Menorrhagia stands for “excessive bleeding”, and unresponsive menorrhagia usually leads to a hysterectomy, because the doctors start thinking that nothing can save the day.

The method of endometrial ablation Mr. Bolanos chose was operative hysteroscopy. The endometrial polyp is cut away with a roller bal. Most hysterectomies arise due to unresponsive uterine bleeding, but surgeries such as this help avoid hysterectomy by controlling the possible cause of it.

For other videos see our main page on hysterectomy video. For other techniques, see the main page on endometrial ablation.

Menorrhagia stands for “excessive bleeding”, so this woman was not a candidate for a full hysterectomy. She had a fibroid in the uterus, several polyps, and a thickened endometrial tissue, which was the mechanical cause of bleeding.

The method of endometral ablation Mr. Bolanos chose was operative hysteroscopy, the instrument chosen is GyneCare VersaPoint. It is a bipolar cutter instrument and in the video you will be able to clearly see how it “shaves off” the endometrium, leaving the red tissue, soon to be exterminated on the left and with the greyed out, ablated, tissue on the right.

In the end, the surface of the endometrium is literally vaporized. The purpose of the endometrial ablation here was to buy time, to put the patient on oral iron, so that in two or three months her blood count would return to normal.

For other videos see our main page on hysterectomy video.

For other techniques, see the main page on endometrial ablation.

The idea in itself is not new: dermatologists and primary care doctors have used cryogenic devices since the beginning of the 20th century to treat warts, pre-cancerous and malignant lesions.

Main Advantages

It is minimally invasive with minimal post-operative discomfort.

Very rapid recovery.

Minimal complication rate.

Is as effective as either modalities.

Can be repeated if the conditions warrant it…

The cryogenic corruption probe is officialy approved by the FDA.

Cryo Ablation for the Uterus

This is destroying the lining of the uterus through cryogenics, the extreme cold. Just as with other types of
uterine ablation, this can reduce or eliminate menstrual bleeding. You would still need to take a birth control pill or apply contraception in general. If the lining is not completely destroyed, there is a small chance of geting pregnant, and such pregnancy must be stopped.

Cryo ablation is an alternative to hysterectomy, and if it works, you will have your problem solved, without a hysterectomy. You will know about 3-4 months after the surgery, whether the bleedings decreased to a tolerable level or not.

The Procedure

Your doctor may prescribe the medications to thin the lining of the uterus, usually 21-28 days before the procedure. In certain cases, you will not be allowed to eat from midnight the night before the procedure.

The doctor may decide to sedate you. He or she will monitor the procedure through the ultrasound machinery. A wand connected to the cryogenic machine will be inserted into your uterus and gently cooled down. If eferything is OK, you will go home within hours of the procedure. It would be best if somebody drove you home.

The Risks of Cryo Ablation

Call your physician in case of

• fever,
• bowel or bladder problems,
• a greenish or foul smelling vaginal
  discharge,
• nausea and/or vomiting.

In rare cases, the procedure may leave you with

• infection,
• ruptured uterus (hole in the uterus),
  and
• freezing of internal organs adjacent
  to the uterus.

Also rarely, there may be problems with blood:

• excesive loss of it,
• hemorrhagia,
• collection of blood and/or tissue in
  the uterus or Fallopian tubes.

What Cryo Ablation of the Uterus is Not Suitable For

If you want to have children, don’t go for cryo or any other ablation, or for that matter, for any surgical procedure of the uterus and related organs. Cryo ablation is also not for cases of endometrial hyperplasia, which is an increased number of cells in the uterus, and neither is it suitable for adenocarcinoma of the endometrium (endometrial cancer).

Cryo ablation may be used to treat cancers of prostate in men, but currently is not used to treate cancer in uterus.

Post-operative Course

You should expect mild cramps, bloody or watery vaginal discharge for 7-10 days. No harder physical activity
and no sexual intercourse for at least a week or two. Consult with your physician for all the details after the intervention.

Cryo Ablation for Heart Problems

This techniques is an important new addition for treatments of heart, especially for arrhythmia. The advantage
of cryo ablation for heart patients is that doctors can test the place to put catheter on before actually doing the operation.

Cryo Ablation for Liver Cancer and Tumors

Cryo ablation might come very handy in treatments of inoperable tumors such as cancer of liver. The problem with this deep probing is that the catheter must be put exactly in the center of tumour, which an unreliable procedure without visual guidance in real time. However, in combination with magnetic resonance imaging
(MRI) surgeon can pinpoint the right spot in real time and actually see how the snowball in the tumor grows. Results are positive so far, but the whole technique is so rarely done that many independent studies must be made in order for it to become routinely accepted.

