What is Balloon Ablation

Many woman experience problems like heavy bleeding during their periods; prolonged periods with a lot of bleeding; or bleeding between periods. One of the ways of dealing with these problems is to remove or destroy the lining (endometrium) of the womb (uterus). This is called endometrial ablation. It is done when it is not possible to identify a specific, potentially treatable, cause for the heavy bleeding such as the presence of polyps, which are non-cancerous growths that can sometimes bleed a lot, or a hormone problem, which can also sometimes cause a lot of bleeding. When a specific cause cannot be found, endometrial ablation is a very good option to correct the problem.

The Operation

It is possible that for a period of time before the operation (sometimes up to two months) you will need to take medications (possibly in the form of injections) that will decrease the thickness of the lining of the womb. This will make the operation easier and will increase the chances of success.

The operation can be done as a day surgery case. This means that you can go home the same day of the operation, usually a few hours after it is completed. The operation lasts between 30 and 45 minutes.

The operation is usually carried out under general anaesthetic. This means that you will be asleep and unconscious and you will not feel pain during the procedure.

The operation starts with a hysteroscopy, which allows the surgeon to have a look in the womb by using a special telescope, which is connected to a TV monitor. The telescope (and any other instruments that are needed during the operation) is entered into the womb by passing it first through the vagina and then through the cervix, which is the entrance of the womb lying in the deep part of the vagina.

Although the modern telescopes used in such procedures are very thin, in most cases, the surgeon will need to dilate (widen/open up) the cervix by using a special device so that he can pass the telescope or other instruments into the womb. The inside of the womb is a collapsed cavity and the surgeon needs to inflate it by using a special liquid so that he can see everything clearly.

Using many different techniques can destroy the lining of the womb. The most common one is by using the wire loop of an electrocautery device. This is a device that burns the lining of the womb and at the same time stops any bleeding. Another commonly used method is the insertion in the womb of a triangular balloon which when inflated has the shape of the cavity of the womb. The balloon is inflated with fluid, which is then heated for several minutes and eventually destroys the lining of the womb. Freezing techniques, microwaves or laser ablation have also been used on a more experimental basis but there is no clear proof that they offer any substantial advantages compared to the traditional methods.