Postablation Tubal Sterilization Syndrome

Postablation tubal sterilization syndrome is cyclic pelvic pain with or without vaginal bleeding seen women with tubal sterilization following endometrial ablation.

It is thought that after endometrial ablation, retained or regenerating endometrium at the cornua continues to cyclically produce menstrual blood, which gets trapped by endometrial synechia caused by ablation. The retained blood can reflux into the blocked fallopian tubes and cause hematosalpinx.

These ultrasound images show complex material within the endometrial cavity, consistent with retained blood. There is a dilated tube-like structure (better appreciated on real-time imaging) in the left adnexal region, consistent with hematosalpinx.

Reference

Huang SY, et al. Postablation tubal sterilization syndrome. Taiwan J Obstet Gynecol. 2008 Mar;47(1):120-2. (PDF)