What The Heck is Post Ablation Tubal Sterilization Syndrome?

Post ablation tubal sterilization syndrome is a complication that occurs in patients who previously undertook tubal sterilization following an endometrial ablation procedure. The endometrial ablation medical procedure removes or destroys the endometrial lining of the uterus. It is done to patients who suffer prolonged and excessive bleeding during normal menstrual cycle.

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The endometrial ablation procedures are mostly used for the treatment of menorrhagia on premenopausal patients who fail in medical therapy. These procedures are known to result in unusual and adverse outcomes. Post ablation tubal sterilization is a complication that follows a global endometrial ablation done to women with previous tubal sterilization. The complication presents as cyclic pelvic pain caused by tubal distention from occult bleeding into the obstructed tubes. Endometrial ablation procedure has several risks such as, pulmonary edema or embolism, bowel burn leading to death, perforation of the uterus, burns of the uterus and post ablation tubal sterilization syndrome. Some of the positives of endometrial procedure are that some patients will have reduced menstrual bleeding and others will stop having periods.

Complications Connected

The Endometrial ablations are normally performed on patients experiencing some of the following problems, uterine fibroids, uterine infection, prior C-section undiagnosed endometriosis, a titled or enlarged uterus, uterine dysplasia and tubal ligation. These ablations at times cause complications whose symptoms and signs may take time to detect. After an endometrial ablation, the uterine contracture and scar tissue may obstruct the cornual areas and prevent normal antegrade passage of menstrual material or result in retrograde menstruation. Patients who have undergone endometrial ablation with prior tubal ligation, retrograde bleeding into the proximal tubal segment causes recurrent tubal distension.

Post ablation tubal sterilization syndrome is yet to be determined as completely involved with endometrial ablation. Women who had prior done tubal sterilization followed by endometrial ablation face the risk of developing an ectopic like symptom complex. Salpingectomy is effective in relieving the symptoms. Post ablation tubal sterilization complications are noted in patients with a history of tubal ligation and are known as a delayed complication of endometrial ablation. The pain endured by patients is cyclic and is frequently associated with vaginal spotting. Symptoms begin to be noticed within 6 to 10 months after the endometrial procedure is done.

Early Diagnosis is Vital

The most preferred process of diagnosis of post ablation tubal sterilization syndrome is by performing a combination of clinical suspicion and image findings. Sonography is an important initial screening since most patients present to the emergency department with chronic pelvic pain. The incidence of having post ablation tubal sterilization syndrome is estimated to be at 6 percent though it could be likely higher due to lack of awareness of the syndrome and its imaging findings.

Magnetic resonance imaging is a good modality for evaluation since it is the most sensitive for detection of blood within the cornua or proximal tube. Imaging evaluation is important due to the fact that any obstructed fluid collections may be reabsorbed during the remainder of the patient’s cycle. Hysterectomy may be performed on a patient to solve symptoms associated with post ablation tubal sterilization syndrome.

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