Abstract The objective of the cohort study was to iden-tify clinical factors that influence the rate of further surgical intervention in women who had endometrial
ablation. Electronic databases and patient records were scrutinised to obtain examination, investigative and pro-cedural data considered to be potentially predictive of the need for further surgical intervention after endome-trial ablation in the office setting. A total of 391 con-secutive women were identified who received endome-trial ablation in the office setting between July 2005 and December 2012, with an average follow-up of 4.3 years. Univariable and multivariable logistic regressions were used to estimate the influence of these variables on prognosis. Factors predictive of further surgical treat-ment were dysmenorrhea (odds ratio [OR] 4.01; 95 % CI 1.63 to 9.91) and a uterine cavity length >9 cm (OR 2.65; 95 % CI 1.33 to 5.27). In conclusion, dysmenor-rhoea before treatment or a uterine cavity length >9 cm was associated with the need for further surgical inter-ventions after office endometrial ablation. These find-ings should help inform clinician and patient upon decision-making when considering treatment options for heavy menstrual bleeding