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ObjectiveTo prospectively evaluate the intraoperative outcomes and longitudinally assess, by means of 6-monthly questionnaires, the long-term menstrual symptom relief and satisfaction rates in women with dysfunctional uterine bleeding (DUB) who were treated exclusively by rollerball endometrial ablation (REA). DesignA prospective study. SettingGynaecology Minimal Access Unit of a large teaching hospital. MethodsAll women undergoing REA between July 1993 and March 1997 (n = 130) were followed up by postal questionnaires approximately every 6 months. Main outcome measuresOperative details and complications, relief of menstrual symptoms, need for further surgical treatment and satisfaction rates. ResultsMean age at operation was 40.5 years (95% confidence interval (CI) 39.2–41.7). Mean operation time was 18.4 min (95% CI 16.8–20.3) and mean fluid deficit 142 ml (95% CI 104–180). Of the patients 87% were treated as day cases. For the 6-month periods up to 42 months of follow up, the mean satisfaction rate for women with amenorrhoea, brown discharge or substantially lighter periods was 97% (95% CI 93–100) and the mean rate for women who had complete resolution or less dysmenorrhoea was 90% (95% CI 85–91). An average of 96% (95% CI 91–100) of women were either very satisfied or satisfied with the operation. Four (3.3%) women required repeated REA. There were no differences between each 6-month period for menstrual status, pain and satisfaction rates. Response rate for all questionnaires was 95%. A total of 25 (19.2%) women underwent hysterectomy; five (3.8%) at the time of REA for perforation of uterus, 16 (12.3%) for persistent menorrhagia mainly because of adenomyosis or unsuspected fibroids (mean time after REA 13.3 months; 95% CI 8.8–17.8) and four (3.1%) for other unrelated reasons. Life-table analysis suggests a 17% hysterectomy rate after excluding cases of hysterectomy for other reasons. ConclusionsREA is a... [ABSTRACT FROM AUTHOR]