Radio-Frequency Endometrial Ablation

Radio-frequency endometrial ablation (RFEA) is a minimally invasive surgical procedure used to treat abnormal uterine bleeding, particularly heavy menstrual bleeding. The goal of the procedure is to destroy the lining of the uterus (endometrium) using radiofrequency energy, thereby reducing or eliminating menstrual bleeding.

How it Works

RFEA uses a special device that emits radiofrequency energy to heat and destroy the endometrial tissue. The device is inserted through the cervix and into the uterus, where it is expanded to fit the shape of the uterine cavity. The radiofrequency energy is then applied to the endometrium, causing it to heat up and eventually die.

Types of RFEA Procedures

There are several types of RFEA procedures, including:

• Novasure: This is a type of RFEA procedure that uses a special device to deliver radiofrequency energy to the endometrium. The procedure typically takes about 90 seconds to complete.
• Minerva: This is another type of RFEA procedure that uses a similar device to deliver radiofrequency energy to the endometrium. The procedure typically takes about 2-3 minutes to complete.
• Channeling Optimized RF Ablation (CORA): This is a newer type of RFEA procedure that uses a special device with multiple channels to deliver radiofrequency energy to the endometrium. The procedure typically takes about 2-3 minutes to complete.

Benefits and Risks

The benefits of RFEA include:

• Reduced menstrual bleeding: RFEA can significantly reduce or eliminate menstrual bleeding, improving quality of life for women with heavy menstrual bleeding.
• Minimally invasive: The procedure is minimally invasive, requiring only a small incision and no overnight hospital stay.
• Quick recovery: Women can typically return to normal activities within a few days of the procedure.

The risks of RFEA include:

• Pain: Some women may experience pain or discomfort during and after the procedure.
• Bleeding: There is a risk of bleeding or spotting after the procedure, which can be heavy in some cases.
• Infection: As with any surgical procedure, there is a risk of infection with RFEA.
• Uterine perforation: There is a small risk of uterine perforation during the procedure, which can lead to serious complications.

Candidates for RFEA

RFEA is typically recommended for women who:

• Have heavy menstrual bleeding: Women with heavy menstrual bleeding that interferes with daily activities may be good candidates for RFEA.
• Have failed medical management: Women who have tried other treatments for heavy menstrual bleeding, such as hormones or birth control pills, without success may be good candidates for RFEA.
• Do not want to become pregnant: RFEA is a permanent procedure and should only be considered by women who do not plan to become pregnant in the future.

Preparation and Aftercare

To prepare for RFEA, women should:

• Stop taking hormones or birth control pills: Women should stop taking any hormones or birth control pills at least 1-2 months before the procedure.
• Avoid heavy lifting and strenuous activities: Women should avoid heavy lifting and strenuous activities for at least 24 hours before the procedure.
• Follow a liquid diet: Women may be instructed to follow a liquid diet for 24 hours before the procedure.

After the procedure, women can expect:

• Pain or discomfort: Women may experience pain or discomfort after the procedure, which can be managed with pain medication.
• Bleeding or spotting: Women may experience bleeding or spotting after the procedure, which can be heavy in some cases.
• Follow-up appointments: Women will typically need to follow up with their doctor 1-2 weeks after the procedure to check on their progress and remove any remaining tissue.

Success Rates and Long-Term Outcomes

The success rate of RFEA varies depending on the individual and the type of procedure used. Studies have shown that:

• Up to 90% of women experience significant reduction in menstrual bleeding: RFEA can significantly reduce or eliminate menstrual bleeding in up to 90% of women.
• Up to 50% of women experience complete cessation of menstrual bleeding: Some women may experience complete cessation of menstrual bleeding after RFEA, although this is not guaranteed.
• Long-term outcomes are generally positive: Women who undergo RFEA typically experience long-term reduction in menstrual bleeding and improvement in quality of life.

Alternatives to RFEA

There are several alternatives to RFEA, including:

• Hysterectomy: A hysterectomy is a surgical procedure that removes the uterus entirely. This is typically considered for women with severe uterine problems or cancer.
• Endometrial resection: Endometrial resection is a surgical procedure that removes the lining of the uterus using a special device.
• Ablation using other energy sources: Other types of ablation procedures use different energy sources, such as microwave or laser energy, to destroy the endometrium.