Medium-term clinical outcome of women with menorrhagia treated by rollerball endometrial ablation versus abdominal hysterectomy with conservation of at least one ovary

Background To compare patients' satisfaction, health related quality of Lif e, and sexual function among women who were either treated with rollerball endometrial ablation or abdominal hysterectomy with conservation of at leas t one ovary for the treatment of menorrhagia. Method. Between March 1992 to June 1997, 91 women underwent rollerball endo metrial ablation and 78 women had abdominal hysterectomy with preservation of at least one ovary for the treatment of intractable menorrhagia. Each wa s sent a detailed questionnaire at least 18 months (range 18-60) after surg ery. Case notes were reviewed to collect additional data relating to pre-op erative management and operative details. Results. Of 169 women, 120 (71%) returned a completed questionnaire [80/91 women (88%) had ablation and 40/78 women (51%) had hysterectomy]. Non-respo nse analysis did not reveal any differences in prognostic characteristics b etween responders and non-responders. The length of hospital stay and time taken to return Co normal dairy activity were significantly less in the abl ation group. Pre-menstrual symptoms improved over time but more so in the h ysterectomy group, who also rated their improvement in general health highe r. Women who had hysterectomy were more satisfied (100% versus 79%) and wou ld be more likely to recommend it to a friend (100% versus 91%). Conclusion. Both procedures are effective for the treatment of menorrhagia but hysterectomy is associated with better general health and fewer pre-men strual symptoms. Rollerball ablation is a useful alternative with many shor t term benefits and acceptable satisfaction rate. Further work is required to evaluate long term effects.