Endometriosis is a disorder in which tissue that normally lines the inside of the uterus (the endometrium) grows outside of the uterus. This endometrial tissue can grow into the ovaries, bowel or other tissue which lines the female pelvis. Endometriosis can cause severe pain, particularly during menstruation and also during intercourse.
One of the methods of treating endometriosis is endometrial ablation. This procedure attempts to destroy the lining of the uterus (the endometrium) in an effort to alleviate the patient’s symptoms. One method of endometrial ablation is using heat to destroy endometrial tissue. This is called hydrothermal ablation.
Currently, this office represents a young woman who underwent a hydrothermal ablation. This procedure is performed by introducing a solution heated to a temperature of 190 degrees Fahrenheit into the uterus. The theory is that such a hot solution will ablate or destroy the endometrial lining of the uterus and, in general, this can be a very successful procedure. However, during the course of this procedure it is extraordinarily important that the physician does not permit the heated solution to leak from the uterus since such a hot solution can burn the patient’s cervix, vagina and other surrounding tissue.
In our case, at approximately seven (7) minutes into the procedure it was noted that water was leaking out of the uterus. This occurred because the gynecologist failed to achieve a good seal to prevent fluid from escaping the uterine cavity. In addition, rather than set the machine on retrograde flow (the process removing the fluid from the uterus), the physician simply began to cool the hot fluid down while still within the patient’s uterus. Regrettably the fluid continued to leak while its temperature was sufficiently hot to cause extensive damage to the surrounding tissue. As a result of the leak, the patient suffered third degree burns to her cervix, vagina, perineum, buttocks and to her lower back.
Moreover, rather than treat these burns when they occurred, the patient was sent home without any treatment. The standard of care dictated that the physician flush the area with cold water and cleanse the entire area with antibiotic cream and silver sulfadiazine cream. The patient should also have been admitted to the hospital for the application of cold compresses and burn therapy. As a result of the physician’s failure to properly treat these burns, they clearly ended up being far worse than they would have been with proper treatment.
If you or any member of your family or friends are contemplating hydrothermal ablation, you should assure yourself that the physician who is performing the procedure is not only knowledgeable about the performance of the procedure, but is also knowledgeable about how to handle and treat burns which can occur as a result of the procedure.