Advice after your nerve block for surgery
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This leaflet is designed to give you the information about endometrial ablation and various techniques (including Novasure and Minitouch) that will help you to make an informed decision. Your doctor will help you decide if endometrial ablation is the right treatment for you. If you have any further questions, please do not hesitate to discuss with your doctor or the contact information provided on this leaflet.
What is Endometrial Ablation?
Endometrial ablation is a surgical procedure to destroy the lining of the womb (endometrium) and in doing so, relieve the symptoms of heavy periods. Endometrial ablation is an effective procedure, recommended by NICE guidance, that is less invasive than hysterectomy, has fewer complications and quicker recovery. After the procedure, most women experience a noticeable reduction in their periods and in some cases, periods stop completely.
Ablation can be performed using various forms of energy – laser, heat, radiofrequency waves, electricity or microwave and either technique can be used according to local protocol. At Frimley Park Hospital, we have used Novasure endometrial ablation technique for women under general anaesthesia and have introduced Minitouch endometrial ablation recently for women wishing to have the procedure under local anaesthesia in the clinic.
What should I know before I decide endometrial ablation?
- Endometrial ablation should be discussed / offered as an option prior to hysterectomy, as per NICE guidance.
- It is a short procedure with quick recovery.
- It can be performed either under general anaesthesia (GA) as a day case or under local anaesthesia (LA) in the clinic.
- It should be offered only after ruling out other causes of heavy bleeding like large fibroids or polyps and in rare cases, cancer of the womb.
- It should be offered only to women who are certain that they have completed their family.
Pregnancy following endometrial ablation can be dangerous for both mother and baby as the thinned uterine lining will not be able to support the development of the baby. Women who have had endometrial ablation should continue to use contraception. Alternatively, you may choose to have laparoscopic sterilization at the same time as endometrial ablation under GA.
It is NOT a suitable option if:
- you have not completed your family
- you do not want to use contraception
- you have large fibroids
Risks with endometrial ablation
Overall, endometrial ablation is a safe and simple procedure, as compared to hysterectomy and is associated with minimal complications.
- Uterine perforation (injury) – very rare. The procedure will need to be stopped to assess and repair the damage as necessary. This does not usually have any long term implications.
- Infection – rare
- Incomplete / abandoned treatment
- Post-operative pain – it is advisable to take regular pain killers for the first 1-2 days
- Bleeding (uncommon) - may be associated with blood stained watery discharge in the first few weeks.
How is endometrial ablation performed?
Novasure endometrial ablation may be performed performed under general or local anaesthesia. The cervix is dilated and the Novasure device is inserted through the cervix. The device performs a cavity safety check and the treatment usually takes 90-120 seconds.
Minitouch Endometrial Ablation
Minitouch is a smaller, softer and a more flexible device, and is used in outpatient setting. The treatment duration is about 72-96 seconds. The procedure is being offered effectively for over 3 years in other NHS units, and long term data is awaited.
You will be given local anesthesia (injections into the neck of the womb) prior to the procedure to numb the area. It is essential you take pain killers 1-2 hours prior to the procedure – Diclofenac
suppository (100mg) and two co-dydramol tablets. If you are unable to take diclofenac, you will be prescribed codeine 30-60 mg. It is also important that you have eaten prior to the outpatient appointment.
The advantages of outpatient endometrial ablation include avoidance of general anesthesia and its effects, immediate recovery and no need for fasting and your companion will be allowed to sit with you during the procedure. The main disadvantage is discomfort during the procedure.
There will be a dedicated Nurse who will support you throughout the procedure. You can also choose to use gas and air (similar to that used in labour) if you wish. However, if you find the procedure uncomfortable and do not wish to continue at any stage, please inform the doctor or
the nurse.
What to expect after the operation ?
- Soon after the operation, you may experience crampy pains. This can usually be managed by regular painkillers for the next 24-48 hours. You will be given stronger painkillers as necessary.
- Following GA, you will be allowed to go home the same day and you should not drive for 24 hours.
- Following procedure under LA, you can go home within half an hour and although you will be able to drive, you may prefer to be driven home.
- You may experience a pinkish watery vaginal discharge for up to 4 weeks. It is important that you avoid tampons and sexual intercourse during this period to reduce the risk of infection.
- Your period will occur at about the usual time. The effect of the operation may be immediate but can take up to 2-3 months before the full effect is noted.
Please contact Urgent Gynae Care centres at FPH 03006136418 and WPH 03006154429 if you develop high temperature, worsening pain that is not relieved by paracetamol and ibuprofen or an offensive vaginal discharge.
Opening hours 8am - 8pm
Contact us
If you have any queries relating to this information, please contact the Gynaecology service.
About this information
Service:
Gynaecology
Reference:
L/130
Approval date:
1 March 2018
Review date:
1 March 2021
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.