Endometrial Ablation

We strongly recommend you read the patient information sheet below.

RANZCOG Endometrial Ablation Patient Information -  RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) is the college responsible for training and accreditation of gynaecologists in Aotearoa; they have released this information pack about endometrial ablation, which includes an outline of what the procedure involves, the risks and information about what to expect after the procedure.

Novasure - The device we usually use for endometrial ablation is Novasure (produced by Hologic). The attached pamphlet is the information provided by the pharmaceutical company about the device.

An endometrial ablation is generally considered a safe and very low risk procedure. With any surgery there are some risks involved, and it is important that you are aware of these risks before agreeing to the procedure. The risks involved are:

• Bleeding (risk of major bleeding <1/100) - we will routinely ask whether you consent a blood transfusion, even though this is extremely unlikely, we need to know whether you consent to this before you have an anaesthetic or sedation

• Infection inside the uterus after the procedure (<1/100) - this is usually mild and can cause an odorous discharge, ongoing bleeding, pain or fevers. The important things to look out for will be explained to you and given to you in writing

• Perforation of the uterus (where the instrument passes through the wall of the uterus into the abdomen <1/1000 before menopause, and <1/100 after menopause) - if this happens there is a small risk of injury to other organs inside the abdomen, which is rare but serious and could lead to further surgery. The Novasure device has automatic checks for this, and will not allow the procedure to be performed if it suspects there is a perforation, as this would risk injury to the surrounding organs.

• Pregnancy is not advised after endometrial ablation; it may not be possible to fall pregnant after the procedure; but there are significant risks associated if you do fall pregnant. It is recommended that reliable contraception is used after the procedure.

• The success rates are listed below, these vary depending on different studies. There is an approximately 10-20% chance of not being satisfied with the outcome of the procedure, in which case further treatments can be offered (for example hysterectomy, or medications). The endometrium can slowly regenerate over time, and therefore the effect can wear off after 5 or more years.

• A meta analysis (summary of all the available studies to date) from 2022 (available here) suggested that:

  •  83-93% of women have an improvement in bleeding after an endometrial ablation

  • 59-63% of women have no bleeding after endometrial ablation

  • 79-86% of women were satisfied with the results of endometrial ablation

• The Novasure manufacturers cite that 94% of women were satisfied with the results after ablation with Novasure