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The primary indication for endometrial ablation is abnormal uterine bleeding, including chronic heavy menstrual bleeding, in premenopausal patients. [6] Typically, these are patients for whom first-line medical therapy was unsuccessful or contraindicated. [1] In some cases, endometrial ablation is use to treat small uterine fibroids. [7]
A further surgical technique is endometrial ablation (destruction) by the use of applied heat (thermoablation). [58] The effectiveness of endometrial ablation is probably similar to that of LNG‐IUS but the evidence is uncertain if hysterectomy is better or worse than LNG-IUS for improving HMB. [21]
Additionally, hematometra may develop as a complication of uterine or cervical surgery such as endometrial ablation, where scar tissue in the endometrium can "wall off" sections of endometrial glands and stroma causing blood to accumulate in the uterine cavity. [1] It can also develop after abortion, [4] as well as after childbirth.
Illustration of uterine fibroids with examples of their possible locations. Uterine artery embolization (UAE, uterine fibroid embolization, or UFE) is a procedure in which an interventional radiologist uses a catheter to deliver small particles that block the blood supply to the uterine body.
57-75% of women who undergo UAE for adenomyosis typically report long-term improvement in their menstrual pain and bleeding. However, there is a recurrence rate of symptoms in 35% of women following a UAE. Also, UAE has the risk of causing major complications in 5% of women who undergo the procedure.
Menorrhagia (heavy or abnormal menstrual bleeding) may also be treated with the less invasive endometrial ablation which is an outpatient procedure in which the lining of the uterus is destroyed with heat, mechanically or by radio frequency ablation. [52] Endometrial ablation greatly reduces or eliminates monthly bleeding in ninety percent of ...
Ulipristal acetate is a synthetic selective progesterone receptor modulator (SPRM) that has tentative evidence to support its use for presurgical treatment of fibroids with low side-effects. [46] Long-term UPA-treated fibroids have shown volume reduction of about 70%. [47]
In patients with endometrial cancer who use progestin releasing IUDs concluded mixed results. A 2020 meta-analysis by Livia Conz et al. estimated that users of levonorgestrel-releasing systems had an increased breast cancer risk in general (with an odds ratio of 1.16) and higher risk for those over age 50 (odds ratio 1.52), and suggested ...