Endometrial Ablation
What is Endometrial Ablation?
Endometrial ablation is a minimally invasive procedure to remove or destroy the endometrial lining of the uterus to treat heavy menstrual bleeding (menorrhagia) when medical treatments fail. It is not a contraceptive method and is typically recommended for women who do not wish to have future pregnancies. In India, endometrial ablation is performed in obstetrics and gynecology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, offering advanced care at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients in India to make informed decisions.
Why do you need Endometrial Ablation?
Endometrial ablation is indicated for:
- Heavy menstrual bleeding (menorrhagia):
- Persistent, excessive bleeding interfering with quality of life (e.g., soaking a pad/tampon in <1 hour, bleeding >7 days).
- Failed medical treatment: Hormonal therapy (e.g., oral contraceptives, progesterone) or non-hormonal options (e.g., tranexamic acid).
- Underlying causes (after evaluation):
- Endometrial hyperplasia (without atypia): Thickened lining causing bleeding.
- Dysfunctional uterine bleeding: Hormonal imbalance without structural issues.
- Small submucosal fibroids or polyps: If contributing to bleeding.
- Patient profile:
- Women who have completed childbearing (procedure reduces fertility).
- No desire for future pregnancies; sterilization or contraception advised post-procedure.
- Contraindications:
- Endometrial cancer or precancer (atypical hyperplasia).
- Active pelvic infection or pregnancy.
- Large fibroids (>3–4 cm) or significant uterine abnormalities (e.g., large adenomyosis).
The procedure aims to reduce or stop menstrual bleeding by destroying the endometrium, offering an alternative to hysterectomy for women with menorrhagia.
Why Do Endometrial Ablation Costs Vary in India?
Costs range from ₹50,000 to ₹1.5 lakh :
- Procedure Type: Thermal balloon or radiofrequency (₹50,000–₹1 lakh); with hysteroscopy (₹1–1.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹20,000–₹50,000).
- Surgeon’s Expertise: Experienced gynecologists charge more.
- Additional Costs: Hysteroscopy (₹10,000–₹30,000), ultrasound (₹2,000–₹5,000), hospital stay (if overnight, ₹5,000–₹15,000).
- Insurance: Covered for menorrhagia with failed medical treatment; confirm with your provider.
Endometrial Ablation Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Hysteroscopy: Visualizes the uterine cavity to rule out polyps, fibroids, or cancer.
- Endometrial biopsy: Confirms no cancer or atypical hyperplasia.
- Ultrasound (transvaginal): Assesses endometrial thickness, fibroids, or adenomyosis.
- Blood tests: Check hemoglobin (for anemia), thyroid function (to rule out hormonal causes), and clotting profile.
- Medications: Hormonal pre-treatment (e.g., GnRH agonists) to thin the endometrium (4–6 weeks prior); antibiotics (e.g., doxycycline) to prevent infection.
- Consent: Risks, including failure to stop bleeding, are explained.
- Diagnosis:
- Surgical Techniques:
- First-Generation Techniques:
- Rollerball Ablation:
- Performed under general or spinal anesthesia, lasting 20–30 minutes.
- Hysteroscopy guides the procedure; a rollerball electrode burns the endometrial lining.
- Transcervical Resection of Endometrium (TCRE):
- A resectoscope (with a wire loop) removes the endometrium; higher risk of complications.
- Rollerball Ablation:
- Second-Generation Techniques (More Common):
- Thermal Balloon Ablation (e.g., Thermachoice):
- A balloon catheter is inserted into the uterus, filled with fluid, and heated (e.g., 87°C for 8 minutes) to destroy the endometrium.
- Done under local anesthesia or sedation, lasting 10–15 minutes.
- Radiofrequency Ablation (e.g., NovaSure):
- A mesh device delivers radiofrequency energy to ablate the endometrium (1–2 minutes).
- Outpatient procedure under local anesthesia or sedation.
- Microwave Endometrial Ablation (MEA):
- Microwave energy heats and destroys the endometrium; less common in India.
