Radio Frequency Ablation of the Uterus

Radio frequency ablation (sometimes shorthened as “rf ablation” or RFA) is more precisely known as the impedance-controlled bipolar radiofrequency ablation. It destroys endometrium, the inner lining of the uterus in order to stop heavy menstrual bleeding (menorrhagia) and introduce the state of no bleeding at all (amenorrhea).

How Does Radio Frequency Ablation Work?

The scope of this method in medicine is much larger then pure gynecology. The first high frequency generators were devoloped in the late 1800’s and were used to create spectacular lightning. Later, such machines were used in cosmetics and dermatology. For surgical purposes, radio frequency ablation is useful because the heat it induces coagulates small vessels during an operation. The first such device was used in 1928, and since then, its successors can be found in operating theathers all over the world.

The principle of operation is that the generator sends high frequency power, which causes ions in the tissue to vibrate at high speeds. The ions move back and forth and thus produce heat. When heat rises above 45 degrees C (113 degrees F), protein is permanently damaged and the cell membranes fuse. The tissue is killed and the whole process lasts no more than 15 minutes.

Where Can It Be Used?

Radio frequency ablation can be used as a kind of a minimally invasive surgery for: . liver tumors and cancerous tissues,

. unresectable hepatic tumors,

. various cases of breast, kidney, lung, adrenal and bone cancer,

. atrial fibrillation,

. cardiac ablation

and many others.

Radio Frequency Ablation of the Uterus

For endometrial ablation, a sheath with bipolar radiofrequency electrode is placed through the cervix. When the sheath is pulled back, the electrode expands and conforms to the shape of uterine cavity. The electrode then emits radio frequencies. In the end of the procedure, the electrode is retracted back to the sheath and removed from the uterus. There is no need to prepare endometrium in advance for the procedure, which means there is no need to take drugs that might have side-effects. If there are large fibroids in the uterus, they may interfere with the placement of the device.

If the uterus is irregular in shape, the procedure may not be a feasible option.

The patient must receive general or local anesthesia.

The rate of success is comparable and practically identical to other newer endometrial ablation techniques — 80% and above success rate after a year.

Possible Complications

Just like with any other type of ablation, there may be certain problems, such as

. pelvic pain,

. endometritis,

. urinary tract infection,

. nausea and vomiting.

Normally, this is an out-patient procedure and you should be able to go home the same day if there are no complications. Be sure to discuss the outcome of the procedure with your doctor and/or surgeon. Try to access in advance what are the possibilites of complications in your case.

What To Do Next?

For more information on endometrial ablation in general (the general course of reconvalscense after the procedure, symptoms, the outcome of endometrial ablation in general etc.),  please visit our page on endometrial ablation.