Skip to main content
SpringerLink
Log in

Endometrial ablation: normal appearance and complications

  • Pictorial essay
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Practice Committee of the American Society for Reproductive Medicine (2008) Indications and options for endometrial ablation. Fertil Steril 90(5):S236–S240. https://doi.org/10.1016/j.fertnstert.2008.08.059

    Article  Google Scholar 

  2. Tresserra F, Grases P, Ubeda A, et al. (1999) Morphological changes in hysterectomies after endometrial ablation. Human Reprod 14(6):1473–1477. https://doi.org/10.1093/humrep/14.6.1473

    Article  CAS  Google Scholar 

  3. Silvernagel SW, Harshbarger KE, Shevlin DW (1997) Postoperative granulomas of the endometrium: histological features after endometrial ablation. Ann Diag Pathol 1(2):82–90. https://doi.org/10.1016/S1092-9134(97)80012-2

    Article  CAS  Google Scholar 

  4. American Congress of Obstetricians and Gynecologists (2007) ACOG Practice Bulletin No. 81: Endometrial Ablation. Obstet Gynecol 109(5):1233-1248. https://doi.org/10.1097/01.aog.0000263898.22544.cd

  5. Sharp HT (2017) An overview of endometrial ablation. Falcone T, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 2017

  6. Hazard D, Harkins G (2009) Patient satisfaction with thermal balloon ablation for treatment of menorrhagia. Am J Gyencol 200(5):e21–e23. https://doi.org/10.1016/j.ajob.2008.09.006

    Article  Google Scholar 

  7. Lethaby A, Penninx J, Hickey M, Garry R, Marjoribanks J (2013) Endometrial resection and ablation techniques for heavy menstrual bleeding. Cochrane Database Syst Rev https://doi.org/10.1002/14651858.CD001501.pub4

    Article  PubMed  Google Scholar 

  8. Longinotti MK, Jacobson GF, Hung YY, Learman LA (2008) Probability of hysterectomy after endometrial ablation. Obstet Gynecol 112(6):1214–1220. https://doi.org/10.1097/AOG.0b013e31818c1766

    Article  PubMed  Google Scholar 

  9. Daub CA, Sepmeyer JA, Hathuc V, et al. (2015) Endometrial ablation: normal imaging appearance and delayed complications. Am J Roentgen 205(4):W451–W460. https://doi.org/10.2214/ajr.14.13960

    Article  Google Scholar 

  10. deSouza NM, McMillan DL, Puni RK, et al. (1996) Laser ablation of the endometrium: MR appearance during and after treatment and the relation of MR appearance to clinical outcome. Am J Roentgenol 167(5):1121–1126. https://doi.org/10.2214/ajr.167.5.8911162

    Article  CAS  Google Scholar 

  11. Anzai Y, Lufkin RB, Castro DJ, et al. (1991) J Magn Reson Imaging 1(5):553–559

    Article  PubMed  CAS  Google Scholar 

  12. Rogerson L, Duffy S (2002) A European survey of the complications of a uterine thermal balloon ablation system in 5800 women. Gyn Endo. 11:171–176

    Article  Google Scholar 

  13. Dood RL, Racia CR, Sammel MD, Haynes K, Senapati S, Strom BL (2014) Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding. J Minim Invasive Gynecol 21(5): 744–752. https://doi.org/10.1016/j.jmig.2014.02.012

  14. Davis JR, Maynard KK, Brainard CP, et al. (1998) Effects of thermal endometrial ablation clinicopathologic correlations. Am J Clin Pathol 109(1):96–100. https://doi.org/10.1093/ajcp/109.1.9

    Article  PubMed  CAS  Google Scholar 

  15. McCausland V, McCausland A (1998) The response of adenomyosis to endometrial ablation/resection. Hum Reprod Update 4(4):350–359

    Article  PubMed  CAS  Google Scholar 

  16. Mengerink BB, van der Wurff AAM, ter Haar JF, van Rooij IA, Pijnenbord JM (2015) Effect of undiagnosed deep adenomyosis after failed NovaSure endometrial ablation. J Minim Invasive Gynecol 22(2):239–244. https://doi.org/10.1016/j.jmig.2014.10.006

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Washington University in St Louis, 216 S. Kingshighway Blvd, St. Louis, MO, 63110, USA

    Monica R. Drylewicz, Kathryn Robinson & Cary Lynn Siegel

Authors
  1. Monica R. Drylewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathryn Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cary Lynn Siegel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cary Lynn Siegel.

Ethics declarations

Funding

This study received no funding.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was waived for this study by the Institutional Review Board. This study was covered by Washington University in St Louis IRB Number 201601119.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drylewicz, M.R., Robinson, K. & Siegel, C.L. Endometrial ablation: normal appearance and complications. Abdom Radiol 43, 2774–2782 (2018). https://doi.org/10.1007/s00261-018-1552-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-018-1552-x

Keywords

Search

Navigation