- Cryoablation:
- Freezing probes destroy the endometrium; rare due to cost.
- Thermal Balloon Ablation (e.g., Thermachoice):
- Procedure Steps:
- The patient is in the lithotomy position (legs in stirrups).
- The cervix is dilated (if needed); the device is inserted into the uterus.
- The endometrium is ablated using the chosen method; no incisions are required.
- Hysteroscopy (optional): Confirms ablation completeness.
- Intraoperative Tools:
- Hysteroscopy: Visualizes the cavity pre- and post-ablation.
- Ultrasound: Guides device placement in complex cases.
- First-Generation Techniques:
- After Surgery:
- Observation: 1–2 hours (outpatient); 1-day stay if general anesthesia.
- Pain management: Analgesics (e.g., ibuprofen) for cramping (1–3 days).
- Discharge: Watery or bloody discharge for 2–4 weeks as the endometrium sloughs off.
- Instructions: Avoid intercourse, tampons, or douching for 2–4 weeks to allow healing.
Recovery After Endometrial Ablation
- Immediate Recovery: Same-day discharge (most cases); 1-day stay if general anesthesia.
- Post-Surgery Care:
- Pain: Mild cramping for 1–3 days, managed with analgesics.
- Bleeding: Watery, bloody discharge for 2–4 weeks; heavy bleeding is abnormal.
- Activity: Light activities the next day; avoid heavy lifting, intercourse, or tampons for 2–4 weeks.
- Hygiene: Showering allowed; avoid douching or tubs for 2–4 weeks.
- Monitoring: Watch for signs of infection (e.g., fever, foul-smelling discharge).
- Diet: Normal diet; 2–3 liters water daily; high-fiber foods (e.g., fruits) to prevent constipation.
- Follow-Up:
- Visit at 1–2 weeks to check recovery; 3–6 months to assess bleeding patterns.
- Hysteroscopy or ultrasound (if bleeding persists) to evaluate for incomplete ablation.
Most resume normal activities in 2–5 days; full recovery takes 2–4 weeks. Success rates: 70–90% experience reduced bleeding; 30–50% achieve amenorrhea (no periods). Results vary by technique and underlying condition (e.g., fibroids reduce success).
Risks and Complications
- Surgical Risks:
- Infection (1–2%): Endometritis or pelvic infection; treated with antibiotics.
- Bleeding (1–3%): Usually mild; <1% need transfusion or hysteroscopy.
- Uterine perforation (0.5–1%): Device punctures the uterus; may require laparoscopy.
- Procedure-Specific:
- Fluid overload (1–2%, rollerball/TCRE): From irrigation fluid; managed with diuretics.
- Thermal injury (<1%): To nearby organs (e.g., bowel, bladder); rare with second-generation techniques.
- Long-Term:
- Failure (10–30%): Persistent bleeding requiring repeat ablation or hysterectomy.
- Hematometra (1–2%): Blood trapped in the uterus due to scarring, causing pain.
- Pregnancy complications: 0.5–1% risk of pregnancy post-ablation; high risk of miscarriage or placenta accreta (contraception mandatory).
- Endometrial cancer detection: Scarring may mask future cancer (rare, <1%).
- Fertility: Not recommended for women desiring future pregnancies; significantly reduces fertility.
Report fever, severe pain, heavy bleeding, or foul-smelling discharge promptly.
Frequently Asked Questions (FAQs)
What causes heavy menstrual bleeding?
Hormonal imbalances, endometrial hyperplasia, fibroids, polyps, adenomyosis, or rarely, endometrial cancer.
Is endometrial ablation painful?
Not during the procedure (anesthesia used); mild cramping for 1–3 days post-surgery.
Can I avoid ablation?
Yes, 50–70% improve with medical treatment (e.g., hormonal therapy, tranexamic acid); ablation is for failed medical management.
How soon can I resume activities?
Light activities in 1–2 days; normal routines (including intercourse) after 2–4 weeks.
