Adenomyosis following endometrial rollerball ablation

Two cases of adenomyosis following endometrial ablation using a rollerball electrode are reported. In both patients the endometrial ablation was performed for severe menorrhagia in the absence of uterine pathology. The endometrium was not prepared. After the operation, the women had persistent light menstruation for 7 to 9 months which then became heavy. They also developed progressive dysmenorrhoea and uterine enlargement. Abdominal hysterectomy was subsequently performed and adenomyosis was confirmed on histological examination. Prior endometrial preparation with hormone therapy may reduce the risk of incomplete destruction of the endometrium and therefore reduce the risk of postablation adenomyosis.