or tenderness in the calf or leg
  • Menstruation does not get lighter after 2-3 periods

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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