Cryo Ablation For the Prostate Cancer

In prostate cancer, cryo therapy can also be performed. It seems to be a fairly efficient procedure in itself,
but it takes a lot of times for doctors to learn it and the hospital must have specialized equipment. For instance, cryo ablation for cancer of prostate is done by inserting very fine needles in to the prostate, then freezing it by argon gas, down to -40 degrees C. The freezing is constantly monitored by ultrasound.

Cancer of Kidneys

The standard treatment for kidney cancer is by conventional or laparoscopic method. The tumor must be
fairly small (less than 4 cm in size) and the optimal scenario is to discover the tumour while doing an ultrasound for something else. Following the usual post-surgery rules, you can be “up and running” within a few days from the surgery, returning to the full physical activity approximately after two weeks.

Cancer of Esophagus

Gastrointestinal Reflux Disease (GERD)  changes the lower part of the esophagus, and makes it suspectible
for further cancer growths. In the USA only, there may 4.5 up to 7.5 millions of people possibly endangered by this. The cancer of esophagus is known to progress rapidly, so any means of eliminating it in the start out phase is important.

Cryo ablation may also be used in cancer of esophagus, to remove so-called Barett’s cells, which are precancerous and cancerous cells in the esophagus. Once removed, normal cells can grow in their place. This cryo technique delivers cryo-material via a catheter, which is introduced into the esophagus through an accessory channel of an upper gastrointestinal endoscope. The freezing then removes the abnormal cells. The advantage of using cryo device in conjunction with the endoscope is that the surgeon can see exactly wher to put it, without direct mucosal contact. The whole procedure for esophagus takes about five minutes.

. Laser ablation

. Thermal ablation

. Novasure endometrial ablation

. Hydrothermal ablation

. Electrosurgical Technique (Roller Ball or Barrel)

. Operative Hysteroscopy (see the Endometrial Ablation For Fibroids Video)

. Radio frequency ablation

. Thermal baloon ablation

. Microwave ablation

. Cryo ablation

The most frequent disorder where uterus ablation would be applied to, is menorrhagia, heavy menstrual bleeding. Usually, a menstrual bleeding lasts for a few days and then is gone, but in some cases, it not only lasts longer but grows heavier and makes life really difficult. Some women literally cannot go out of the house because of the heavy bleeding! It is one thing to have the bleeding that everybody else is having, it quite another thing not to be able to go shopping, not to be able to go to work and so on.

Endometrial Ablation for Avoiding Hysterectomy

If there is no tissue that bleeds, that there will be no more bleeding, so if the part of the uterus that actually bleeds, endometrium, is removed the patient will be better. Endometrial ablation is a very good technique and can be classified as a minimally invasive surgical technique. After ablation you wouldn’t have endometrium, but would continue to have the rest of the uterus, not to mention that you would have your ovaries intact. Instead of heading to surgical menopause with hysterectomy, your hormonal balance would remain largely intact after ablation of the uterus.

A fibroid is a muscle tumor, in this case, the tumor of muscles in the uterus. Another name for them is myoma, which is short for the more technical name — leiomyoma. Women can endure an entire pregnancy or two with uterine fibroids present, but there are cases in which they produce heavy menstrual bleeding, pain and various others types of discomfort.

The Position Of Fibroids

Fibroids occupy one of the following positions:

Intracavitary myomas — inside the uterine cavity. Will usually produce metrorrhagia (bleeding between periods) and/or severe cramping. This type of myomas can be successfuly eliminated by a procedure called hysteroscopic resection, through the cervix and with no incision.

Submucous myomas — one part in the cavity and the rest in the wall of the uterus. Usually produces menorrhagia (heavy menstrual bleeding) as well as bleeding between periods. For some of these myomas, hysteroscopic resection may be a method of choice.

Intramural myomas — in the wall of the uterus. Can be very small up to large as a grapefruit. There are several fibroid treatments for this group, but — best of all — this type of fibroids may not call for a surgery at all.

Subserous myomas — on the outer wall of the uterus. Can be destroyed by laparoscopy.

Pedunculated myoma — an outside myoma on the stalk. Best eliminated by laparoscopy.

A Video of 18 Large Uterine Fibroids Taken Out of the Uterus

In classical medicine, the only efficient treatment for uterine fibroids is surgery. Iit can have disastrous consequences, the gravest of which is the case of hysterectomy, in which the problem is literally cut away. There is a number of alternatives to hysterectomy, and there is a number fibroid treatments, as well.

You can also have a look at the hysterectomy videos page, to see a number of minimally invasive techniques such as the laparoscopic myomectomy videos page etc

Unfortunately, if there is too much blood life can become unbearable. In some cases, women have heavy menstrual bleedings for ten days in a row!, which is quite debilitating and ruining lifestyles. It is no fun when you have to give up your job because you cannot go out to the street for several days in row. When that happens, go straight to the doctor, probably not GP (General Practice) but an ob-gyn — a gynecologist. The doctor will have ways to examine you and suggest what next. Medical term for profuse bleeding is metrorrhagia.

