Endometrial ablation destroys the endometrial lining to a varying extent (depending on technique and skill). There are numerous different techniques to achieve endometrial ablation that lead essentially to the same end result. These techniques include hot water balloons, cryo-ablation (freezing the endometrium), laser ablation, roller ball cautery, and electric loop resection of the endometrium.
These procedures are quite effective for the treatment of true functional uterine bleeding (bleeding due to hormonal imbalance without the presence of any anatomical abnormality), but in the presence of sub-mucous fibroids, endometrial ablation usually fails (unless effective myomectomy is also performed at the same time). Ablation also fails when the bleeding is caused by deep adenomyosis. Unfortunately, failure to recognize the presence of adenomyosis is a frequent occurrence