post ablation tubal sterilization syndrome 2010 (updated 2013)

My first ablation was incredibly successful, for about four years, then the fibroids started growing again within the walls of the uterus, and my uterus became very enlarged. I had a second ablation, which I found painful and didn't seem to help at all. I am now scheduled for a hysterectomy, and am hoping for some relief. The first ablation was well worth the four years of lighter periods, it was the second one that was worthless.

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Originally Posted by Taylor42 My first ablation was incredibly successful, for about four years, then the fibroids started growing again within the walls of the uterus, and my uterus became very enlarged. I had a second ablation, which I found painful and didn't seem to help at all. I am now scheduled for a hysterectomy, and am hoping for some relief. The first ablation was well worth the four years of lighter periods, it was the second one that was worthless.

Can't believe the Dr would even do a second one with the contraindications of fibroids and an enlarged uterus!

My Nova Sure ablation was done January 2007, along with Essure coils. Up until October 2009 I would of told anyone who would listen how great it was, up until this point had not experienced anymore cramps or bleeding. Last October I experienced awful cramps for almost a week, still no bleeding. Thought it was a fluke until it happened again in December and then in February when I couldn't move for two days I finally went to the doctor. Since then I have been in and out of the doctor's office, ultra sounds, and then a hysteroscopy in May. That is when we found that the right Essure coils was in my uterus, which it was removed at that time. Shortly after this went for another HSG to make sure my right tube was still blocked. It was but this was another story in itself. Middle of June back to the doctor with pain on my left side. Which honestly I thought it was the left Essure coil giving an issue now since I had this pain since the hysteroscopy. End of August off again for a laporoscopy, and was suppose to also have left coil removed, and then a tubual was to be performed. Got the tubal, but still have the left coil, and discovered at this point that because my uterus is enlarged that I probably have adenomyosis. Even after going to my follow up for this the doctor said I should of gotten consent before surgery to do a hysterectomy if I found something. Even tho my husband was at the hospital and new my wishes that if it were to come up to just say take out what needs to go. However per my doctor it is my uterus not his so even if he did talk to him I would of still had to ok it not my husband. So here I sit waiting to for my appointment tomorrow to hopefully schedule my hysterectomy since I still have pain on my left side and was told it is not the Essure coil giving me the pain. After reading so much on here and anywhere I could find info on Adenomyosis, I should probably have never had the ablation and I certainly should of never had those blasted Essure Coils! I am lucky in a sense that I still do not have any bleeding (however I do expect that at anytime), but I have to say it feels like I have cramps 24/7. Hopefully it will soon be over and things will be better.

OMG this sounds like the pain I have had since last fall 2009. I had a tubal 15 years ago and the ablation june 2009. I don't really bleed anymore just spot. I have had excrutiating pain in my right side/groin area that goes to my right thigh. I have had colonoscopies, endoscopes, vaginal ultrasounds, cts scans on my abdomen, checked for kidney stones,I had my gallbladder out this august but it needed to come out was not working at all and I feel less bloated finally after I had a MRI on my back my gyno decided maybe my fibroids (that I had before the ablation) are causing my pain. Today I got my hysterectomy scheduled for 12/20. Finally!!!

What is a curious thing to me is this; if after an ablation, you continue to have bleeding, spotting of any kind, would this NOT suggest in a early way, that the ablation failed? From what I've learned through reading "many" reports on ablations, it sounds like an ablation is supposed to destroy "all" the endometrial lining. If this happens, you should not bleed at all. If this doesn't happen, (complete ablation) then this would most likely mean that there is still "active" endometrial lining which will cause bleeding.
Possibly at first, since the ablated lining is still in recovery, no symptoms/complications, exist. As scarring occurs over time from the healing process, and bleeding continues, this is when the blood becomes trapped and poses the complication factors. Either behind the scarred lining or (in prior tubal ligation patients ) into the fallopian tube. The scarring causes the blood to become trapped.
What else besides scarring, would cause the blood to become trapped?

If no bleeding is present until months or years post ablation then things that can cause bleeding to return are: uterine fibroids, adenomyosis, that were not diagnosed prior to the ablation, as
this is a sure contraindication to an ablation.
So even if all the lining was destroyed initially, but bleeding occurs from fibroids or something else, it most likely will still become trapped because "ALL" ablations cause scarring.

I am scheduled for a hysterectomy in a week.
On my surgery consult, I asked many questions.
One was, could the ablation device be defective in properly ablating the entire uterine lining? I said, so many seem to have problems in the upper right cornua region. He agree that he is seeing this, too. He said, absolutely, a defectively designed device may not be reaching this area.
(Seems too ironic for so many). He also said that in the past with the old abaltion devices, they were harder to use, so not as many Dr's performed ablations. The newer devices like Novasure and Thermachoice are easier to use, so the ablation frequency has increased. BUT, he said, the reason for doing an ablation and only doing ablations on IDEAL candidates, NEVER changed. From what I've read, ideal candidates are only those who have heavy menstrual bleeding due to dysfunctional ovulatory problems often seen in peri-menopausal women. Definately, not enough pre-testing is performed to rule out all the contraindications of ablation surgery.


Personally, I believe, if every women who has complications linked to an ablation, reports their story to the complaint dept at the FDA under "devices" maybe someone will investigate. Maybe only then, many of us will have an answer as to why?

Interesting! I am 50, and according to FSH levels, in menopause.

