Medium-term follow-up of women with menorrhagia treated by rollerball endometrial ablation

Background To assess medium-term efficacy of rollerball endometrial ablatio n in a district general hospital. Method From March 1992 to June 1997, 91 women underwent rollerball endometr ial ablation for uncontrolled menorrhagia unresponsive to medical treatment . Each was sent a detailed questionnaire after at least 18 months (range 18 -55). There was an overall response rate of 88% (80/91). Case notes were re viewed to collect additional data related to pre-operative management and a ctual operative procedure. The main outcome measures included treatment sat isfaction, relief of symptoms, improvement in health related quality of lif e, at least 18 months after surgery. Results: Thirty-five of the 80 women (44%) had achieved amenorrhea. Ten wom en required further treatment; of these seven had a hysterectomy (9%). None of the non-responders had a hysterectomy. Following rollerball endometrial ablation, many women reported improvement in cyclical pelvic pain (73%), p re-menstrual symptoms (65%), ability to do housework (85%), and an improved sexual life (96%). Seventy-nine (99%) women were able to return to normal work within 4 weeks following surgery. The majority of them remained satisf ied with treatment (79%) and they would recommend it to a friend (91%). Conclusions. Rollerball endometrial ablation is a simple, effective, and ac ceptable procedure for the treatment of menorrhagia in selected cases. Long er-term follow up is still needed to establish the ultimate effectiveness o f the procedure.