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Monday, 12 February, 2001, 13:06 GMT
Many hysterectomies 'unnecessary'
Hysterectomy is a major operation
Doctors may be too ready to perform a hysterectomy on women with a common gynaecological problem, experts say.

One third of the 70,000 hysterectomies (womb removals) performed on the NHS each year are carried out on women who have fibroids.

However, a report from the Royal College of Radiologists and the Royal College of Obstetricians and Gynaecologists says that it might be possible to offer many of these women a less radical form of treatment.

The alternative is a process called Uterine Artery Embolisation (UAE) in which the fibroids are starved of their blood supply by blocking the supplying arteries with small particles.

It is important that women are offered the widest range of treatment options

Dr Tony Nicholson, Hull Royal Infirmary
More than 7,000 UAE procedures treating fibroids have been undertaken since 1991 and several studies have shown a success rate of up to 91%.

As well as removing the chance for a women to have children, hysterectomy is a lengthy operation involving pain and often significant blood loss. It is also more likely to lead to illness than UAE.


Dr Tony Nicholson, an interventional radiologist from Hull Royal Infirmary, said: "It is important that women are offered the widest range of treatment options.

"This treatment offers a less invasive alternative and could significantly reduce the number of hysterectomies performed each year."

A report from the two royal colleges says that a database should be established to record the results of UAE treatment.

Some doctors are concerned that UAE carries a risk of infection.

However, the report says that published research suggests that infection is found in only two out of every 100 cases.

A spokeswoman for the Royal College of Obstetricians and Gynaecologists echoed Dr Nicholson's view.

However, she added: "It is still early days. We need to closely monitor the use of this procedure and the long-term outcomes on patients before it can become widely available to women."

Simpler surgery

UAE is carried out under local anaesthetic. A needle is inserted into the main artery in the groin and a guide wire placed through it into the artery.

The needle is withdrawn and a catheter is placed over the wire.

A coloured substance is injected down the catheter to identify the main blood supply to the fibroid.

Once the radiologist has located the blood supply they can inject fluid containing thousands of tiny particles into the artery.

These particles silt up the small blood vessels and block them, starving the fibroid of its blood supply.

Fibroids are non-cancerous growths found in or attached to the uterus.

Smaller fibroids do not tend to cause problems and can remain undetected until they become larger when they can cause abdominal pain, and pain during intercourse.

Occasionally, they can cause fertility problems such as recurrent miscarriage.

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See also:

06 Oct 00 | Health
Damages for surgery nightmare
25 Feb 00 | Health
Wombs removed 'unnecessarily'
24 Nov 99 | Health
Hysterectomy 'may improve sex'
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