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

Ghada S. A. El Senoun, H. Mousa, Tahir Mahmood
In: Acta Obstetricia et Gynecologica Scandinavica · 2000 · vol. 79(10) , pp. 879–883 · doi:10.1034/j.1600-0412.2000.079010879.x · PMID:11304973 · W2166016553
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Rollerball endometrial ablation provided symptom relief, improved quality of life, and high patient satisfaction for women with menorrhagia, with 44% achieving amenorrhea and 9% requiring hysterectomy at medium-term follow-up.

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Abstract

BACKGROUND: To assess medium-term efficacy of rollerball endometrial ablation in a district general hospital. METHOD: From March 1992 to June 1997, 91 women underwent rollerball endometrial 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 reviewed to collect additional data related to pre-operative management and actual operative procedure. The main outcome measures included treatment satisfaction, relief of symptoms, improvement in health related quality of life, at least 18 months after surgery. RESULTS: Thirty-five of the 80 women (44%) had achieved amenorrhea. Ten women 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%), pre-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 satisfied with treatment (79%) and they would recommend it to a friend (91%). CONCLUSIONS: Rollerball endometrial ablation is a simple, effective, and acceptable procedure for the treatment of menorrhagia in selected cases. Longer-term follow up is still needed to establish the ultimate effectiveness of the procedure.

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