A normal menstrual cycle is 25–35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 ml. A blood loss of greater than 80 ml or lasting longer than 7 days constitutes menorrhagia (also called hypermenorrhea). Transvaginal endometrial ablation is minimally invasive, very effective (almost 85%3) and it has a very low complication rate. It is performed under conscious sedation. The procedure is monitored in an ultrasound device. The electrode with a thickness of 5 mm is directed towards the fundus through the vaginal route. The surgeon may choose between the full ablation or partial ablation according to the patient’s needs. This technique offers an advanced temperature control which increases the safety and the effectiveness. The procedure is completed in as little as 5 minutes. The risk of procedure related side effects is minimal.
Blood loss of more than 80 ml per menstrual cycle or lasting longer than 7 days is called menorrhagia. Menorrhagia can reduce the patient’s quality of life physically, mentally and emotionally and can lead to various health problems. Endometrial ablation is one of the most effective treatment methods for women with very painful and heavy bleeding periods. In this method, the inner layer of the uterus is destroyed by burning. After this method, which is applied as an alternative to hysterectomy in women who do not want to have children but have excessive bleeding problems, the patient’s uterus is preserved and the need for surgery is eliminated.
- Hormone imbalance
- Polystic ovary syndrome
- Dysfunction of the ovaries
- Hereditary disorder
- Severe pain – painful menstrual cramps
- Decreased body performance
- Difficulty participating in social life
- Symptoms of pessimism and depression
- Oral medicines
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Tranexamic acid
- Birth control medicines
- Intrauterine devices
- Operation (hysterectomy)
- Endometrial ablation systems
Hormone-containing devices that can be inserted into the uterus (IUD)
- IUD brands that contain hormones are: Liletta and Skyla (works up to 3 years) and Mirena (works up to 5 years)
- After this type of IUD is placed in the uterus, a small amount of the progestin hormone called levonorgestrel is slowly released. They are mainly used for birth control, but can also reduce menstrual bleeding and pain.
IUDs containing hormones can cause side effects similar to birth control pills:
- Chest pain and/or tenderness
- Mood changes
- Weight gain
Operation – Hysterectomy
Hysterectomy is the surgical removal of the uterus. There are several types of hysterectomy, depending on what is removed:
- Kısmi histerektomide uterusu alınır ancak serviksi sağlam bırakılır.
- In a standard hysterectomy, both the uterus and cervix are removed.
- In a total hysterectomy, the uterus, cervix and one or both ovaries and fallopian tubes are removed.
Hysterectomy is done through the abdomen or vagina. Laparoscopic or robot-assisted techniques can be used.
Devices that can be inserted into the uterus and gradually release hormones (IUDs)
They need to be replaced after 3-5 years; the initial periods may be heavier, longer and more painful. They may not be accepted by the body, they may perforate the uterus. It may have side effects such as depression and weight gain, which are also seen in oral contraceptives.
- Minimally invasive and fast procedure
- The EMT electrode is inserted trans-vaginally and the ablation procedure takes place directly under ultrasound imaging.
- Doctors can choose which areas of the endometrium to cut and to what extent.
- This can lead to the desired result, complete cessation (amenorrhea) or persistence (eugenorrhea) of menstruation.
- With conventional endometrial ablation systems, the doctor cannot control which parts of the endometrium are destroyed, and has to remove the entire endometrium of the uterus.
- Again, with traditional endometrial ablation methods, undesirable results such as bleeding and accumulation of blood in the uterus (hematoma) are frequently encountered.
Endometrial ablation using the TCEA technique is performed under sedation. The procedure is completed in a controlled manner under USG guidance. The 5 mm thick electrode is guided vaginally into the uterus. Depending on the needs of the patient, complete ablation or partial ablation can be performed. Another advantage of this method is that it allows for improved temperature control. The procedure is completed in as little as 5 minutes and the risk of side effects or complications is very low. Unlike other treatments for patients with excessive menstrual bleeding, it does not require hospitalization and a two-hour follow-up in the clinic is sufficient.