Abstract
Global endometrial ablation is a commonly performed, minimally invasive technique aimed at improving/resolving abnormal uterine bleeding and menorrhagia in women. As non-resectoscopic techniques have come into existence, endometrial ablation performance continues to increase due to accessibility and decreased requirements for operating room time and advanced technical training. The increased utilization of this method translates into increased imaging of patients who have undergone the procedure. An understanding of the expected imaging appearances of endometrial ablation using different modalities is important for the abdominal radiologist. In addition, the frequent usage of the technique naturally comes with complications requiring appropriate imaging work-up. We review the expected appearance of the post-endometrial ablated uterus on multiple imaging modalities and demonstrate the more common and rare complications seen in the immediate post-procedural time period and remotely.
Similar content being viewed by others
References
Practice Committee of the American Society for Reproductive Medicine (2008) Indications and options for endometrial ablation. Fertil Steril 90(5):S236–S240. https://doi.org/10.1016/j.fertnstert.2008.08.059
Tresserra F, Grases P, Ubeda A, et al. (1999) Morphological changes in hysterectomies after endometrial ablation. Human Reprod 14(6):1473–1477. https://doi.org/10.1093/humrep/14.6.1473
Silvernagel SW, Harshbarger KE, Shevlin DW (1997) Postoperative granulomas of the endometrium: histological features after endometrial ablation. Ann Diag Pathol 1(2):82–90. https://doi.org/10.1016/S1092-9134(97)80012-2
American Congress of Obstetricians and Gynecologists (2007) ACOG Practice Bulletin No. 81: Endometrial Ablation. Obstet Gynecol 109(5):1233-1248. https://doi.org/10.1097/01.aog.0000263898.22544.cd
Sharp HT (2017) An overview of endometrial ablation. Falcone T, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 2017
Hazard D, Harkins G (2009) Patient satisfaction with thermal balloon ablation for treatment of menorrhagia. Am J Gyencol 200(5):e21–e23. https://doi.org/10.1016/j.ajob.2008.09.006
Lethaby A, Penninx J, Hickey M, Garry R, Marjoribanks J (2013) Endometrial resection and ablation techniques for heavy menstrual bleeding. Cochrane Database Syst Rev https://doi.org/10.1002/14651858.CD001501.pub4
Longinotti MK, Jacobson GF, Hung YY, Learman LA (2008) Probability of hysterectomy after endometrial ablation. Obstet Gynecol 112(6):1214–1220. https://doi.org/10.1097/AOG.0b013e31818c1766
Daub CA, Sepmeyer JA, Hathuc V, et al. (2015) Endometrial ablation: normal imaging appearance and delayed complications. Am J Roentgen 205(4):W451–W460. https://doi.org/10.2214/ajr.14.13960
deSouza NM, McMillan DL, Puni RK, et al. (1996) Laser ablation of the endometrium: MR appearance during and after treatment and the relation of MR appearance to clinical outcome. Am J Roentgenol 167(5):1121–1126. https://doi.org/10.2214/ajr.167.5.8911162
Anzai Y, Lufkin RB, Castro DJ, et al. (1991) J Magn Reson Imaging 1(5):553–559
Rogerson L, Duffy S (2002) A European survey of the complications of a uterine thermal balloon ablation system in 5800 women. Gyn Endo. 11:171–176
Dood RL, Racia CR, Sammel MD, Haynes K, Senapati S, Strom BL (2014) Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding. J Minim Invasive Gynecol 21(5): 744–752. https://doi.org/10.1016/j.jmig.2014.02.012
Davis JR, Maynard KK, Brainard CP, et al. (1998) Effects of thermal endometrial ablation clinicopathologic correlations. Am J Clin Pathol 109(1):96–100. https://doi.org/10.1093/ajcp/109.1.9
McCausland V, McCausland A (1998) The response of adenomyosis to endometrial ablation/resection. Hum Reprod Update 4(4):350–359
Mengerink BB, van der Wurff AAM, ter Haar JF, van Rooij IA, Pijnenbord JM (2015) Effect of undiagnosed deep adenomyosis after failed NovaSure endometrial ablation. J Minim Invasive Gynecol 22(2):239–244. https://doi.org/10.1016/j.jmig.2014.10.006
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
This study received no funding.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The article does not contain any studies with animals performed by any of the authors.
Informed consent
Informed consent was waived for this study by the Institutional Review Board. This study was covered by Washington University in St Louis IRB Number 201601119.
Rights and permissions
About this article
Cite this article
Drylewicz, M.R., Robinson, K. & Siegel, C.L. Endometrial ablation: normal appearance and complications. Abdom Radiol 43, 2774–2782 (2018). https://doi.org/10.1007/s00261-018-1552-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-018-1552-x