A Video For Uterine Ablation

Prior to the 1990′s, the only solution would be hysterectomy, surgical removal of the uterus and/or ovaries, but now there are many ways to avoid hysterectomy. One of the most popular is uterine ablation, surgical removal of endometrium. Actually, the procedure is better known as the endometrial ablation instead of uterine ablation (sometimes even called the “uterus ablation”). In order to get a feeling for these gynecological procedures, visit the hysterectomy video page, where you will be able to choose from 20-odd videos; you’ll become expert in not time at all.

Why Thermal Ballon Ablation!?

Thermal Balloon Ablation was invented to rectify the shortcomings of the first generation of endometrial ablation procedures. Hysteroscopic endometrial resection and ablation proved themselves successful in up to 70-90% of cases of heavy menorrhagia, but the former has at least two disadvantages:

– the surgeon must have an excellent training in the method, and

– serious complications may occur. Amongst them are: fluid overload, uterine perforation, infection, haemorrhage, thermal injuries, and even death.

Empirical data show that various ablation techniques, for instance, roller-ball and Nd Yag laser, had the rate of postoperative complication less than 4.4%, which is lower then for the hysteroscopic endometrial resection.

THERMACHOICE Thermal Balloon Ablation Device

In 2003, a new version of the already known thermal balloon ablation device called THERMACHOICE III, appeared. The candidates for this treatment are as follows:

– pre-menopausal women with regular uterine cavity and no cervical or endometrial malignancies,

– a completed family (no desire to have any more children),

– although rare, the patient can be allergic to latex, so it is a contraindication as well.

The procedure is to insert a balloon catheter into the uterus and inflate it with a small amount of sterile fluid. In THERMACHOICE, the catheter is 16 cm long and 3 mm wide, and at its end is a latex balloon filled with 5% dextrose heated to 87°C for 8 minutes. The pressure inside the balloon is maintained between 150-180 mmHg. After these 8 minutes, the fluid is pulled back from the device, the catheter also goes out and nothing stays in the uterus. The whole procedure takes no more than 30 minutes to complete. The uterus will take about 7 to 10 days to heal, while the woman can get back to her normal life the very next day.

The Factors Pro et Contra Thermal Balloon Ablation with THERMACHOICE

The following factors ensure the more successful outcome:

– the increasing age of the patient,

– higher balloon pressure,

– smaller uterine cavity and

– a lesser degree of pre-procedure menorrhagia.

To the contrary, the factors to increase the risk of treatment failure are:

– the patients of young age,

– a prolongued duration of menstruation,

– a retro-verted uterus and

– endometrial thickness of at least 4 mm.

Thermal Balloon Ablation — the Conclusion

With ablation, seven out of ten women avoid further gynecological intervention such as another endometrial ablation, dilatation and curetage (D & C), or the hysterectomy itself. There was no endometrial carcinoma reported amongst the balloon ablation patients. The complete amenorrhea for thermal ablation is 25-35%, and the failure rate is 10-30%. The rest of the patients have light spotting, or light or normal menstrual flow.

The Rollerball Ablation Procedure

Through a hysteroscopy, the physician views the uterine cavity. Hysteroscope consists of long flexible or rigid tube with optic fiber optic light source inside. Camera lenses in the hysteroscope conway the image of the uterine cavity to a video screen.

Then the uterine cavity is filled with fluid. It serves dual purpose:

. to enhance visualization and to

. prevent accidental burns.

The fluid may contain materials such as glycine, sorbitol, or mannitol, which do not conduct electricity.

Each type of endometrial ablation differs by the way used to destroy the endometrium. Rollerball method is more precisely called electrocautery with roller ball diathermy, and uses a device that looks a lot like a tiny steamroller. The device applies heat, rolls across the uterine lining and thus destroys it.

The process takes anywhere from 15 to 45 minutes. Although most of these operations will require general anesthetic, the patient can go home the very same day (of course, if there are no complications).

The success of the operation depends heavily on the operator himself or herself. If well trained, rollerball ablation can be a great success. However, with the advent of second generation ablation devices, rollerball ablation stopped being fashionable. For best results, the operator may not be impatient, but should visit every nook and crany in the uterus. Afitness of sweeping the endometrium is the main reason why this procedure could fail.

Here Is What The Roller Ball Endometrial Ablation Looks Like

[There is a video that cannot be displayed in this feed. Visit the blog entry to see the video.]

For a more general appraisal, please have a look at our main endometrial ablation page.

From this page on rollerball ablation you can go to the home page of this site and see whether is it possible to avoid endometrial ablation, hysterectomy and other surgical procedures in your case, and if it is, how to proceed further to an eventual healing.

Menorrhagia stands for “excessive bleeding”, and unresponsive menorrhagia usually leads to a hysterectomy, because the doctors start thinking that nothing can save the day.

