E F Nigel Holland
Consultant Gynaecologist and Obstetrician
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What is endometrial ablation?

Endometrial ablation is the destruction of the womb lining in order to treat heavy periods. There are a number of ways of doing this. Novasure is a quick, safe method which can potentially be done without a general anaesthetic.

What is NOVASURE?

NOVASURE is a system designed to treat heavy periods. In many cases it can be considered instead of a hysterectomy (surgical removal of the womb).

NOVASURE is an endometrial ablation device that uses electrical energy. It requires no incisions and can be safely performed in an outpatient clinic, if the patient is suitable.

How does it work?

Periods are due to shedding of the womb lining each month. Blood vessels underneath the womb lining may remain open and cause the bleeding to be excessive. The aim of NOVASURE is to permanently remove the womb lining and seal the underlying blood vessels, therefore making periods lighter.

How is it done?

Novasure can be done under a general anaesthetic as a day case procedure, or with a local anaesthetic in the clinic. The NOVASURE system is a narrow instrument that is passed into the womb through the cervix (neck of the womb). Once inside it opens a mesh to fit against the lining of the womb (the endometrium). This delivers a heat source that destroys the endometrium. The whole device (including the mesh) is removed at the end of the procedure.

The whole procedure takes around 5 minutes to perform although the actual treatment takes on average only 90 seconds.

What are the advantages of NOVASURE?

The main advantage is that NOVASURE works well for many women with heavy periods, Studies have shown mat up to 97% of women receiving this treatment were satisfied or very satisfied with the procedure and would recommend it to others, (1) Over 80% felt it was a success with periods being much lighter. (2,3) 40-75% of women in studies had no periods at all after treatment. (1,4, 5). It therefore has a small failure rate. However it is much less invasive than other surgical treatments.

NOVASURE avoids the need to take medications long term and does not require any treatment beforehand to thin out the womb lining. It may also avoid the need for a hysterectomy in over 90% of women.

If you request, it can be done while you are awake. Pre-medication with a light sedative and a painkiller and anti-sickness tablet are given one hour before. Local anaesthetic is injected into the neck of the womb (like the dentist but a different area).There is no need for a general anaesthetic and so recovery following the procedure is much quicker.

The NOVASURE system includes a number of safety features that reduce the risk of injury to the womb and other organs.

What are the disadvantages?

You may experience period-like cramps during and after the procedure. You will be offered painkillers to help with this.

You are likely to have a watery and/or bloodstained vaginal discharge for 4-5 weeks after the procedure.

There is a small risk of infection which may cause pain or bleeding in the weeks following the procedure This may require treatment with antibiotics.

Damage to the womb and/or bleeding that cannot be stopped occurs rarely but may necessitate a hysterectomy.

What happens after the procedure?

You will be advised to remain in the hospital for a couple of hours to make sure you are not feeling nauseous or otherwise unwell. You will then be allowed home with mild painkillers.

Most women will return to normal activities within a day or two. You can resume sexual intercourse within around 7-10 days.

You will be followed up in the clinic to assess your response to the treatment. You may find it useful to keep a diary of any periods or other bleeding to report to your doctor at this appointment.

Is NOVASURE right for me?

If you have heavy periods then this may be a suitable treatment for you. It is important that the appropriate investigations such as hysteroscopy and biopsy (see leaflet) have been performed to ensure there is no other abnormality and the diagnosis of ‘dysfunctional bleeding confirmed’.

If your periods are also painful then this procedure may still be helpful but a small number of women will find that their pain continues after the procedure even though their periods are lighter. These women may require a hysterectomy at a later date.

Some women with lots of fibroids may not be suitable for this procedure. If you have had a classical (up and down incision) caesarean section or a myomectomy (removal of fibroids operation) then it is not suitable for you.

You must be certain you have completed your family. Although it is still possible to get pregnant after this procedure such pregnancies are likely to miscarry. We recommend that you continue effective contraception.

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