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endometrial ablation endometrial ablation

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  #1  
Unread 10-08-2003, 12:43 PM
endometrial ablation

Hi everyone,

I am scheduled to have an endometrial ablation in November of 2003. I have two very small fibroids but they are very painful and I also have very heavy bleeding and irregular cycle each month. Because I am 44 years old and have three children, I've had a tubuligation. I spoke with my gyn about a partial hysterectomy because of the fibroids, heavy bleeding and history of cervical and uterine cancer in my family. Her suggestion was the endometrial ablation because she felt that it was not necessary for major surgery. I feel that the surgery i am schedule for would only solve some not all of my problems. I would like a little feedback if possible.

Thanks!
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  #2  
Unread 10-08-2003, 03:22 PM
endometrial ablation



At age 38 I had endometrial ablation done because I had some fibroids which were causing painful periods and heavy bleeding. The ablation removed the lining of the uterus and most of the fibroids but the fibroids had already grown deep into the wall of my uterus so I knew there was a good chance I may have to have a hysterectomy someday. After the ablation I had no pain or bleeding for over a year but gradually the bleeding and pain did come back. I had my hysterectomy (LAVH) about 20 months ago at age 41 - my uterus and cervix were removed, I kept both ovaries.

If your fibroids are into the wall of the uterus there is a possibility they could come back.

Here is a link you may find helpful:

http://www.fda.gov/fdac/features/2001/601_tech.html

Take care!

s
  #3  
Unread 10-08-2003, 05:58 PM
endometrial ablation

I had an ablation in January of this year, and it was definitely worth it. I had been having very heavy bleeding during my periods, as well as heavy cramping, and now I have almost no bleeding and no cramps as well. Even if it isn't permanent, I will be glad I tried this first. It gave me back a normal life - and it was a relatively easy procedure to have. So far it is working well, although my fibroids are big and may eventually cause more problems.

Good luck,
Debbie
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  #4  
Unread 10-10-2003, 12:39 AM
endometrial ablation

You've gotten some great advice, but I wanted to raise a possibility with you that you may not have considered.

Adenomyosis is when endometrial tissue grows into and infiltrates the muscular wall of the uterus. It can cause all the symptoms you describe, and it is far more common in those of us who've had tubal ligations.

It's tricky to diagnose, but one thing that would cinch it for you: if the ablation doesn't work, it's a significant clue that what you're dealing with is more likely to be adeno than those two small fibroids. Then the hyst is the only option.

If it is the fibroids that are causing the problem, rather than hyperplasia, have you asked about other options, such as embolization, etc.? Each "alternative" procedure has its niche in the whole picture of things; ablation seems to work the best with small fibroids and hyperplasia; embolization works with larger fibroids. Each of them may be a permanent solution; some may at least buy you the time you need to explore what to do for your next step.

Have they done hysteroscopy, to directly visualize and perhaps biopsy the fibroids? That might go a long way toward easing your concerns about the family cancer history.

This is the sort of scenario where a second opinion is quite helpful. It's often useful to get another perspective when discussing the options; many GYNs will urge the procedures they're the most familiar with, but that's not always the right thing for your particular set of circumstances. And often, more diagnostic procedures other than an ultrasound are useful to really pin down what is causing the trouble...or whether it's a combination of a number of different factors.

Ask your doctor to keep an eye on your blood counts; if you're getting anemic, that can change your decision making process!

Hope you get some of the answers you need! A second opinion -- or maybe more -- can give you the feedback to make a truly informed decision.

Audrey
  #5  
Unread 10-10-2003, 01:14 AM
endometrial ablation

I would just like to say that Audrey has given you some excellent advice. I didn't have the ablation my Dr. suggested I try first before my hysterectomy and I am So glad I didn't. It turns out that along with fibroids I had a major case of adeno going on. Unfortunately, the ablation would have done absolutely nothing for me. My dr., bless her heart, was big enough to admit that she was thankful I had decided to have a hysterectomy instead. The ablation procedure may have actually made my condition worse! My dr. would have done a hysterscopy prior to my ablation which, one would hope, would have revealed the adeno. I don't know if it is common practice for dr.'s to automatically do this or not, but I would certainly ask about it. There is no sense in going through a procedure that may not bring you any relief, or perhaps make it worse......I have also heard that some dr.'s are able to find adeno with a MRI. Has anyone else heard this? Also, after my hysterectomy, my dr. told me that the only treatment for adeno is a hysterectomy. Whew, that made me feel better about my decision. It's a tough one. Audrey is right, a second opinion is often a great peace of mind.
  #6  
Unread 10-10-2003, 08:48 AM
endometrial ablation

