New research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme suggests that Uterine Artery Embolisation (UAE) may provide a useful alternative to hysterectomy for the removal of fibroids. This condition can cause heavy painful periods and impair both urinary and reproductive functions. Currently, the standard treatment for fibroids is hysterectomy, the surgical removal of the womb. UAE is a less invasive alternative to hysterectomy and offers women the possibility of remaining fertile, by reducing the size of fibroids and encouraging the symptoms to disappear. The treatment also reduces their hospital stay and recuperation time is much shorter. Previous research has shown UAE to be effective over a 12 month period, however there is no evidence on its long term effectiveness.

Professor Klim McPherson at the University of Oxford led the research team who recruited around 1700 women from 20 collaborating hospitals over eight years to evaluate the safety, plus the clinical and cost-effectiveness of UAE compared with hysterectomy. The research team examined participants' hospital records and conducted a follow-up questionnaire looking at complication rates, patient satisfaction, fibroid shrinkage, aftercare treatment and the number of pregnancies following the treatment with UAE. Professor McPherson stated, "Written comments from the patients some time after the procedure (hysterectomy or UAE) were analysed in detail to understand their perception of the complex balance necessary to make an informed choice between invasive surgery, which solves the immediate problem, and embolisation which may not."

The research team concluded that UAE is a safe and effective alternative treatment for fibroids. They found that complications are less common for UAE than hysterectomy, particularly those which are deemed severe or major. From the economic analysis the researchers suggest that UAE would be a cost-effective treatment for women who would like to retain fertility or to prevent early onset of menopause.

"Hysterectomy is a very invasive technique and so it is important that research is conducted into alternative treatments," says Professor McPherson. "Our research suggests that UAE is a clinically and cost-effective treatment for fibroids providing clinicians and patients with the evidence to make more informed choices, resulting in a healthier female population and better use of NHS resources."

The report published in Health Technol Assess 2008; Vol. 12:5 to view and download the full report visit: hta.ac/1382

1. The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the Technology Assessment journal, with over 400 issues published to date. The journal's 2006 Impact Factor (5.29) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, hta.ac. The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

2. The National Institute for Health Research provides the frame work through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. nihr.ac

University of Southampton

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