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NICE Guidelines

NICE Guidelines on 'Heavy Menstrual Bleeding' - January 2007, state that women with symptomatic fibroids >3cm requiring treatment MUST be offered fibroid embolisation, myomectomy and hysterectomy. It also states that healthy ovaries should not be removed prophylactically. However, to this day many women are given no alternative to hysterectomy and end up having a much more invasive treatment than they wanted, which is very expensive to them and their families or they contact us. NICE have kindly allowed us to reproduce their care pathway here.

NICE HMB Care Pathway

NICE Interventional Procedures Reviews review the safety and effectiveness of interventional procedures such as UAE, new surgical techniques etc. In the first such review of UAE in 2004 NICE concluded that UAE was safe enough for routine treatment in hospitals, but as it was a new technique a registry should be set up to review the results.  This was done by the British Society of Interventional Radiologists.  Here is the first report.

The second NICE Interventional Procedures Review of UAE published in November 2010 states -

1.1 Current evidence on uterine artery embolisation (UAE) for fibroids shows that the procedure is efficacious for symptom relief in the short and medium term for a substantial proportion of patients. There are no major safety concerns. Therefore this procedure may be used provided that normal arrangements are in place for clinical governance and audit.

Uterine artery/fibroid embolisation (UAE/UFE) is an interventional radiology technique. Recovery is much quicker than hysterectomy (return to work 1-5 weeks compared with 2-3 months), much less invasive with fewer long term side effects and lower morbidity and mortality. It requires an overnight hospital stay and no general anaesthetic. [1]-[31],[60],[65],[68] - see comparison chart.