Surgery is generally reserved for treating
abnormal uterine bleeding (AUB) that can't be
controlled with medicine.
The following procedures are used to treat abnormal
- Hysteroscopy can be used to diagnose
and treat abnormal uterine bleeding at the same time. A lighted viewing
instrument called a hysteroscope is inserted through the
vagina and cervix and into the
uterus. When areas of bleeding are located,
biopsies can be taken and then the areas of bleeding
can be treated with either a laser beam or electric current
- Hysterectomy is the removal of the
uterus. It may be done when a sample of the uterine lining (endometrial biopsy) shows abnormal
cell changes or cancer, when uterine bleeding is uncontrollable, or when the
cause of chronic bleeding cannot be found and treated. A hysterectomy is a
major surgery with risks of complications. Recovery from surgery can take 4 to
8 weeks, depending on the type of hysterectomy done. If the
ovaries are also removed, you may need to take
estrogen therapy after surgery.
- Endometrial ablation is a minimally invasive
alternative to hysterectomy when other medical treatments fail or when you or
your doctor have reasons for not using other treatments. Endometrial ablation
scars the uterine lining, so it is not a treatment option if you are planning
to become pregnant.
What to think about
Hysteroscopy may be done to
rule out serious uterine conditions:
- Before long-term treatment with medicines or
surgical treatment for abnormal uterine bleeding.
- When uterine
bleeding has continued despite nonsurgical treatment.
Hysterectomy may be used as surgical treatment for abnormal
uterine bleeding when:
- Abnormal uterine bleeding does not respond to medicine or other treatment.
- Childbearing is completed and you do not wish to try treatment with medicine.
- Symptoms of abnormal uterine bleeding outweigh the risks and discomforts of surgery.
Regrowth of the endometrium may occur after you have endometrial ablation.