I had a tubal 18 years ago and an ablation done 10 years ago. For the first 5 years, I had spotting at period time. Then I started missing periods altogether, and for about the next 3 years, I would have maybe 3 periods a year. These periods were now light bleeding. In the last 2 years, I've had one to two periods per year, and they were normal flow. I had a period last January(pretty heavy and crampy) and in February I was told my FSH was way high and in menopause. They told me the same thing the year before!

I kind of wonder--the last couple of yearly checkups they did ultrasounds because I always have off/on pain in right sight related to an ever-present cyst. They also notice a slightly "thickened" lining and/or stripe, and then send me to a radiology clinic so a radiologist can read the ultrasound.

Now I wonder about endometrial cancer presenting in a new and unusual manner. How do they know without always doing a D & C if what is growing is normal?? I'm like one of the posters above, nothing should be regenerating. And if it is, how do they know how to evaluate it in this new uterine setting of scar tissue?

I am wondering, why does everyone get right-sided pain? I get it but always assumed it was from my cyst(but I'm in meno!!). Now I wonder if what y'all are having may be contributing to my right-sided, on and off pain.

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Originally Posted by sue1234 Interesting! I am 50, and according to FSH levels, in menopause. I had a tubal 18 years ago and an ablation done 10 years ago. For the first 5 years, I had spotting at period time. Then I started missing periods altogether, and for about the next 3 years, I would have maybe 3 periods a year. These periods were now light bleeding. In the last 2 years, I've had one to two periods per year, and they were normal flow. I had a period last January(pretty heavy and crampy) and in February I was told my FSH was way high and in menopause. They told me the same thing the year before! I kind of wonder--the last couple of yearly checkups they did ultrasounds because I always have off/on pain in right sight related to an ever-present cyst. They also notice a slightly "thickened" lining and/or stripe, and then send me to a radiology clinic so a radiologist can read the ultrasound. Now I wonder about endometrial cancer presenting in a new and unusual manner. How do they know without always doing a D & C if what is growing is normal?? I'm like one of the posters above, nothing should be regenerating. And if it is, how do they know how to evaluate it in this new uterine setting of scar tissue? I am wondering, why does everyone get right-sided pain? I get it but always assumed it was from my cyst(but I'm in meno!!). Now I wonder if what y'all are having may be contributing to my right-sided, on and off pain.

I was told I have cysts on both of my ovaries. Not likely to be causing the debilitating pain though. What are your findings on U/S? Mine were fluid/blood pockets in both my uterus and right fallopian tube.

It could be, since you are in menopause, your ovaries are still producing hormones, but sporadically, so the bleeding would not be in a regular pattern nor would the pain. I am not a DR so my guess might be the thickened area could be adenomyosis. Usually, menopause does help with the pain over time, because as the hormones decline, so will the bleeding. If it is adenomyosis, (usually only a MRI or biopsy on hysterectomy can provide a definate diagnosis) I understand this will resolve too, once you get through menopause.
If you have trapped blood behind scarred tissue, this would be painful, especially if it is getting trapped in the area where the tube and uterus are joined.

If I were you, I would ask for a vaginal ultrasound and tell them you suspect Post Ablation Tubal Sterilization Syndrome.
During the exam, ask them to pay specific attention to your right fallopian tube area. Best to have this done when you are cyclic or experiencing the pain. Tell them (show them) exactly where you have the pain so they pay special attention to this area.

If nothing shows up, then I would ask for further testing. At this point, I would not personally be comfortable with NOT having a hysterectomy, because I am not sure if a D&C would be able to detect pre-cancerous or cancerous conditions post abaltion??? Not saying that you have this, but for myself, even down the road, I would always wonder if the scarring might obscure something serious.

This is my opinion. Please talk with your doctor until you are comfortable with the conclusion to your individual case.

Hope this was helpful.

I am very blessed that the medical professionals I have worked with seem to understand this proceedure (ablation) and the effects. I normally have my anual exams done by the same midwife that delivered my children. This year I let her now that I have been having a lot of trouble with extremely heavy periods, to the point that it is difficult to work on the heaviest of days. She suggested I consider the ablation, and I set up a consult with a dr. that specialized in gyn care and surgery.

When I went in for the consultation, he took a lot of time and reviewed all of my symptoms, not just the heavy bleeding. He did a pelvic exam and a T/V ultrasound, and found that the Uterus was enlarged to the size of someone who is 12 weeks pregnant, and that there was quite a bit of scar tissue. I had a lot of pain during the T/V ultrasound, and at one point, it felt like I was being stabbed.

He told me that he suspected that I had Adenomyosis, and the ablation would not help. He recomended a hysterectomy, and said that he could do it laproscopically. I was adimant that I did not want the hyst. and went forward with scheduling the ablation. He gave me lots of info on both proceedures, and even let me know that the ablation would not cure the problem, just one symptom.

I called my midwifes office and spoke with the nurse to let them know what was going on, since my midwife gave me the referral. She said she was going to have my midwife call me, but she was gone for the weekend for a long weekend out of town, and would not be back in until the following Wednesday. On Monday, my midwife called me from her home, because she knew I was upset and having to make a big decision. She also told me that the ablation would only be a temporary solution, and recomended the hysterectomy. She also gave me a referral for a second opinion so I would have piece of mind.

I ultimately decided to have the hysterectomy, and am scheduled for Nov. 8th.

Good choice. Best of luck with your surgery!

Having my Robotic Assisted Laproscopic hysterectomy tomorrow. I will let you guys know how it all went and what the results of the PATSS showed post op. Talk to you soon....