AUSTIN, Texas, Aug. 21, 2018 /PRNewswire-PRWeb/ -- Uterine ablations are minimally invasive procedures that destroy the
"Researchers have determined that the beneficial effects of this procedure -- endometrial ablation (or EA) can be sustained for years afterwards," says Austin Texas-based obstetrician-gynecologist with River Place OB/GYN, John Thoppil, MD, commenting on this medical report.
However, he cautions that not every woman with heavy periods is a candidate for EA -- even if other first-option treatments, including medications and intrauterine devices, fail to correct the bleeding problem -- and that undergoing the procedure is no guarantee for preventing a hysterectomy in the future.
More than 500,000 endometrial ablations are performed in the United States annually, says Dr. Thoppil. The procedure, which often can be done in a doctor's office, involves insertion of a thin instrument into the uterus by passing it through the vagina and cervix. Using this tool, the physician can apply various types of energy – radiofrequency, microwaves, hot fluids, heat or extreme cold – to ablate the uterine lining (endometrium), thereby lessening the amount of blood lost during menstruation.
"Menorrhagia, or heavy menstrual blood flow, is a serious, but treatable medical problem, affecting quality of life for thousands of women. Unfortunately, more than half of those who suffer from it never see a physician. Many of them presume the condition is just part of the normal course of aging," states Dr. Thoppil.
Among pre-menopausal women who do visit a gynecologist, 20 percent to 30 percent seek help for menstrual bleeding, adds Dr. Thoppil.
"Abnormally heavy periods, those lasting more than seven or eight days, are a frequent reason why women miss work and social events" Dr. Thoppil indicates. "If left untreated, the blood loss can lead to anemia,"
Not all women are good candidates for this technique. She must generally have a normal size uterine cavity without signs of pre-cancer (hyperplasia) or cancer, Dr. Thoppil says.
"The procedure also should not be performed on women who are past menopause or on patients of child-bearing age who may still want to become pregnant," he says. While EA is not a sterilization process it can make pregnancy difficult – and dangerous, greatly increasing a woman's risk for complications like miscarriage and ectopic (tubal) pregnancies.
Meanwhile, in a 2017 discussion published in Case Reports in Women's Health, experts say that about 25 percent of women who undergo endometrial ablation require a hysterectomy within five years following the procedure but indicate this failure rate could be reduced with improved patient selection.
Dr. Thoppil concurs. "EA is not new, however, there remains a surprising lack of comparative, clinical data about the long-term effectiveness of the various EA techniques and tools," he says. "For that reason, physicians must take special care to understand each patient's specific needs and condition, conduct a thorough examination, select the most appropriate device for performing the procedure, and develop the necessary protocols for close monitoring of patients following ablation," he adds.
Dr. Thoppil emphasizes that EA is extremely effective in well selected patients, with roughly 90% patient satisfaction. In fact, 50% of patients don't have menses at all.
"If all else fails, contact your gynecologist for a thorough examination to ensure the heavy bleeding is not due to more serious disorders. The doctor may initially prescribe progesterone tablets, oral contraceptives or insertion of a hormonal intrauterine device. If done with child bearing an ablation may be the best choice," Dr. Thoppil says.
John Thoppil, MD, leads River Place Obstetrics and Gynecology, based in Austin, Texas. A board-certified obstetrician-gynecologist and a Fellow of the American College of Obstetricians and Gynecologists, Dr. Thoppil also is an assistant professor at Texas A&M University College of Medicine. He earned his MD at Baylor College of Medicine and completed residency training at Wilford Hall Medical Center, Lackland Air Force Base. http://www.riverplaceobg.com
SOURCE River Place Obstetrics and Gynecology
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