The objective was to assess the feasibility, acceptability, efficacy and safety of outpatient microwave endometrial ablation (MEA) under local anaesthesia in the treatment of therapy-resistant menorrhagia. This was carried out as a prospective observational study with a follow-up postal questionnaire at the Royal United Hospital Bath, NHS Trust, Bath, UK. For the study, 117 selected women fulfilled the selection criteria with a mean age of 42.4 years (range 29-53 years), referred because of uncontrolled menorrhagia. They were recruited between April 2000 and March 2003. Preoperative evaluation included history taking, physical examination and ultrasound scanning. Follow-up was by specially designed home postal questionnaire, which was mailed to all women 3 to 6 months after surgery. The acceptability of MEA under local anaesthesia, efficacy in changing the menstrual pattern and operative and postoperative complications were measured. For a total of 117 women, 116 procedures were successfully performed under local anaesthesia. One procedure was abandoned. There were no intraoperative or postoperative complications. The procedure was well tolerated. The menstrual satisfaction rate was 89.5%. The percentage of women reporting amenorrhoea was 41.2%. All other measures of pain were improved. Five women requested a repeat MEA, and 12 women underwent hysterectomy following MEA. In conclusion, MEA is a feasible, safe, easy and effective outpatient method of endometrial ablation in women suffering from therapy-resistant menorrhagia. Outpatient MEA is accepted and tolerated by patients. It has a place in current modern practice in treating menorrhagia.

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