Hysterectomy and Endometrial Ablation Compared

Hysterectomy and Endometrial Ablation Compared

Ablation has the advantage of speed of recovery. If patients are advised before admission for hysterectomy that early discharge home is likely, all domestic arrangements can be made. For those women who feel that they need surgical treatment for their heavy periods but who are reluctant to lose their uterus, the ablation techniques are attractive. Even with relatively short follow-up, it has become apparent that a significant number of patients undergoing ablation require further surgery. This means that the overall difference between hospital admission times between ablation and hysterectomy may be less than original estimates and this is also true when comparing economic differences.

The risks of surgical procedures in general, and hysterectomy in particular have been presented (surgery risks and 21). Complications can occur with ablation particularly if the uterus is inadvertently perforated (punctured).

In a randomised trial between hysterectomy and transcervical resection (ablation), the effect on health related quality of life at an average of 2.8 years after surgery was evaluated. Those women allocated to hysterectomy had better scores in seven out of eight parameters. The greatest difference was for pain. Twenty eight per cent of those allocated to endometrial resection required a second resection or hysterectomy.

Endometrial resection is less likely to be associated with urinary incontinence than hysterectomy.

Related Medical Abstracts - Click on the paper title:-

• Readmission to hospital 5 years after hysterectomy or endometrial resection in a national cohort study. (2005-01)
• Why do women choose endometrial ablation rather than hysterectomy? (1998)
• Hysterectomy following failed endometrial resection (1997)
• Randomised trial comparing hysterectomy with endometrial ablation for dysfunctional uterine bleeding:Psychiatric and psychosocial aspects (1996)
• Hysterectomy vs. resectoscopic endometrial ablation for the control of abnormal uterine bleeding: A cost-comparative study (1994)
• An economic evaluation of transcervical endometrial resection versus abdominal hysterectomy for the treatment of menorrhagia (1993)
• Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia (1993)

Please click on the required question.

• 1 Are heavy periods a common problem?
• 2 What is in my menstrual flow?
• 3 What range of menstrual cycle length is considered to be normal?
• 4 How can menstrual blood loss be measured?
• 5 How can I tell if my periods are abnormally heavy?
• 6 What could be the cause of my very heavy menstrual periods?
• 7 I have been sterilised. Could this be the cause of my heavy periods?
• 8 Should I have tests to find the reason for my heavy periods?
• 9 How will my heavy period problems be investigated?
• 10 What is meant by anaemia due to heavy periods?
• 11 What is intermenstrual bleeding?
• 12 What is a hysteroscopy and D and C?
• 13 What is cervical cautery?
• 14 What happens after the D and C?
• 15 What treatments are available for my heavy periods?
• 16 What are the medical treatments available for heavy periods?
• 17 How do the various medical treatments for heavy periods work?
• 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
• 19 What is a hysterectomy?
• 20 What are the indications for hysterectomy?
• 21 What are the risks (complications) of hysterectomy?
• 22 What is vault granulation?
• 23 What are the different types of hysterectomy?
• 24 Is it essential to remove the neck of the womb at hysterectomy?
• 25 Should my ovaries be removed or conserved during hysterectomy?
• 26 How long will I be in hospital when I have my hysterectomy?
• 27 I have had a hysterectomy. Do I still need to have smear tests?
• 28 What are the other surgical alternatives to hysterectomy?
• 29 How do endometrial ablation and hysterectomy compare?
• 30 Are there any psychological effects following hysterectomy?
• 31 How do we decide the best treatment for my period problems?
• 32 Could I have some recommended hysterectomy support groups?
• 33 Are there any support groups?
• Intermenstrual Bleeding - Bleeding between periods.

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

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