
Can D&C Or Endometrial Ablation Procedure Help In Abnormal Uterine Bleeding?

1) Why would she have decided to do this ablation during surgery? She did not even mention this in the office, I had no pre-op education about this nor did I sign a consent for it.
2) Does this mean that she no longer suspects cancer? I realize we need to wait for biopsy reports for final answer but everything I've read this afternoon says that an ablation is not appropriate when cancer is suspected.
3) how is the ablation different or better than the D&C? Don't they both do the same thing?
4) are polyps sometime cancerous?
I'm sure I will think of other questions but this is a good start. Please help me understand why this procedure was performed. Thank you!
Details below.
Detailed Answer:
Hi,
Welcome to Healthcare magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.
Here are the answers for your concerns.
1. She probably felt that it is just simple overgrowth of endometrium. That is why she did the ablation also.
2. Yes. She probably does not suspect cancer. Ideally we should have biopsy report before this ablation procedure is done.
3. D&C and ablation both help in reducing the uterine bleeding.
During D&C only the superficial lining of uterus can be scraped. So after few months with regeneration of endometrial lining from deeper layers uterine bleeding recurs.
Ablation burns the deeper layers of endometrial lining. So the endometrial lining does not usually regenerate and the uterine bleeding does not occur or reduces drastically.
4. Yes polyps are sometimes cancerous, specially if associated with postmenopausal bleeding ( risk is 10-16%).
I hope this helps.
If you have further concerns, I will be happy to answer.


she would have taken the biopsy & removed the polyps before the ablation.
Detailed Answer:
Hi,
Welcome back.
Surely she would have taken the biopsy and removed the polyps before the ablation procedure. Definitely she would have sent the samples for histopathology. There is no doubt about it.
If you have further concerns, do write to me.
Best wishes,
Dr Rama


Your doctor is on the right track.
Detailed Answer:
Hi,
Welcome back.
Great relief to know that ablation was not done.
Your doctor is for sure on the right track.
In 8 out of 10 women it is not cancer.
I sincerely pray that you are one among these 8.
With regards
Dr Rama


Also, does this mean I should see a GYN for my annual exam each year? I've always just seen my family doctor for this however if they need to keep an eye on these growths I could see the benefit of going to the GYN who would have access to ultrasounds and things that my daily doctor might not be able to do. Please,tell me what your recommendation would be for your patient in a similar situation.
Thanks so much, blessings, XXXXXXX
No need for any treatment at present.
Detailed Answer:
Hi,
welcome back.
Thank God for the good news. Very happy to know that polyps are benign.
At present there is no need for any additional treatment.
In the literature the risk of recurrence of polyps is 3-13% during 2-9 years follow up.
Tiny polyps that you had are less likely to recur.
Since you have additional risk factors, for a similar woman in my hospital, I advise follow up with yearly ultrasound.
In case you develop vaginal bleeding in future then you need to get the ultrasound done at the earliest.
Please try to reduce weight and keep diabetes under control. These factors may help reduce the risk of recurrence of endometrial polyp.
I hope this helps.
If you have further concerns, I will be happy to answer.
with regards,
Dr Rama


I know about the weight and have already begun the process for gastric bypass surgery. I hope to have the surgery before the end of the year.
Blessings, XXXXXXX
Do the Pap test once in 5 years.
Detailed Answer:
Hi Miss XXXXXXX
Yes , plan to see the gynecologist once a year for ultrasound only.
There is no need to repeat the Pap test every year. Do the Pap test once in 5 years.
I hope this helps.
Best regards,
Dr Rama


Yes some people do get such bleeding.
Detailed Answer:
Hi,
Welcome back. Please excuse me for the delay in replying.
Yes some people do get such bleeding as the endometrium is getting healed. The cramping and bleeding should gradually reduce and stop in a week's time.
If cramping and bleeding worsen's please consult your Gynecologist as infection needs to be excluded in this scenario.
I hope this helps.
If you have further concerns, you can definitely write to me.
With regards,
Dr Rama.

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