The method of endometrial ablation Mr. Bolanos chose was operative hysteroscopy. The endometrial polyp is cut away with a roller bal. Most hysterectomies arise due to unresponsive uterine bleeding, but surgeries such as this help avoid hysterectomy by controlling the possible cause of it.

[There is a video that cannot be displayed in this feed. Visit the blog entry to see the video.]

For other videos see our main page on hysterectomy video. For other techniques, see the main page on endometrial ablation.

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.

Next, a small quantity of CO2 inflates the uterus so that the device is placed properly. If everything is OK, a short burst of radiofrequency energy, for no more than 90 seconds, destroys the endometrium, and the whole procedure lasts for less than 5 minutes. The device will also remove the desiccated issue from the cavity. Most patients can go home within an hour of the procedure.

Besides speed, the main advantage of this system is that no preparation of the uterus need be done in advance. With other methods of ablation, the patient must receive several injections of Lupron Depot two months beforehand the scheduled date, the idea being to thin the endometrium so that the ablation can succeed better. One injection costs $400 — you will need several of them, so it is very expensive. Not only that: it produces many unwanted side-effects, such as hot flushes, sweats etc. The procedure itself must be executed when the patient would not have her usual menstrual cycle.

Contrary to all that, Novasure does not need thinning of the endometrium, so there is no need for preparation and costly injections, and it can be done at any time of the woman’s menstrual cycle.

Types of Anesthesia for Novasure

Even being that fast, Novasure endometrial ablation still is an ablation, so there must be some kind of anesthesia. Usually, it is local anesthesia and sedation, although epidural and general anesthesia are also an option in certain cases. With other types of ablation, cramps are to be expected and even feared, but with Novasure, there are cases of women playing competetive tennis matches the same weekend.

Whom Is It Not For

The uterus has to be of fairly regular shape. Fibroids or large polyps will interfere with the placement of the device, so if that is the case, it would be best to eliminate them in some other way first, and then proceed with the ablation itself. Novasure can be used even if there are polyps up to 2 cm large, and it can be even used to treat fibroids if they do not distort the shape of the cavity.

If the wall of the uterus is too thin, this type of ablation is also not for you.

As with all other types of endometrial ablation, if you want more children, this is not for you. After ablation, you should best be under some kind of contraception as there is a possibility of getting pregnant. As remote as it is, it best didn’t happen, since most of the endometrium — the very tissue that your eventual baby would be linked to under normal curcumstances — is almost all dead (“flamed up” in the case of Novasure, “boiled” with thermal balloon and so on, depending on the device used).

The Effects of Novasure Endometrial Ablation

In tests that led to the approval of Novasure by the FDA, 93% of women were satisfied with the outcome of the ablation within one year and after 3 years, 44% of the women were amenorrheic. In other words, this is comparable and even marginally better than other types of ablation. However, the same objections apply to Novasure as to any other type of ablation — there can be watery and not so watery discharges for weeks after the procedure, and only after 3-6 months will you be able to tell whether it all made sense or not. For a small number of patients, all this will only prolongue their route towards hysterectomy. Even if everything looks fine from the surgical point of view, you should still be looking for alternative kinds of healing.)

For more general information on ablation, please visit our main endometrial ablation page.

Who Is A Good Candidate For Novasure Endometrial Ablation?

You will be a good candidate if all of the following indications are met:

• you are not yet in menopause,

• you have menorrhagia (excessive bleeding),

• the causes of menorrhagia are benign, and

• you have completed your childbearing.

Contraindications for Novasure Endometrial Ablation

• The main contraindication is current pregnancy or a woman who wants to become pregnant in the future. In some cases, not the entire endometrium is destroyed, or even if it is, it may develop again, which makes it possible for the fertilized egg to get implanted. Such pregnacies must be terminated, since nobody knows what to expect, even if such a pregnancy were carried out to a full term.

• Known or suspected uterine cancer (endometrial carcinoma), or a pre-malignant condition such as unresolved adenomatours hyperplasia.

• Weakness of the myometrium, maybe as a result of previous classical cesarean section or transmural myomectomy.

• Active vaginal or urinary tract infection, such as cervicitis, vaginitis, endometritis, salpingitis, or cystitis.

• A patient with an intrauterine device (UID) in place.

• A patient with a uterine cavity length less than 4 cm. The minimum length of the electrode array is 4 cm. Treatment of a uterine cavity with a length less than 4 cm will result in thermal injury to the endocervical canal.

• A patient with active pelvic inflammatory disease.

How Novasure Endometrial Ablation Works

Novasure consists of an electrode with a sheath at the end; in the beginning of the procedure, the sheath is placed through the cervix. The electrode then expands and conforms to the shape of the uterine cavity. The device tests whether there is any rupture of the cavity and will not turn on if there is one. (As a safety measure, the device will turn itself off if 50 ohms of resistance occurs.) Next, a small quantity of CO2 inflates the uterus so that the device is placed properly. If everything is OK, a short burst of radiofrequency energy, for no more than 90 seconds, destroys the endometrium, and the whole procedure lasts for less than 5 minutes. The device will also remove the desiccated issue from the cavity. Most patients can go home within an hour of the procedure.