I was initially diagnosed with three fibroids during my first vaginal sonogram. At that time it was recommended that I have a Thermachoice Uterine Balloon therapy ablation. At that point it seemed like the right choice. However, since that day, I had another Saline Infused Sonogram to get a better picture of what was actually going on and it was then updated to only ONE Fibroid and ONE Polyp. The Fibroid is growing within my uterine wall and can not be totally removed. She said she could only remove a portion but not all of it since it was too deep in the uterine wall. I asked my doctor about getting a tubal ligation at the same time to insure no pregnancy. My insurance wont cover the tubal ligation so we discussed further options. My insistance is that #1- I DONT want to return later at any time to go thru this again so I dont want any chance of recurance. #2- I dont want children and want a permenant birth control. So it was suggested that I get an LSH- Laparascopic Supracervical Hysterectomy. It was a great solution to >DEFINITIVELY< solve my problems......NO more fibroids or polyps, NO chance of pregnancy. It also has a faster recuperation time, I keep my cervix, tubes, and ovaries.

Ive read alot of stories here and Im really happy that Im an excellent candidate for this procedure as it seems to take less time to heal afterwards...only three small 1/2 inch incisions....and I retain my cervix, tubes, and ovaries. Also.....NO MORE PERIODS!!! They cauterize the internal incisions and cervix...no stitches internally and no periods. Im so glad Im not getting the ablation just to worry about when it may return to haunt me again and subject me another procedure of some sort.

I cant wait for this to take place!!!! Today Im starting hopefully what will be my last 12 day nightmare period of heavy flooding, clotting, and debilitating cramps. I dont want to ever have to buy any more tampons or pads!! ::::crossing fingers::::

GOOD LUCK with your decisions!! Get a second opinion and make sure they know what you want out of any procedure they perform. Make sure you let them know if youre willing to take a chance on recurance or if you in no way want to be back again to redo anything. Your age may help determine whats best as they say fibroids shrink during menopause do to lack of estrogen. If they will pose less risk of returning versus if youre years away from menopause.

Also...make sure the doctors are proficient in ALL procedures and not biased to certain ones simply because its what theyre most familiar with. I read alot of these posts and think that some doctors stick with what they know best instead of advancing to less invasive newer methods. It would be a shame to suffer with larger than necessary incisions or healing times for less complicated issues.

GOOD LUCK!!!! =)
  #7  
Unread 10-11-2003, 09:27 AM
ablation

I had an abalation in June and really felt much better for several months, and then the bleeding started again. I am now about 3 weeks post-op from a TAH/BSO. My dr also explained to me that insurance sometimes requires us to work through this in steps. You might want to keep that in mind. My dr. had taken care of the pre-certification for the TAH, but when I got home from the hospital there was a letter from them that said they had denied the coverage for the procedure, because I hadn't exhausted all of options yet. At that point the pathology report had come back, which indicated this was absolutely necessary.
You may want to keep insurance in mind as well.
Kathy
  #8  
Unread 10-11-2003, 09:58 AM
endometrial ablation

Yes youre right about the "steps" insurance companies require. My doc mentioned during my visits that I had exhausted my steps unkowingly already before I even showed up in her office by using the Depo Provera, trying another BC method to regulate bleeding (which didnt work), getting a second opinion with her, several paps within 3 months, the sonogram, the SALINE infused sonogram, and the fact the initial ablation procedure would not definitively solve my problems, the tubal ligation I requested for birth control was not covered which left me with the LSH procedure.

Its funny how insurance companies work.....they want you to start with less effective procedures to save costs but by the time youre healed youve cost them way more sometimes from more than one procedure.
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