Specifically, what symptoms are you having, then and now?
Are you saying you don't get your period at all anymore?
Were you diagnosed with endometriosis or any other pelvic/reproductive disorder?
Also, how old are you?
The endometrium is the living lining on the inside of the uterus that produces, stores and builds up blood and nutrients that would be needed in the event that an egg is fertilized and implanted in the uterus.
Under the right circumstances (and assuming the procedure was successful), endometrial ablation is not something that can be reversed, as the endometrium, or lining of the uterus, is usually destroyed during the procedure (for the most part) and replaced with scar tissue. This scar tissue does not allow regrowth of the endometrium, even when taking medication to thicken the uterine lining. However, it is sometimes possible for some areas of the lining to regrow due to tissue being left over from an incomplete ablation, or a condition known as adenomyosis, where the endometrium lining has grown into the walls of the uterus (in which case, an ablation would not be effective for curing heavy bleeding). You can read more about adenomyosis here: http://www.heavybleeding.com/adenomyosis.htm.
A D and C procedure may be useful for removing any pieces of endometrium that have regrown, but can't remove scar tissue, and isn't likely going to be a permanent solution to your problem. Despite what your surgeon is suggesting, it seems as though his ablation was not successful if your uterus has thickened after ablation. Many young women have to undergo repeat ablations in this case, preferably after taking a course of gonadotropin-releasing hormone analogues to thin the lining of the uterus.
Other than a repeat ablation, your options to treat severe bleeding and associated fatigue are:
A laparoscopy and/or and imaging studies are advised to see if endometriosis and/or adenomyosis are the reasons your ablation failed, and whether a repeat procedure is indicated here. From the description of the pressure, you may also be having a secondary problem, such as uterine prolapse or fibroids, that is causing this sensation, and would need to be evaluated and treated for this as well.
You can read more about heavy bleeding and treatment options at these sites:
I hope this helps!
Under normal circumstances, the endometrium can't grow back, as the purpose of an ablation was to detroy the lining permanently. When the cells that produce the lining of the uterus are destroyed, there's really nothing you can do to reverse this. As I mentioned above however, the endomentrium does occasionally grow back after an ablation in some cases, but only as a complication when:
And I believe it's fairly certain, with what you've told me, that one of the above has occured in your case, so further treatment is necessary to correct this.
Also, and ablation can result in a lot of scar tissue on the uterus that will cause pain. You can have some of this scar tissue removed with a simple laparoscopy (not a D&C), and this will probably help reduce pain, but removing scar tissue doesn't bring back that healthy endometrium that was destroyed from the ablation. Yes, if some tissue was left behind inadvertently after your ablation (and this seems to be the case), some of it is going to grow back, but this will require another ablation, and not a D&C procedure.
A D&C is a simple superficial scraping of the contents of the uterus. Removing endometrial tissue with a D&C procedure is just like mowing your lawn... you're not removing any of the cells that produce the thick endometrium, but just some of the extra thickness and the blood so that, when you do menstruate, it's not as heavy. And like mowing the lawn, it's going to grow right back after the procedure. D&C is only a very temporary solution to heavy bleeding problems, and is usually only done when bleeding needs to be controlled, but when the woman is still planning to have children in the future (the endometrial lining is crucial for nourishing a pregnancy, of course). Sure, you can always have a D&C to control heavy bleeding, but unless you have a successful ablation, you're going to have to get repeated D&Cs every few months or so to keep this problem under control. On the other hand, when successful, an ablation is more like a permanent D&C... you're not just "trimming the grass," so to speak, but removing the roots and seeds of all the grass on the lawn so that it can never grow back and cause an overgrowth again.
Your treatment needs to be as follows:
Aside from this, your only other treatment options are going to be medications, which will control the symptoms, but not cure the problem, or a hysterectomy.
I hope this helps, and feel free to ask any more questions you may have.