Besides speed, the main advantage of Novasure endometrial ablation is that there is no need to prepare the uterus with expensive or dangerous drugs such as Lupron Depot. Lupron not only costs $400 per shot, but has side effects such as hot flushes, sweats, effectively, introducing a termporary menopause.

Novasure endometrial ablation can be executed at any time of the woman’s menstrual cycle.

Types of Anesthesia for Novasure Endometrial Ablation

Usually, for Novasure only local anesthesia and sedation are needed, although epidural and general anesthesia are also an option in certain cases. With other types of ablation, cramps are to be expected and even feared, but with Novasure, there are cases of women playing competetive tennis matches the same weekend.

Practical Contraindications for Novasure Endometrial Ablation

The uterus has to be of fairly regular shape. Fibroids or large polyps should be done away with in some other way before Novasure could be applied. Actually, Novasure can be used even if there are polyps up to 2 cm large, and it can be even used to treat fibroids if they do not distort the shape of the cavity.

If the wall of the uterus is too thin, this type of ablation should also be ruled out.

As with all other types of ablation, if you want more children, this is not for you. After ablation, you should best be under some kind of contraception as there is a possibility of getting pregnant. As remote as it is, it is best it didn’t happen, since most of the endometrium — the very tissue that your eventual baby would be linked to under normal curcumstances — is almost all dead (“flamed up” in the case of Novasure, “boiled” with thermal balloon and so on, depending on the device used).

Other Methods To Treat Excessive Uterine Bleeding Due To Benign Causes

If you go to the medical doctor to help you combat excessive uterine bleeding, the drug therapy will be the first step. Failing that, a Dilatation and Curettage (D&C) will be next, as the first surgical step. After, that it may be a choice between hysteroscopic endometrial ablation, thermal endometrial ablation, laser ablation, electrosurgical technique (roller ball or barrel), Radio frequency ablation, Microwave ablation, and Cryo ablation. Failing all that, hysterectomy remains as the final choice.

Of course, there are many other ways to combat excessive uterine bleeding, please see the main energy healing page on this site for a list of possible alternatives.

The Effects of Novasure Endometrial Ablation

In tests that led to the approval of Novasure by the FDA, 93% of women were satisfied with the outcome of the ablation within one year and after 3 years, 44% of the women were amenorrheic. In other words, this is comparable and even marginally better than other types of ablation. However, the same objections apply to Novasure as to any other type of ablation — there can be watery and not so watery discharges for weeks after the procedure, and only after 3-6 months will you be able to tell whether it all made sense or not. For a small number of patients, all this will only prolongue their route towards hysterectomy.)

The idea of endometrial ablation is to destroy the inner lining of the uterus, since technically speaking, it is the endometrium that produces menstruation if there were no fertilised and implanted egg. Ever since the 1980′s, the race is on and new devices appear every three or four years, especially since 1997/8.

A Short Comparison of Techniques for Endometrial Ablation

The first generation techniques are:

. resection,

. roller-ball and

. laser ablation

and they all require direct visualization of the endometrium using a hysteroscope. The operator must be thoroughly schooled, since all these techniques require great skill and knowledge on his or her behalf.

Newer techniques are, amongst others,

. microwave (explained on this very page that you are reading now) and

. thermal balloon endometrial ablation, as well as

. Novasure.

In theory, they offer a one day out-patient procedure, and should enable the patient to go home the same day (if there were no complications).

The Technology of Microwave Ablation

In microwave ablation, heat is generated through a high frequency microwave energy. The endometrium is being rapidly heated and then destroyed. The frequency of microwave rays is 9GHz and endometrial tissue absorbs it up to the depth of 3mm. The actually destroyed level of tissue is 5-6 mm — more than enough to destroy the endometrium without damaging the other organs.

The applicator is introduced to the uterus through a dilated cervix, and once in, it starts to deliver the microwaves. The operator slowly moves it, making broad sweeping movements so that the whole interior of the womb is under control. The length of the treatment is 10-15 minutes, and some kind of anesthesia must be present.

Whom is Microwave Ablation For?

Microwave endometrial ablation (MEA) is for women who have

. excessive uterine bleeding (menorrhagia), and who

. do not want to have any more children and

. in cases in which it is certain that menorrhagia is not due to some cancerous condition.

Whom Microwave Ablation is Not For?

