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I have a cousin with heavy problems of her reproductive system. She got endometrial ablation as first advance in the surgical treatment of menorrhagia, since hysterectomy. She said she is worried since she has heard worrying fact. Someone told her that delayed complications include infection, the post-ligation and post-ablation syndrome. I wonder if you could tell us anything about it, if ablation could be an alternative to tubal ligation.

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That is exactly as she has heard, that delayed complications of ablation include infection, and post ligation syndrome. She might also experience and cervical stenosis and finally failure of the procedure. The post-ligation post-ablation syndrome occurs when a patient has had a tubal ligation and then undergoes endometrial ablation. Rarely, bleeding will return in either uterine cornua, or the interstitial portion or the tube. It could also flow retrograde into the blocked tube. This ablation as alternative to tubal ligation results in distention and severe cyclical pain involving lower quadrant. Visualization of the tube at laparoscopy shows a distended discolored tube. It is similar in appearance to an ectopic pregnancy, which is what her gynecologist might see. Therapy she might undergo is aimed at removing the fallopian tube, generally laparoscopically. This syndrome is quite rare and you should know that tubal ligation should not be considered a contraindication to endometrial ablation. Rather, this syndrome should be kept in mind in the patient presenting often months after the ablation with severe pain in her lower quadrant.
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