Uterine fibroids may be diagnosed by endometrial biopsy and treated with endometrial ablation. However, there are other ways to treat them in case they aren’t suited for you.
Endometrial biopsy procedures
As with any kind of surgical procedure, endometrial biopsies have some risks: bleeding, infections, and punctures (rarely).
You must inform the health care providers if you are pregnant. Having this procedure when you’re pregnant may cause you to have a miscarriage.
These conditions may interfere with the results of the biopsy:
- Pelvic inflammatory disease
- Acute infections of the vagina or cervix
- Cancer of the cervix
- Prolapsed uterus
The doctor will check your other medical conditions before approving the procedure.
The procedure involves inserting a suction catheter through the opening of the cervix and into the uterus. It is done to get samples of tissues from the uterus to learn more about what’s causing problems. Biopsies are usually done to study the endometrium as well as evaluate infertility, screen for cancer, and to find the cause of abnormal bleeding.
You may experience cramping during the procedure or after it. You may be prescribed with some painkillers for them.
Some women, especially those nearing or experiencing menopause, may have a tight cervical opening so the catheter may be hard to insert. For this, an osmotic dilator can be given a few hours before biopsy until the cervix widens sufficiently.
Endometrial Ablation
Endometrial ablation is a procedure that removes the interior lining of the uterus called the endometrium. It is done when there is heavy bleeding or other symptoms that may be caused by polyps or uterine fibroids.
It involves inserting a small tool into the vagina until it reaches the uterus. It can involve the following:
- Hydrothermal: fluid is pumped into the uterus and heated until the uterine lining becomes destroyed
- Balloon: a balloon filled with warm fluid expands into the uterus and breaks the lining apart
- Cryoablation: a cold tool is used to freeze the lining
- Microwave: a wand sends microwaves that damage the lining
- Radio waves: an electrical mesh emits high frequency waves into the uterus
- Electrical therapy: electricity is used to tear off the lining, but this is not frequently used
Endometrial ablation has the same risks as endometrial biopsies. If you have infections, a weak uterine wall, Caesarian section scars, endometrium/uterus problems, or an IUD, this procedure may not be done to you.
Inform them if you are sensitive to anything that will be used in the procedure, such as any kind of anesthesia, medication, or iodine (cleansing agent), or if you experience skin irritation because of the tape or latex. They can find ways to make the procedure more comfortable for you.
Alert your doctor if you are taking blood-thinning medicine or if you have a bleeding disorder. You may need to stop taking these for some time before the procedure to minimize your risk of bleeding excessively.
If you must be sedated, you need to have someone pick you up afterwards. It may be challenging to drive safely after sedation.
How to Choose a Procedure for Uterine fibroids
Your doctor will inform you of your options. He will consider your medical history and preferences. If you can’t choose what procedure to take, these are some things that will help you decide:
- Whether or not you want to have a pregnancy
- Whether you want to remove the fibroids permanently or not (permanent removal may require severe measures)
- The benefits and risks of medical and surgical treatments
Talk openly with your doctor so that you can find the best procedures for you.
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