[Hysteroscopic Sterilization]

Menstrual Ablation is a surgical procedure to remove the menstrual lining permanently.  This procedure is indicated to stop menstrual bleeding and/or cramping.  The main purpose of this procedure is to be an alternative to hysterectomy.  Only women done having children should do this procedure.

A small telescope is inserted through the vagina and cervix to view the inside of the uterus.  This is called hysteroscopy.   Then surgical instruments are inserted to remove the lining.  Removal of the menstrual endometrial lining is called ablation.  Anesthesia in the operating room is necessary.  The patient may either be asleep as in general anesthesia, or awake, as in spinal or epidural anesthesia.


  1. There are no incisions.

  2. Minimal recovery of one to two days.

  3. No negative hormonal changes.

  4. Does not cause menopause of the ovaries.

  5. Frequently improves premenstrual syndrome (irritability, headaches).


  1. Approximately 5-10% of patients will have minimal periods, but rarely will menses be heavy again.

  2. Risk of infection, bleeding, injury to the uterus, or other complications would be uncommon.

  3. Ablation will not correct other problems such as large uterine tumors or weakness of the bladder or uterine prolapse.

  4. Excess irrigation fluid absorption, causing internal swelling.


  1. No treatment if bleeding is not heavy or interfering with the lifestyle.

  2. Medical therapy such as hormones.

  3. Abdominal, vaginal or laparoscopic hysterectomy.

Menstrual ablation is an excellent procedure for women who have heavy menstrual bleeding that interferes with their lifestyle and is an important alternative to other current therapies.

NOTE: Menstrual ablation is not considered a form of birth control.  See Hysteroscopic Sterilization for more information.



Hysteroscopic sterilization

Tubal ligation with no abdominal incisions became available in 2002-2003. This procedure is done similar to the ablation procedure with a telescope through the vagina. A typical form of this is called Essure with springs that cause scarring over three months. Dr. MacFarlane does a direct cauterization of the tubal entrance into the uterus in conjunction with the ablation procedure. As these procedures are fairly new, confirmation of the effectiveness is done after three months. At this time the radiologist does a pap smear type exam and places xray contrast fluid into the uterus. An xray determines if the iodine contrast leaks out the tube. Exact numbers are still unclear but approximately 95% of hysteroscopic sterilizations by Dr. MacFarlane are confirmed by xray as blocked tubes. The other 5% that are not confirmed as blocked have many choices including no treatment if no periods are seen after 3-6 months.








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