Endometrial ablation has become a cornerstone procedure in the treatment of abnormal uterine bleeding, but is it the right solution for every patient that meets the indication? In this episode of the BackTable OBGYN Podcast, Dr. Ted Anderson from Vanderbilt University joins host Dr. Mark Hoffman to discuss the evolution of endometrial ablation and its contemporary utilization, including patient selection, technical considerations, and alternative treatments for abnormal uterine bleeding.

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SYNPOSIS

Dr. Anderson begins by detailing the history of abnormal uterine bleeding alongside the evolution of the endometrial ablation techniques that have been used to treat it. Shifting focus to current day practice, he then shares his approach to endometrial ablation, covering patient selection and the technical aspects of his approach.

Throughout the conversation, Dr. Anderson emphasizes the importance of how we define success in endometrial ablation, explaining that eumenorrhea (normal bleeding that no longer interferes with life events) is the goal, as opposed to the more traditional view that amenorrhea is the target outcome. The episode closes with a discussion on the role of alternative treatments, such as the Mirena IUD and hysterectomy for abnormal uterine bleeding.

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TIMESTAMPS

00:00 - Introduction

09:29 - History of Abnormal Uterine Bleeding and Endometrial Ablation

23:31 - Evolution of Endometrial Ablation Devices/Techniques

31:11 - Selecting the Right Patient for Ablation Success

34:38 - Post-Tubal Sterilization Ablation Syndrome

38:27 - The Role of IUDs in Managing AUB

44:07 - Reevaluating Endometrial Ablation Success Metrics

49:55 - Innovative Ablation Techniques: Cryoablation and Steam

51:48 - Adenomyosis and Fertility-Sparing Treatments

57:28 - Final Thoughts