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Endometrial Ablation

During the Procedure for Endometrial Ablation

An endometrial ablation may be performed in a physician’s office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician’s practices.

The type of anesthesia will depend upon the specific procedure being performed. Ablations using a hysteroscope or resectoscope may be performed while you are asleep under general anesthesia, or while you are awake under spinal or epidural anesthesia. If spinal or epidural anesthesia is used, you will have no feeling from your waist down. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Local anesthesia may be used for other types of ablations.


Generally, an endometrial ablation follows this process:

For ablations using a hysteroscope or resectoscope:

  1. You will be asked to undress completely and put on a hospital gown.
  2. An intravenous (IV) line may be started in your arm or hand.
  3. You will be positioned on an operating or examination table, with your feet and legs supported as for a pelvic examination.
  4. A urinary catheter may be inserted.
  5. Your physician will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
  6. Your cervix may be cleansed with an antiseptic solution.
  7. A type of forceps, called a tenaculum, may be used to hold the cervix steady for the procedure.
  8. The cervix will be dilated by inserting a series of thin rods. Each rod will be larger in diameter than the previous one. This process will gradually enlarge the opening of the cervix so that the hysteroscope or resectoscope can be inserted.
  9. The hysteroscope or resectoscope will be inserted through the cervical opening into the uterus.
  10. A liquid solution or carbon dioxide gas may be used to fill the uterus for better viewing.
  11. The ablation instrument will be inserted through the hollow opening of the hysteroscope. A rollerball or wire loop with electrical current will be passed across the endometrial tissues, destroying the tissues.
  12. For hydrothermal ablation, a heated liquid is placed into the uterus through a catheter and circulated with a computer-controlled pump until the endometrial tissues are destroyed by the high temperatures.
  13. After the procedure has been completed, any fluid will be pumped out from your uterus and the instruments will be removed.

For other types of ablation techniques:

  1. You will be asked to undress completely and put on a hospital gown.
  2. An intravenous (IV) line may be started in your arm or hand.
  3. You will be positioned on an examination table, with your feet and legs supported as for a pelvic examination.
  4. Your physician will insert an instrument called a speculum into your vagina to spread the walls of the vagina apart to expose the cervix.
  5. Your cervix may be cleansed with an antiseptic solution.
  6. The physician will numb the area using a small needle to inject medication.
  7. A thin, rod-like instrument, called a uterine sound, may be inserted through the cervical opening to determine the length of the uterus and cervical canal. This may cause some cramping. The sound will then be removed.
  8. With balloon ablation, a silicone balloon will be inserted through the cervical opening into the uterine cavity and will be connected by a catheter to a computer console. Hot liquid will be circulated inside the balloon to destroy the endometrial tissues. The pressure, temperature, and time of the treatment will be controlled by the computer. This may cause some mild to strong cramping.
  9. With radiofrequency ablation, a triangular mesh electrode will be inserted through the cervical opening and expanded to fill the uterine cavity. Radio-frequency energy will be passed into the mesh to destroy the tissues it contacts. Suction helps remove liquids, steam, and other gases that will be produced during ablation. This may cause some mild to strong cramping.
  10. For cryoablation, a special probe that produces very cold temperatures will be inserted through the cervical opening into the uterus. An ultrasound transducer will be placed on your abdomen to guide the cryoablation probe to the appropriate areas in the uterus for freezing. This may cause some mild to strong cramping.
  11. The instruments will be removed.

Locations for Endometrial Ablation