The gold mesh method (synonyms: Novasure method; endometrial ablation, endometrial ablation) is a procedure by which the endometrium (lining of the uterus) is gently obliterated by high-frequency current with few complications, removed as much as possible and suctioned off. If hormone therapy fails and family planning is complete, endometrial ablation is a treatment option for dysfunctional uterine (“uterine-related”) bleeding (abnormal uterine bleeding without clinical or sonographic evidence of structural abnormalities and inflammation). Note: Hysterectomy (removal of the uterus) is indicated only after failure of endometrial ablation.
Indications (areas of application)
- Menorrhagia (menstruation is prolonged (> 6 days) and increased).
- Hypermenorrhea (menstrual bleeding is too heavy)
Contraindications
- Not yet completed desire to have children
- Malignant disease of the uterus or its precursors.
- Acute inflammation in the genital area or urinary bladder.
- Uterine cavity < 4 cm or > 6.5 cm
- Submucosal or intramural fibroids (absolute or relative contraindication depending on size and location).
The surgical procedure
Prolonged and increased menstruation (menorrhagia) or excessive menstruation (hypermenorrhea) can be caused by various factors. The most important causes are hormone imbalances, followed by organic changes in the uterus such as muscular nodules (fibroids), polyps, and tumors. Very rarely, infections, medications or blood clotting disorders are the causes. The consequences of increased bleeding are often anemia, fatigue and pain. Initially, conservative treatment is attempted to reduce the bleeding. Either by hormone administration, e.g. by means of the pill, the hormone coil, the hormone implant or by a curettage (Abrasio). However, these methods often do not have the desired effect. When family planning is complete, removal of the uterus is then often recommended. With the removal of the uterine lining, the so-called endometrial ablation, a very gentle method is available today to stop the excessive bleeding in the long term or at least to limit it considerably. Among the various methods, the gold mesh or Novasure method is a very effective option with few complications. To remove the endometrium, the gold mesh is advanced into the uterine cavity (uterus cavum) via the vagina and the cervical canal. There it is deployed. It adapts individually to the length and width of the uterus. In about 90 sec, the endometrium is sclerosed under radiofrequency energy and the dead tissue is aspirated. The endometrium (lining of the uterus) is completely removed during this procedure to prevent future bleeding. Usually, this procedure is performed under short anesthesia. This method is especially recommended for premenopausal women with a completed desire to have children. It is also suitable for high-risk patients with heart defects or on Marcumar therapy. The results are excellent.
Potential complications
- Perforation (puncture) of the uterus with possible injury to adjacent organs (bladder, bowel)
- Cramps and abdominal discomfort especially in the first hours after the procedure
- Accumulation of blood or fluid in the uterine cavity
- Spotting
- Minor discharge (up to 4 weeks)
- Inflammation
- Recurrence of bleeding disorder (failure).
Your benefit
- No surgical or hormonal pretreatment.
- The implementation is independent of the cycle
- The ablation technique is gentle, fast, simple and safe
- An excellent safety system and thus an extremely low complication rate.
- High success rate of 98
- Fast recovery time within one day
