Help Me!

I'm 50 years old, abnormal uterine bleeding. I had a D&C several years ago (polyps). I've been on low-dose birth control pills for the last 5 years and the polyps have probably grown back. I have hypertension, want to get off these pills because they are contributing to my hypertension. I also need contraception. I just saw the gyn, he offered me 2 options--D&C and stay on birth control pills, or hysterectomy. He doesn't do ablations because of the risk of endometrial ca. (I have no family hx of such, all paps normal). I want an ablation with a tubal ligation. What have your docs told you about ablation therapy?

Dear Runner: I had a uterine thermal ablasion in November of 2000 due to severe adenomyosis. In my case, it did not work, but my problems were more 'pain related' than 'bleeding issues'. There are a few different methods of uterine ablasion and you should research them all. I haven;t heard of any causal connection between uterine ablasions and cancer but I am not a doctor. Most doctors want to try a more conservative approach to treatment before considering a hysterectomy. Please get a second opinion. Let me know how you make out.....

All the best,
Rita

I also had a thermal balloon ablation, and don't remember hearing anything about a connection to endometrial cancer. I agree with Rita and would most definitely get a second opinion. Many women do get long-term relief from ablations. If you can avoid having major surgery (hysterectomy), I think it's a good thing to consider. Just my opinion.

My very best to you...

I tried to have an ablation w/tubal, but fibroids were in the way, so I ended up with a D&C w/tubal, hysterscopy, and partial myomectomy instead. 6 weeks later I went back for a hyst.

Ablations do help in many cases though. I had to call about 6 gyns before I found one who did them at all. You might just need to keep looking, if that's what you really want.

Here's a great site (a lot like this one, but smaller) for ablations:
http://home.att.net/~endometrial_ablation/index.html
Tons of good info and helpful ladies there.

You have the advantage of time - so you can look into all your options thoroughly before picking one. Best of luck with your decision.

I had a D&C/hysteroscopy/laproscopic removal of adhesions & tubal 5 years ago. This past Nov., when my dr told me I needed a hyst, he said a couple of other options were to try controlling my problems with 1. hormones, but can't take because they cause horrible migraines for me AND from his experience they only work temporarily for the adenomyosis he saw evidence of and 2. an ablation, but again, he's only known this to be a temporary fix. I did lots of research on the net after this and from what I found, everything he said was also said on the internet. I didn't want to face having to go through another surgery later on, so with all this in mind and with the recurring dysplasia, I decieded to go through with the hyst and am very happy I did.

Thanks ladies,
I called my PCP and we're looking for a 2nd opinion. I'm seen at the University of California Medical Center so I have lots of confidence in the them. The reason that gyn doesn't do ablations is because the procedure can't get rid of all the endometrium and once it scars over there is no way to detect cancer. Endometrial ca is treatable if it's localized but can be deadly if it spreads. Unfortunatley, he couldn't give me the stats on endometrial ca.
I'l keep you posted.

I had a Thermal Ablasion last tuesday. I am 24 years old, so my doctor was hesitant to do the hysterectomy. My problem was unexplained heavy bleeding (no polyps, no endo, no reason at all!), and my iron was so low i was passing out frequently. I am still waiting to see what the results will be because the end result is no more periods, or very light periods. The doctor I went to said that she has had tremendous results with the thermal ablasion. many of her patients never have bleeding again at all. She also said there is no need for a tubal along with this procedure because once you burn away the lining of your uterus, there is no possible way you could carry a baby, and a tubal would increase your risk of a tubal pregnancy.
I also only missed 3 days of work, a definite plus compared to a hyst. where you would be out for weeks!! ( i also had a right oopherectomy last january, and i had the incision that they would do for a hyst. i was out of commission for 8 weeks recovering from having an ovary removed due to a 4 inch hemmoraghic cyst. I think the thermal ablasion is a good procedure, not very painful, and much better than a hysterectomy. i will not know for another 2 weeks if it worked for sure, and if it doesn't work, then i will consider a hyst.

My very best friend had an ablation about 8 years ago for uncontrolled bleeding. It worked swell. Not sure why you need the birth control after an ablation. Even now, you are having periods but most likely are not ovulating. ( Not that I would take that risk!)

Let us know what you learn and decide to do. I'm almost 54 and have made it this far without the surgery. Good luck!

You need birth control (or a tubal, in my case) because it is *possible* to get pregnant after an ablation, but can be life-threatening, since the fetus attaches to the uterus, not the lining, I believe. And if you didn't have periods, you might not even know that you *were* pregnant.

You do still ovulate, because the ablation does not touch the ovaries. Your period is the shedding of the lining of your uterus. your ovary releases the egg on the same schedule as before, but there is no lining to shed. you may still have light periods after an ablation, because of the regenerative capabilities of the endometrium, but it will decrease bleeding if nothing else. you may also have cramping, because the release of the eggs will spur your uterus into action (contracting to shed the lining). so according to what i read, if you have heavy cramps or are close to menopause, then a hysterectomy is a better option for you. I am nearing 2 weeks post ablation, and I am feeling great. some of the side effects are cramping, bleeding, watery discharge that can all last up to 4 weeks. mine has pretty much stopped. we had a christmas party friday night, and I was in the mood to dance all night long. and since I am not bleeding heavily anymore, and I am taking my iron and vitamins, i have so much more energy! I am glad my doctor suggested this, and there are a lot of informative articles on the internet about ablation. just go to Google.com and type in "uterine thermal ablation". Good luck to all of you.