Endometrial ablation: normal appearance and complications

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.

Comparison of Combined Bipolar Radiofrequency Impedance-Controlled Endometrial Ablation with Levonorgestrel Intrauterine System versus Bipolar Radiofrequency Endometrial Ablation Alone in Women with Abnormal Uterine Bleeding

“…One of the most popular nonhysteroscopic endometrial ablation techniques is the bipolar radiofrequency impedance-controlled endometrial ablation, NovaSure (Hologic Inc., Bedford, MA) [10,11]. However, this technique is associated with the drawback of recurrence of menstrual bleeding or dysmenorrhea in a few years after endometrial ablation in some patients because of the continuation or regeneration of the endometrium, which necessitates a repeat hysteroscopy or hysterectomy [12,13]. Another reported complication is the development of adenomyosis after endometrial resection in cases where there was no evidence of the disease before the hysteroscpic surgery [14,15].…”