Microwave ablation may not be used on a patient that

. has undergone any previous endometrial ablation procedure,

. has had the MEA applicator re-inserted following treatment or partial treatment,

. is pregnant,

. wants to become pregnant in the future,

. has had a classical cesarean section childbirth,

. transmural myomectomy or any other anatomic or pathologic condition in which weakness of the myometrium could exist, .has an intrauterine device (IUD) currently in place,

. has Essure contraceptive micro-inserts,

. has undiagnosed vaginal bleeding,

. has a myometrial thickness of less than 10 mm in any area of the uterus,

. has a uterine sounding length less than 6 cm,

. has uterine perforation or wall damage observed or suspected during pre-procedure examination,

. has pre-malignant conditions of the endometrium, such as

. unresolved (atypical) adenomatous hyperplasia (non-cancerous excessive tissue growth),

. has a known or suspected endometrial carcinoma (uterine cancer)

. has undergone mechanical endometrial thinning such as dilation and curettage (D&C) or suction aspiration,

. has an active genital or urinary tract infection at the time of the procedure, or

. has active pelvic inflammatory disease (PID).

Precautions for the Operator

There have been a small number of recorded cases of serious injuries induced by the microwave ablation procedure. Typically, the applicator would burn through the uterus and the intestines, which then lead to further surgeries to repair the damages. In order to minimize the risks, the operator should be obliged to

. ensure that the uterine wall is thick enough for the procedure to work (this means an ultrasound evaluation before the procedure),

. use hysteroscopy (visual inspection) of the inside of the uterus just before the operation,

. train more for the entire procedure, and

. conduct at least three MEA procedures under supervision before being allowed to operate on their own.

If your doctor wants a microwave ablation for you, please ensure that the above rules and procedures are being held in regard.

The Outcome of the Microwave Ablation

In preliminary tests, the success rate of stopping menorrhagia was 87%. This means that menstrual bleeding was reduced to normal levels. For 55% of women in the study, the bleeding was totally stopped.

These results are comparable to other methods of endometrial ablation. For the largest part of participants, all went well; for a small part of patients, the after procedure period was problematic, while for 10-15% of patients, it all ended with this or that type of hysterectomy anyway.

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 main endometrial ablation page.

Normal loss of blood during the period is around 25 ml, and anything above 80 ml is too large. Besides anemia and the problems it can bring you, losing so much blood may make your life unbearable. Many women describe this not as having a period but as downright hemorrhaging. It is difficult to live when you cannot sleep, cannot move because of blood, cannot go to work for several days or even for a whole week. It is exactly in this situation when you say “I can’t live like this anymore, doctor, do anything, just save me now!” Next thing you know, you’re discussing all kinds of surgery, all up to hysterectomy. If you’re lucky, and fall into one of the groups of patients described below, you can settle for “smaller” surgery such as endometrial ablation.
Laser ablation is a good alternative to other types of ablation of the uterus. Laser stands short for Light Amplification by Stimulated Emission of Radiation. It has been discovered in the middle of the twentieth century and has quickly found its way to the various fields of medicine.

Lasers produce a hot, precisely focused beam of light, which can remove or vaporize tissue and control bleeding. They are so focused that are somethimes called the “scalpels of light”. They can cut and destroy tissues, shrink tumours or lesions, and seal (cauterize) blood vessels to prevent excessive bleeding.

Applications of Lasers In Medicine

One of the first applications of lasers in medicine was in

Types of Lasers

There are three types of lasers used today in gynecology:

Lasers in Gynecology

In gynecology, lasers are most frequently used for

Laser Ablation in Gynecology

One of the well-known methods for endometrial ablation now is laser ablation. It was first performed by Dr. Goldrath in 1979 using a Nd:YAG laser.

Often the patient will have both the myoma and heavy bleeding, and both can be treated with this laser. The Nd:YAG laser will better serve the surgeon for fibroids, however, it can be used for ablation as well in spite of its small field of focus. It would take an hour to ablate a small uterus with this type of laser, and can come very expensive in hospital costs. The results of laser ablation are comparable to those of other devices, say roller electrode.

Whether through laser ablation or through roller-ball ablation, the 95% of patients can control their bleeding and the uterine size is reduced to 50%. The final effect, the state of amenorrhea, will depend both on the technique used and on the size of uterus. 60% of women with preoperative uterine cavity less than 7 cm and only 30% of women with uterine cavity less than 10 to 15 cm reach the goal, i.e. enter the state of amenorrhea.

All in all, the Nd:YAG and bipolar needles for fibroids result in the same-day surgery, avoidance of hysterectomy, and elimination of bleeding.

Just as with any other surgical procedure, you should first ask why the physician chose that method for you and what are his or hers experiences with the procedure, the rate of failure or success etc. Be an informed patient and stick to your views until the doctor wins you over.

Problems with Laser Ablation

The person guiding the laser must be thoroughly trained for the procedure. Even if the procedure is done in the doctor’s office, the precautions taken must be the same as for an inpatient procedure. All the personnel should be trained and all the necessary equipment should be near and ready.

