Hysteroscopic endometrial resection

An endometrial resection is an operation to remove the lining (endometrium) of your uterus (womb).

The most common reason for having an endometrial resection is to relieve the symptoms of heavy periods (abnormal uterine bleeding).

Most women will have much less bleeding when they have their period. Pain is usually significantly reduced, although for some women mild cramping may still happen.

About a third of women who have the operation will not have periods anymore.

Heavy periods can be treated using a variety of non-hormonal and hormonal oral (by mouth) medications.

Other alternatives include an IUS (intrauterine system) — an implant containing a synthetic form of the hormone progesterone that fits in your womb — but these are usually tried before surgery is recommended.

Your doctor will continue to try to control your symptoms with medication, or you can continue without treatment.

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes about 30 minutes.

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Feeling or being sick.
• Bleeding or discharge, lasting up to 4 weeks.
• Infection.
• Allergic reaction to the equipment, materials or medication.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific early complications

• A small hole in your womb made by one of the instruments, with possible damage to a nearby structure.
• Bleeding during the operation. The bleeding can prevent the procedure from being completed or lead to you needing a hysterectomy.
• Fluid overload, where the fluid used to expand your womb enters your bloodstream.
• Failed procedure.

Specific late complications

• Haematometra, where blood and other menstrual fluid collect in pockets in your womb.
• Blood and fluid collecting in your fallopian tubes and becoming trapped.
• Continued bleeding or pain needing further treatment. This may involve a hysterectomy.
• Pregnancy problems, if you become pregnant after an endometrial resection.

Consequences of this procedure

• pain

You should be able to go home the same day.

You should be able to return to normal activities after 2 to 4 days. Most women are fit for work after about a week.

You should expect to have some bleeding or discharge for up to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The operation is not recommended for women who still want children.

Even if your periods stop, there is still a risk of becoming pregnant.

An endometrial resection is a common gynaecological operation. It helps relieve the symptoms of heavy periods. You should get less bleeding and pain.