Minor procedures that treat heavy bleeding can take anywhere from 5 to 45 minutes, and are performed in the operating room or the doctor’s office. Depending on the procedure, patients usually recover in a few hours or days. Minor procedures include:
Dilation and curettage (D&C)
This procedure, which involves scraping away the top layer of the uterine lining, requires anesthesia. D&C is typically used to determine the cause of heavy bleeding; however, it may lighten your period, but only for a couple of cycles. It’s normal to experience vaginal bleeding and/or cramps for several days following a D & C. The most common complication is perforation of the uterus.
Myomectomy and polypectomy
A myomectomy is a procedure that removes intrauterine fibroids (a polypectomy removes polyps). There are different ways your doctor can perform a myomectomy, depending on the location of your fibroids. One method, called laparoscopic myomectomy, involves making a small incision by the belly button and cutting into the uterus to remove any fibroids. The recovery time is typically two to seven days. Risks from this procedure include injury to the bladder, bowel, ureter, and blood vessels.
Some types of polyps and fibroids can be removed through a procedure called hysteroscopic myomectomy. The doctor inserts an instrument (hysteroscope) through the vagina to visualize the inside of your uterus in order to identify the fibroid or polyp. A tool is then inserted through the hysteroscope to remove the tissue. This treatment may be an option if you are looking to reduce your heavy bleeding caused by fibroids or polyps, while retaining a fully functional uterus.
The MyoSure® procedure is a type of hysteroscopic procedure (it is not indicated for the removal of intramural and subserosal fibroids). Your physician will insert the MyoSure device through the hysteroscope to remove the tissue from the uterus. Recovery time from this type of myomectomy is typically two days.
The most common complications following a hysteroscopic myomectomy include abdominal cramping and pain, bleeding, fever, nausea, vomiting, shortness of breath or dizziness. Learn more about the risks and considerations for the MyoSure procedure.
You may want to consider this procedure if you don’t plan to have children. The doctor gently removes the lining of the uterus by using heat, extreme cold, electricity, or a laser beam. He or she may use a lighted viewing instrument called a hysteroscope to see inside and asses the uterus before and/or after the procedure.
For any endometrial ablation procedure, commonly reported postoperative events include cramping/pelvic pain, nausea and vomiting, vaginal discharge and vaginal bleeding/spotting. Some forms of endometrial ablation can only be performed at certain times during the menstrual cycle, and most require a pre-treatment drug to help thin the lining of the uterus. The pre-treatment drug must be started anywhere from a few weeks to several months before the procedure. Your periods will be a lot lighter or may stop altogether after endometrial ablation, although it’s not uncommon to have to repeat the procedure if menstruation starts again.
The NovaSure® procedure is a type of endometrial ablation procedure that can be performed at any time during your menstrual cycle and doesn’t require a pre-treatment drug. The procedure takes about 5 minutes and can be performed in the hospital or your doctor’s office.
It is safer and less expensive than a hysterectomy, and many women can return to work the day after the procedure.
In addition to the risks for endometrial ablation, risks from the NovaSure procedure include post-ablation tubal sterilization syndrome, pregnancy-related complications (NOTE: PREGNANCY FOLLOWING ENDOMETRIAL ABLATION IS VERY DANGEROUS FOR BOTH THE MOTHER AND THE FETUS), thermal injury to adjacent tissue and perforation of the uterine wall. Learn more about the risks and considerations for endometrial ablation and the NovaSure procedure.