One wrong move and the laser will cut anything it touches. In the first years of using lasers in gynecology, there were two deaths from gas embolism. Both occured when the laser was activated while in contact with endometrial tissue. A gaseous embolism occured, and in those two cases, that led to death through irreversible cardiac arrest. Thefore, oxygen and other drugs must be at hand if the need arises for cardiopulmonary resuscitation (CPR). An emergency transportation to a hospital or a similar acute care unit must be provided whenever laser surgery is performed in a non-hospital setting.

What Can Happen After Laser Ablation

Laser or non-laser, the general rules still apply. You can leave the hospital or office when your vital signs have stabilized. If you were sedated, you should not leave until you know who you are and where you are. You should leave home accompanied by a responsible adult; it is best not to drive while going home.

There will be pain so you will probably get some analgesic drugs (pain relievers). Other possible risks are:

hemorrhaging,

the wound becoming infected, and

piercing — a perforation of an organ or tissue.

For other pre- and post-op procedures have a look at the general page for endometrial ablation on this site.

Hi

For a new blogger, this is certainly a strong start. The challenge, however, is to continue blogging, especially when you don’t feel like it.

Now, I’m a man and let me tell you that women much too often underestimate their hubbies. I certainly like what your hubby did, and I am sure many others would do the same if they were only called to the task. Fetching things for their wifes and kids is what males do best, you only have to ask!

As for the “female” troubles you’ve had, yes, they are very common. Something is seriously wrong with your endocrine glands, but if you talk to your gyno only, he’ll only consider what he knows best, and in this case, those would be the ovaries. The root of your problems is in the pituitary gland, treat that first, and the rest will fall in place, given time and the continuation of proper treatment. It is the pituitary body that commands your ovaries and the thyroid, not vice versa.

I haven’t read all of your blog, but I’m sure you have been considering alternative medicine treatments for your child. Why not consider the same for your gynecological health!? At least, do not fall for the hysterectomy hoax, endometrial ablation is very efficient in many cases (you can see a lot of information about it on my blog). Do try to think out of the box when your health is in danger!

Wishing you and your family all the best

Sincerely, Dusko
www.how-to-avoid-hysterectomy.com

She has three daughters (that is what those Three Weddings stand for, in case you haven’t guessed it already), and one of them has a Down syndrome, which, incidentally, is the main theme of her blog.

For a comprehensive line-up of endometrial ablation methods please have a look at our page called Can Endometrial Ablation Replace Hysterectomy in Cases of Heavy Menorrhagia? The video that we have present here is at

http://www2.marketwire.com/mw/frame_mw?attachid=574778

It is 46 minutes long and shows hydrothermal endometrial ablation performed as a live webcast, on September 27th 2007. Enjoy!

Question: I have had problems with an irregular cycle. I also have fibroids. My doctor has recommended a hysterectomy, but I am uncomfortable with such radical surgery. Do I have other options? I am 45 and otherwise in good health.

which is answered by Dr. Richard T. Bosshardt for Orlando Sentinel, under the title of
Weigh your options before you undergo hysterectomy. Here is my comment to the article:

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Hi

A nice article written from the doctor’s point of view. I’d also like to remind that there are other methods from alternative medicine that can help with fibroids and irregular bleeding.

With the advent of the Internet, women to which hysterectomy was suggested can ask other women through specialized forums and groups, and there are dozens of sites devoted to hysterectomy and its consequences. Here are suggestions for some of these:

www.youtube.com, search for hysterectomy, laparoscopy, myoma, myomectomy etc.
www.nohysterectomy.com, written by a leading gynecologist in the USA
www.how-to-avoid-hysterectomy.com — minimally invasive procedures such as endometrial ablation instead of hysterectomy, then homeopathy, Bach flower remedies, herbal remedies, Su Jok, Reiki, enzymes… are the methods of energy healing that can all help with the fibroids. The site also contains a collection of annotated videos from youTybe and Google Video.
www.hystersisters.com — a site for hysterectomy recovery, very large, contains a ton of info, but geared to those that have already had their hysterectomy, preferably a “happy” one.

There are other links of course, but these can be a useful start. You have the right to know what will happen to your body after such a major surgery so do your homework well.

All the best, Dusko

Low Libido in Women — What To Do About It?

So many women have low libido, a low drive to have sex with their partners. Almost half of the women actually fall into this category and some of the actually want to do something about it. This story, Pills Not Always the Cure for Women Suffering Low Libido, tells us about a case in which testosterone pills actually helped a woman regain her libido, and at the same time, it also states that the low male hormones are far from the only cure.

A typical situation in which sex drive is diminished is after the hysterectomy, you can read an article testosterone for women on this site about it.

Although, as as astrologer, I must add that the quality of your sex drive depends both on your Mars and Venus in the natal chart, as well as on the interplay of these two planets with your partner’s Mars and Venus. (Hint, hint: find a partner with any kind of crossed aspect with your Mars and Venus and you won’t even need artificial hormones!)

