Patients should follow all preparatory steps recommended by their physician. This may include dietary restrictions and changes in medication regimens. Patients who are to undergo hysteroscopic endometrial ablation and endometrial resection may be required to take preoperative medications to thin the uterus for several weeks before the procedure.

Endometrial ablation and resection are performed as an outpatient procedure. Patients are placed under either general or regional anesthesia, which means they may or may not be asleep during the procedure. During the procedure, a physician inserts a lighted telescope called a hysteroscope into the uterus. The uterus is filled with a clear fluid so that its contours may be visualized on a monitor.

Depending on the procedure, the cells of the uterine lining are destroyed with a laser, electrical energy, heat or cold, or a balloon that is placed in the uterus and filled with hot water. These surgeries usually take less than an hour, sometimes only a few minutes.

Recovery typically takes a day or two. Following the procedure, the uterine wall will heal through scarring, which further reduces or prevents uterine bleeding. Many women experience symptoms such as cramping or a watery, pink discharge following the procedure. This may last for up to two weeks and pain medication may be prescribed, if necessary. Women may be advised to avoid strenuous activity for a 24-hour period. They may also be advised to refrain from sexual intercourse for one to two weeks, until the discharge has stopped.

Women who have ablation and resection still have all of their reproductive organs. As a result, they will need to continue to have regular Pap smears and pelvic examinations. Although ablation and resection destroy the uterine lining, there remains a very small chance that pregnancy could occur. Such pregnancies can be dangerous for the mother and the fetus. As a result, women who have these procedures must continue to use contraception.

Women who undergo endometrial ablation and resection should take progesterone to reduce the risk of developing uterine cancer. Because ablation has been performed for only about two decades, the long-term effects of the procedure are largely unknown.

In rare cases, ablation will not be wholly successful, and women will need to undergo a hysterectomy to stop abnormal bleeding.