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Is endometrial abiation covered through amerigroup ks

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Post-ablation syndrome describes the symptoms of pain or a return to heavy bleeding that often leads to hysterectomy, as MedPage Today reported in an earlier story in this series. Contraindications in the device's Instructions for Use IFU -- the equivalent of a drug label -- include pregnancy or a desire to become pregnant, endometrial cancer, anatomic conditions such as classical cesarean section or transmural myomectomy, genital or urinary tract infection, IUD implantation, small uterine cavity, and active pelvic inflammatory disease.

In addition to these "absolute" contraindications, Ghomi said, doctors are starting to learn that there are "soft" ones as well, such as younger age, polyps, fibroids, painful periods, and any type of cesarean section.

Some doctors might still perform the procedure in these circumstances, and that's when complications such as post-ablation syndrome or perforations at the time of surgery are more likely to occur, he said.

Hologic spokesperson Marcia Goff said the company continuously assesses the "appropriateness of all our product IFUs based on clinical trial data and reports from healthcare providers and patients" and any changes are approved by regulatory authorities. Still, Ghomi says his ideal candidate for endometrial ablation would have the following characteristics:. As for guidance about patient selection for the physician doing a NovaSure procedure, the label states that there are many causes for menorrhagia and that physicians should consult the medical literature before performing any ablation procedure.

Sue Ferrier didn't have heavy menstrual bleeding when she was referred for a NovaSure procedure in After months of frustration with a "brownish, very light" discharge, Ferrier, now 54, of Burks Falls in Ontario, Canada, reached out to her primary care doctor. The discharge was merely "a nuisance," she said, but one that was affecting her life and her marriage. Ferrier wasn't on board immediately. She was otherwise healthy, wasn't in any pain, and wondered whether undergoing a procedure made sense.

I'm a little bit of a fearful person to begin with," she said. But she eventually convinced herself not to "overthink it, it's a second procedure. Its rates of success are, you know, way, way up there. So, let's go for it. About three days later, she woke up "moaning in pain" and told her husband she needed to go to the hospital.

Although she lives less than 15 minutes from the emergency room, by the time she arrived, she had no memory of what happened. She relies on her husband's memory instead. He told her about her blood pressure "bombing out," her sky-high heart rate, and being transferred to another hospital for an emergency hysterectomy.

She had sepsis severe enough to require a medically-induced coma. She went home 10 days later, but within a week began to feel sick again. Doctors found an abscess, which Ferrier opted to let drain on its own, but she was soon back at the hospital as she continued to get weak. Doctors gave her the strongest medicines they had and were even nervous to finally send her home in December in time for her youngest son's birthday.

Ferrier says she has lingering consequences from her ordeal. She can't read more than a short chapter of a book without losing focus. She used to manage her family's finances, but now has trouble with math.

She can't work because under any form of time pressure, "my mind goes blank. Ferrier does puzzles to try to improve her attention span, lifts weights and, during warmer weather, rides her bicycle to improve her strength. It's difficult to assess individual consent discussions, but like Ferrier, other women interviewed by MedPage Today who suffered complications said they felt the risks were given short shrift by their physicians.

She says many patients come to her with endometrial ablation failures. Louie rarely offers an ablation, but when she does, she says she's upfront about its risks and the likelihood that it's a temporary solution.

She doesn't offer it to younger women, especially those in their 20s or 30s, because of concerns about failure and post-ablation syndrome. She counsels them about the "high likelihood that they will require another procedure when endometrial ablation has reached the end of its effectiveness. For example, she might recommend it to a patient who has young kids and can't commit to a hysterectomy now, but may be able to have the surgery a few years down the line.

Or if a patient with a history of tubal ligation really wants endometrial ablation, she'll discuss the possibility of post-ablation tubal sterilization syndrome. Not all doctors describe ablation as a temporary procedure. While she does encourage an IUD first, she said many don't want hormones, so ablation becomes a good option. She said she cautions all her patients about post-ablation syndrome, especially those with adenomyosis, as "ablation can make them worse.

But even if they have adenomyosis, a lot of them choose to try ablation hoping it will be good enough so they don't have to get a hysterectomy. Sweeney, who uses NovaSure with most ablations, said she was surprised to read about high follow-up hysterectomy rates and that hers are very low.

Physicians who look to the patient counseling section of the NovaSure label would learn that they should discuss the risks and benefits of ablation as well as treatment alternatives. They'll also find information about the dangers of getting pregnant following an ablation; common post-procedure complications like discharge, cramping, nausea, vomiting, and signs of perforation that should be reported immediately.

There's nothing in that section about the risk that the procedure simply won't work. Elsewhere in the document, in a section titled "clinical observations," a table shows a 6. Or the pregnancy might occur in one of the fallopian tubes or cervix instead of the uterus. This is called an ectopic pregnancy. If you have an endometrial ablation, long-lasting or permanent birth control is advised to prevent pregnancy.

During radiofrequency ablation, a triangular ablation device uses radiofrequency energy to destroy the tissue lining the uterus. The lining is called the endometrium.

The ablation device is then removed from the uterus. The opening in your cervix may be made wider through a process called dilation. This allows room for the tools needed for the ablation to be inserted. Dilation of the cervix can happen with medicine or by inserting a series of rods that gradually get bigger.

Endometrial ablation procedures vary by the method used to remove or destroy the endometrium. Options include:. Ask your health care provider about when you can return to your usual activities, such as exercise, work and sex. During a follow-up visit, your provider can check your healing. It might take a few months to see the final results. But endometrial ablation often reduces the amount of blood lost during periods.

You may have lighter periods. Or you may stop having periods entirely. Endometrial ablation isn't a sterilization procedure.

You should continue to use birth control. Pregnancy might still be possible, but it will likely be dangerous to you and the baby. It may end in miscarriage. Permanent sterilization is also an option to avoid pregnancy after the procedure.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Overview Endometrial ablation is a surgery that destroys the lining of the uterus. Request an Appointment at Mayo Clinic. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry.

Radiofrequency ablation Open pop-up dialog box Close. Radiofrequency ablation During radiofrequency ablation, a triangular ablation device uses radiofrequency energy to destroy the tissue lining the uterus. By Mayo Clinic Staff. Share on: Facebook Twitter. Show references FAQs: Endometrial ablation. American College of Obstetricians and Gynecologists. Accessed Aug. Endometrial ablation for heavy menstrual bleeding. Food and Drug Administration. Munro MG. Endometrial ablation.