Treatments For Menorrhagia Evaluated, UK

Heavy menstrual bleeding (menorrhagia) is a common problem in women. About 5% of women asks their GP about that such bleeding. In previous decades, hysterectomy was the only way to resolve it, but in the meantime, new surgical techniques evolved. Professor Siladitya Bhattacharya of the University of Aberdeen will lead a team of researchers to review the existing evidence about hysterectomy, endometrial ablative techniques (microwave endometrial ablation and thermal balloon ablation), and the Mirena coil. The goal of the study is to establish long term effectiveness of all these methods, and then to create a set of guidelines for doctors to follow in clinical decision making. The estimated publishing time is mid 2010.

Here are the technical details of the proposed study.

New Hysterectomy Offers Faster Recovery

A sugar-coated story of how a woman had increasingly heavy periods and anemia, how her doctor persuaded her to take the uterus out and how she walked home the next day after the laparoscopic, or minimally-invasive, hysterectomy.

This story reads like an open advertisement for hysterectomy. Laparascopy is better than laparotomy, and yes, you do walk away from the hospital much faster as compared to the usual gynecological surgery. What the story does not tell is that from now on that woman will live without her main sex organ, and that can hurt in more ways that one.

Incidentally, in this hysterectomy news here is an animated video of laparoscopic hysterectomy. If you are interested in video presentations concerning hysterectomy, you can use a rich collection of annotated hysterectomy videos from the very site that you are reading now, How To Avoid Hysterectomy.com.

You can learn more about laparoscopy in hysterectomy, here.

Peggy Anderson Blog: September is
National Gynecological Awareness Month

I’ll just quote Peggy Anderson:

I know that I didn’t consider myself at risk. I was at 23 years of age, had cervical cancer, and had a hystertomy. At 33 years of age I had vaginal cancer due to bad cells left over from my surgery from that caused some major problems for me. Hemorrhaging problems that brought me to emergency wards, even though I had a hysterectomy. I had a procedure called cryosurgery or freezing of the cells. (Since I will turn 60 this next year, I don’t get embarrassed about “the little things in life.” Health is important in our society!)

I always say, “Every day is a gift.” This is especially so for many cancer patients, who cherish the rising of the sun, and the smell of a flower, a new taste, a new day, and a new event. We see the beauty in every day and every tomorrow.

Read her blog post about the conditions that can lead to various forms of gynecological cancers.

I’d like to do her natal chart and see why she had all these medical problems and also what enabled her to survive them all for decades.

Sex After Hysterectomy

Here is an ongoing discussion on the effects hysterectomy has on sex. I added a comment and here is what I have said (I’ll record it here, in case they don’t allow my comment on their blog):

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Hi to all here

Although my site is active for more than two years by now, I have only today stumbled upon this blog. The comments here show how painful everything about hysterectomy seems to be and what I find most disturbing is this sheep mentality that so many women succumb to. Oh, the doctor said it would be OK, so it must be OK, right? The thought that some real healing should be tried before the surgery is so alien to the Western World that the results really are sickening.

Every illness has its cause. Removing the cause will lead to true healing, but what do women do instead!? They go to a doctor and hope that they will be able to purchase a solution. Hysterectomy is so widespread in the USA because there is an implicit belief that doctors hold the keys to everything and vise versa, if they don’t know what to do, than all the means are exhausted. This enervates me because I know that there are at least 5, 6 or 7 ways to heal uterine fibroids, heavy menstrual bleeding, cancer and so on. In 20% of cases, hysterectomy will be the only way to proceed, but what about those 80% that can really avoid hysterectomy if only they knew it were possible.

Somebody in these comments said it was not possible to predict the outcome of a hysterectomy. Well, it is possible to predict it through the methods of medical astrology. On my site I list many such cases, and I openly give the recipes that helped several women stop their menstrual bleeding, avoid hystrectomy etc. And here we are not talking about $5000 cost of surgery, we are talking about cheap natural remedies such as herbal remedies, homeopathic remedies, enzymes and the like, that can all be gathered for a few bucks from Amazon.

The point is this: if you want to get healed, you will be — but somebody first has to tell you that you can be healed. Surgery is cutting out, not healing. The Moon rules both the uterus and the breasts, and when they take away the uterus, the energy goes to the breasts… which is why so many women on HRT after hysterectomy develop cancer of the breasts.

For the ladies here that experienced sex drive through the roof after hysterectomy, that kind of behavior is astrologically described as an aspect of Mars and Uranus. It may well be possible that such an aspect was made during the surgery, and that it may affect you harder that it normally would. Strong sexual drives may also come as a result of too much testosterone, so everybody with this type of behavior should control their hormonal mix from time to time.

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You can read about hysterectomy side effects from this very site. Also, here is what I wrote about sex after hysterectomy.

That’s it for this week, then!