Microwave Endometrial Ablation

About the Procedure

Microwave Endometrial Ablation (MEA) is one of several types of minimally-invasive surgeries which treat menorrhagia, excessive uterine bleeding, in women who want to avoid a hysterectomy. Applying the high temperature of microwave energy to the lining of the uterus, results in the formation of scar tissue which reduces or prevents the bleeding. This procedure is appropriate for women who are pre-menopausal and no longer interested in bearing children, but it's not used as a sterilization method. MEA is not recommended for women who: have cancer of the reproductive organs, have had the procedure before, have had a cesarean birth with a classical incision or any other condition which compromises the abdominal lining, currently has an implantable birth control device, or has pelvic inflammatory disease, as well as other restrictions. In 87% of women in a clinical study, MEA was very successful in reducing excessive bleeding during menstruation and 55% of participants ceased menstruating completely.

Performed by a specially-trained gynecologist in an out-patient facility or their office, using local or spinal anesthesia (rarely general), the entire MEA process takes less than an hour. With the assistance of ultrasound, the doctor inserts a long, thin, microwave emitting device into the patient's vagina and enters the uterus. The device is moved across the lining in a sweeping motion, essentially melting away the endometrial layer. As the area heals, scar tissue forms, preventing or reducing further bleeding. When the device is removed, there is no incision to worry about and patients are usually discharged the same day.

What to Know Before the Procedure

When microwave endometrial ablation was initially introduced as a treatment for uterine bleeding, there were sufficient complications to warrant FDA oversight. Some complications found were: perforation of the uterus, burns to the uterus, bowel, and rectum, cervical tearing, fluid in the lungs, and pulmonary embolism. While these issues no longer occur frequently, they can be severe if they do. Standards were established for improved physician training, longer periods of supervision, and mandatory use of ultrasound during the procedure.

The ease of this surgery requires little preparation. Any prerequisite testing or food intake restrictions will be discussed by the doctor. It is advised to have a driver at discharge.

What to Know After the Procedure

Patients sometimes experience uterine cramps, nausea, vomiting, and vaginal discharge which looks like bloody water. In a few days the discharge will become clear and will last up to two weeks. Complete recovery ranges from about one to three weeks. Normal activities and returning to work can be resumed within a couple of days.

MEA treatment generally leaves a woman sterile but because an area of the endometrium could have been missed during the procedure, pregnancy may be possible. Patients should use birth control until their physician determines they are no longer fertile because pregnancy can be problematic after MEA.

If you Need to Travel Outside of your Local Hospital

Considering the rarity of complications involved with an MEA and the short duration of the procedure, receiving surgery at a distant location presents no difficulties. However, for those same reasons, as well as its simplicity, lack of wound care, few post-op effects, the possibility of having it done in the gynecologist's office, and its relatively low cost, it may be unnecessary to travel long distances. Many gynecologists are trained in MEA, so finding one that is local or a short distance away who performs this procedure for a reasonable cost is likely.