Novasure: the 90 Second Endometrial Ablation

The Novasure System is the latest generation of devices that treat the entire inside of the uterus (endometrial cavity) at once. The procedure does not require any incisions, and does not require hospitalization.

A slender device is inserted through the cervix under local anesthesia with sedation, or general anesthesia. Once it is in place, treatment time averages 90 seconds. Most women can resume most of their normal activities in a day or two.

Before endometrial ablation is done using most other methods, it is necessary to thin the lining of the uterus with hormonal medication that induces temporary menopause or with birth control pills. Some of these medicines can have troublesome side effects. Also, with other devices the ablation must then be done at a specific time of the menstrual cycle. A major advantage of Novasure is that hormonal pre-treatment is not needed, and it can be done at any time of the cycle.

Steps of the Novasure procedure:

1.	Under general or local anesthesia, a sheath containing the electrode (the part that does the ablation) is placed through the cervix. The sheath is pulled back, allowing the electrode to expand and conform to the shape of the uterine cavity.
2.	The system inflates the uterus with a small amount of CO2 to ensure proper placement of the device.
3.	The device is activated, and automatically turns off when it senses that treatment is complete. Usually this takes about 90 seconds.
4.	After ablation is complete, the electrode safely retracts into the sheath for easy removal. Most women are ready to go home within an hour after the procedure.

Advantages of the Novasure System

The Novasure System is the most rapid of all endometrial ablation techniques. FDA studies show that it has a high success rate and low complication rate. It can be done under local anesthesia (usually with sedation) or asleep. One of the risks of conventional ablation, the absorption of excess fluid, is eliminated. One of the biggest advantages is that no hormonal pretreatment is needed, and it can be done at any time of the menstrual cycle.

Disadvantages of the Novasure System

The size and shape of the uterus must be fairly normal in order to use the system. Fibroids or large polyps inside the cavity of the uterus will interfere with the placement of the device. In that situation I would first use a resectoscope to remove the fibroids or polyps, and would then would do the ablation. The Novasure system, however, is the only FDA approved device that was tested and found to be safe and effective in patients with smaller polyps, up to 2 cm, without having to first remove the polyps. It can also be used to treat a uterus that has fibroids as long as the fibroids do not distort of the shape of the cavity.

The medical information presented in this website represents the opinion of Dr. Indman, and is based on his knowledge and experience. It is not applicable to all patients or physicians. Anyone visiting this or other related medical sites should discuss symptoms, findings, and alternatives with their personal gynecologist.