Is endometrial ablation covered by insurance in India?
Yes, for menorrhagia with failed medical treatment; confirm with your provider.
Signs of complications?
Fever, severe pain, heavy bleeding, or foul-smelling discharge.
Can I get pregnant after ablation?
Possible but not recommended; 0.5–1% risk of pregnancy, often abnormal (e.g., miscarriage, placenta accreta); contraception is essential.
Lifestyle changes post-procedure?
Avoid intercourse/tampons for 2–4 weeks, use contraception, attend follow-ups, and monitor bleeding patterns.
Conclusion
Endometrial ablation is an effective, minimally invasive option for managing heavy menstrual bleeding, offering significant relief for most women while avoiding hysterectomy. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable, expert care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach ablation confidently. Consult a gynecologist for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Endometrial Ablation
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
50,000 |
1,80,000 |
Ahmedabad |
80,000 |
2,50,000 |
Ajmer |
50,000 |
1,80,000 |
Aligarh |
50,000 |
1,80,000 |
Allahabad |
50,000 |
1,80,000 |
Amritsar |
60,000 |
2,00,000 |
Aurangabad |
60,000 |
2,00,000 |
Bangalore |
80,000 |
2,50,000 |
Bareilly |
50,000 |
1,80,000 |
Belgaum |
60,000 |
2,00,000 |
Bhopal |
60,000 |
2,00,000 |
Bhubaneswar |
60,000 |
2,00,000 |
Bikaner |
50,000 |
1,80,000 |
Chandigarh |
80,000 |
2,50,000 |
Chennai |
80,000 |
2,50,000 |
Coimbatore |
80,000 |
2,50,000 |
Dehradun |
60,000 |
2,00,000 |
Delhi |
80,000 |
2,50,000 |
Dhanbad |
50,000 |
1,80,000 |
Durgapur |
50,000 |
1,80,000 |
Faridabad |
80,000 |
2,50,000 |
Ghaziabad |
80,000 |
2,50,000 |
Gorakhpur |
50,000 |
1,80,000 |
Guntur |
60,000 |
2,00,000 |
Gurgaon |
80,000 |
2,50,000 |
Guwahati |
60,000 |
2,00,000 |
Gwalior |
50,000 |
1,80,000 |
Hyderabad |
80,000 |
2,50,000 |
Indore |
60,000 |
2,00,000 |
Jabalpur |
50,000 |
1,80,000 |
Jaipur |
80,000 |
2,50,000 |
Jalandhar |
60,000 |
2,00,000 |
Jamshedpur |
60,000 |
2,00,000 |
Jodhpur |
50,000 |
1,80,000 |
Kanpur |
50,000 |
1,80,000 |
Kochi |
80,000 |
2,50,000 |
Kolkata |
80,000 |
2,50,000 |
Kollam |
60,000 |
2,00,000 |
Lucknow |
60,000 |
2,00,000 |
Ludhiana |
80,000 |
2,50,000 |
Madurai |
60,000 |
2,00,000 |
Mangalore |
60,000 |
2,00,000 |
Meerut |
50,000 |
1,80,000 |
Moradabad |
50,000 |
1,80,000 |
Mumbai |
80,000 |
2,50,000 |
Mysore |
80,000 |
2,50,000 |
Nagpur |
60,000 |
2,00,000 |
Nashik |
60,000 |
2,00,000 |
Navi Mumbai |
80,000 |
2,50,000 |
Noida |
80,000 |
2,50,000 |
Patna |
50,000 |
1,80,000 |
Pune |
80,000 |
2,50,000 |
Raipur |
60,000 |
2,00,000 |
Rajkot |
60,000 |
2,00,000 |
Ranchi |
50,000 |
1,80,000 |
Surat |
80,000 |
2,50,000 |
Thane |
80,000 |
2,50,000 |
Vadodara |
60,000 |
2,00,000 |
Varanasi |
50,000 |
1,80,000 |
Visakhapatnam |
60,000 |
2,00,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.