Stop Heavy Bleeding
This is a procedure that can be performed in the operating room or, less expensively, in the office. Both are performed in the same manner. This procedure is used to treat heavy bleeding. After the procedure, 90-98% of women are reported to be satisfied with the results. Approximately 60-70% of women will have little to no bleeding after an ablation procedure with another 20-30% experiencing lighter periods that are markedly improved from pre-treatment. Approximately 10% of patients will fail an ablation procedure and choose to manage bleeding as they have been doing, using hormones to control bleeding, or opting for other surgical treatments such as hysterectomy. If you fail any ablation procedure, it is generally recommended that the procedure not be repeated.
Prior to any ablation, hysteroscopy and D&C are performed to evaluate the lining of the uterus. Dr. Jukes will use a device Microsulis, Novasure, Thermachoice, or HTA System to permanently remove the cells that grow a lining in the uterus. Each month during a period, the uterine lining is shed and a new lining starts to grow. By preventing the re-growth of this uterine lining, we can stop periods permanently. An ablation procedure can take anywhere from 90 seconds to 15 minutes depending on the device we choose and the shape of your uterus.
Dr. Jukes and her staff are committed to providing you the best experience possible by making available the option of IV medications for control of discomfort during your procedure without any additional out-of-pocket expenses. We use both oral medications such as Valium and IV medications during the ablation to achieve relaxation and assist with any cramping you may experience. Dr. Jukes and her nurses have obtained special certification to safely administer IV medications in an office setting eliminating the need for an anesthesiologist and eliminating out-of-pocket anesthesia fees.
Following the procedure, you might have some moderate to intense uterine cramps that can last 4-6 hours following the procedure. We ask that you take your prescription pain pills upon arriving home after your procedure so that you may go to sleep and reduce any discomfort you may experience. Most people find they sleep through a majority of the cramping and awake feeling little discomfort. For some fortunate women, they do not experience any cramping at all.
You may return to work the day following your procedure, but we ask that you avoid sexual intercourse for 4 weeks to avoid infection of the uterus. You may have a watery or bloody discharge for up to 6 weeks following your procedure until the uterine lining heals. If you are not happy with your bleeding pattern after 6 months, you may opt to try hormonal therapy or consider a hysterectomy to control your abnormal bleeding. Repeating an ablation procedure is not generally recommended.
It is also important to understand that while ablations may stop your periods, ablations do not prevent pregnancy. Dr. Jukes encourages her patients to consider permanent birth control such as Essure, tubal ligation, or vasectomy prior to having an ablation procedure. If a women opts not to have permanent birth control, she is at higher risk for an ectopic or tubal pregnancy or a high risk uterine pregnancy.
Tubal Sterilization/Essure Procedure
Tubal sterilization is a procedure used to permanently prevent pregnancy. Traditionally this has been done in the operating room using a laparoscope and burning the mid portion of the fallopian tube. This would require at least 2 incisions and general anesthesia with the same risks.
Fortunately, we now offer the Essure Procedure, which is performed in the office without incisions. You do receive oral medications prior to the procedure, and IV anesthesia is also offered. Dr. Jukes places a blocking coil/device through the vaginal opening and into a woman’s reproductive tubes. Over 3 months the tubes will scar around the coils and result in permanent sterilization. You will need to be on birth control 1 month prior to the procedure to thin your uterine lining so Dr. Jukes can see the tubal openings clearly. You will also need to protect against pregnancy until we can confirm your tubes are blocked. To confirm your tubes are blocked you will be sent to the radiology department to have an X-ray study with injection of dye material into the uterus. This procedure takes on average 7 minutes to perform. You may have an MRI in the future with these coils in place. There is very low risk to the procedure and is 99.5% effective in preventing pregnancy.
Following the Essure procedure you might have some bleeding and cramping that can last 48 hours. This is your fallopian tube reacting to the coil being placed. Over the next 3 months you might have some cramping in the area of the tubes as the tissue is growing around the coils, therefore occluding your tubes.
Post Operative Instructions after Essure
All tubal sterilization procedures and vasectomies have failure rates. If you should get pregnant after a tubal sterilization then it is most like a tubal pregnancy. This is a condition that would require immediate medical attention and removal of the tube with the pregnancy tissue.