C-section and the Risk of Post-Endometrial Ablation Syndrome

In a new study at the Mayo clinic they looked at the patients that underwent enedometrial ablation and also had a prior C-section to see if there was any greater risk of post endometrial ablation surgery. About 23% of their patient population had had a C-section before, which is a bit less than the national C-section overall rate of closer to 30%, but likely fairly close to their overall C-section rate. So just from the rate of C-section in this population we would have to say that a C-section would not protect against or cause a patient to need endometrial ablation! No additional complications were seen in these women, and two patients in each group: with a prior C-section, and without a prior C-section had a hole made in the uterine wall during the surgery so that it was concluded that statistically it was about the same risk although there were fewer women in the group that had had C-section, so a slight trend towards risk. In their study population there was no reduced effectiveness, or change in the overall success rates whether a woman had had a C-section or not. The study was very powerful as they followed women for a full 5 years. And we conclude that your risk of post endometrial ablation syndrome is no greater if you have had one or more Cesarean delivery.

Comments

  1. Is it a great risk after two Caesarian section births to use a diaghram?

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  2. Diaphragm contraception, like all barrier methods of contraception, block the entry of sperm into the uterus, and thus prevent conception. Because barrier methods help to prevent STIs (sexually transmitted infections) the risk of lining infections should be less. There are no studies to show that the use of barrier methods, whether a diaphragm or other barrier like condoms or cervical caps, increase the risk of c-sections. To the extent that they do not prevent conditions that might increase c-section risk, there might be an increase. Gynecologists do not warn patients of increase c-section risk when they use barrier methods. Because failure rates are as high as 20%/year with diaphragms we do encourage our patients to consider a more effective contraceptive method, however, not for the rease of c-section risk!

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  3. I have had 2 c sections and was told I would not be a good candidate for the ablation because I had a higher risk of organ damage, why is this?

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  4. When a uterine ablation is performed with a Minerva or a NovaSure device the system will not fire if there is lack of integrity of the uterine wall, meaning there is a perforation. There are some women who have had previous c-sections who indeed have a uterine wall defect, but that is very rare. If there is no defect in the wall of the uterus then a woman would be a candidate for an ablation just based on prior c-section. Having a very small or very large uterus can be problematic for ablation, as can women with other reasons for the cavity to be oddly shaped. But for the specifics of whether you will be able to have an ablation, that has to be done at the time of direct consultation.

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