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Dilapidating hematoma

dilapidating hematoma-33

With all the adverse effects associated with endometrial ablation, especially the need for hysterectomy later, one must question whether women are informed about those risks.

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It is an increasingly common procedure used to treat heavy menstrual bleeding. Here are the short-term complications for endometrial ablation reported in Pub Med: pelvic inflammatory disease, endometritis, first-degree skin burns, hematometra, vaginitis and/or cystitis.“Any bleeding from persistent or regenerating endometrium behind the scar may be obstructed and cause problems such as central hematometra, cornual hematometra, postablation tubal sterilization syndrome, retrograde menstruation, and potential delay in the diagnosis of endometrial cancer.The incidence of these complications is probably understated because most radiologists and pathologists have not been educated about the findings to make the appropriate diagnosis of cornual hematometra and postablation tubal sterilization syndrome.” Long term complications of endometrial ablation.Another study, reported a similar link between endometrial ablation and hystectomy.“On the basis of our findings one third of women undergoing rollerball endometrial ablation for menorrhagia (heavy menstrual bleeding) can expect to have a hysterectomy within 5 years.And as one physician suggests, neither the pathologists nor radiologists responsible for diagnosing post ablation pathology are trained to recognize these complications.

Without data or access to data and without training, one wonders whether it is even possible to have informed consent for a procedure like ablation.

Many of the articles cited for this post come from paywalled journals that are not readily available to either the patients or the physicians – the costs are prohibitive for both.

So it is not clear whether the physicians performing these procedures are aware of the long-term risks associated with ablation.

The procedure is premised on the notion that if the endometrial lining is destroyed – ablated – bleeding can no longer occur. A search of the FDA MAUDE database included complications of thermal bowel injury (one resulting in death), uterine perforation, emergent laparotomy, intensive care unit admissions, necrotizing fasciitis that resulted in vulvectomy, ureterocutaneous ostomy, and bilateral below-the-knee amputations.

Additional postoperative complications include: Endometrial ablation to block menstruation.

In order to understand the long-term risks of endometrial ablation, one must understand the hormonal interaction between the uterus and ovaries.