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Last Updated: Tuesday, 8 July, 2003, 10:27 GMT 11:27 UK
Hysterectomy alternatives backed
Surgery
Hysterectomy is usually a major surgery
State-of-the-art heat techniques that could prevent the need for a hysterectomy should be offered to all women who could benefit from them, say experts.

Many women who suffer from excessive blood loss during their period - a condition known as menorrhagia - are currently offered a hysterectomy.

But the surgical removal of the womb is major surgery, which carries a risk of complications, and, in a small number of cases, of dying. The recuperation period is also lengthy.

A large number of women could potentially benefit from this technique
Mr Ellis Downes
Doctors believe that many of these women could instead be treated by one of two techniques known as microwave endometrial ablation (MEA) and fluid-filled thermal balloon endometrial ablation (TBEA).

Not only do they appear to be much safer and faster treatments than a hysterectomy, their use would save the NHS many millions of pounds a year.

MEA uses heat from a microwave probe to remove or reduce the thickness of the lining of the womb.

TBEA is similar, but applies heat to the womb lining by using a heated liquid contained in a balloon.

Versions of the treatment have been available for some time, but have proved difficult to administer. Now more sophisticated technology has made them far easier for doctors to use.

Trials have produced impressive results. Almost every one of 600 women who had MEA reported that blood loss was significantly reduced, and said they were happy with the outcome.

Overall, blood loss was completed stemmed in 62% of cases.

Jacky Hill suffered from such heavy bleeding during her period that even simple tasks such as shopping were an ordeal.

However, MEA solved the problem in minutes under local anaesthetic.

She said: "There was a small amount of pain, but it was fine, and after a little rest I went home, had a paracetamol and went shopping at the local supermarket."

Preliminary guidance

microwave endometrial ablation
MEA is administered using a microwave probe
Now experts from the government's drugs advisory group, the National Institute for Clinical Excellence (NICE) have decided that both MEA and TBEA should be made available on the NHS to women who would benefit.

However, the guidance at this stage is preliminary, and NICE has stressed that no final decision has yet been taken.

In a statement, it said: "The consultation document does not suggest that microwave endometrial ablation should replace hysterectomy per se.

"It reflects the committee's thinking at that stage of the appraisal that this technology might be used alongside other surgical treatments for menorrhagia, including hysterectomy."

Mr Ellis Downes, a consultant gynaecologist at Chase Farm Hospital in North London described MEA as a "fantastic" advance.

He told BBC News Online that 60,000 women a year underwent hysterectomies and any technique that offered a safer alternative would be very welcome.

He said: "A large number of women could potentially benefit from this technique which has a low complication rate, and which is a day case procedure."

Mr Downes said ablation techniques were not suitable for all patients, for instance women with large fibroids or ovarian cysts.

But it could potentially benefit most women with normal sized uteruses.




WATCH AND LISTEN
The BBC's Fergus Walsh
"This gives hope to thousands of women"



SEE ALSO:
Womb ops higher in poorer women
14 May 02  |  Health
Many womb ops 'unnecessary'
20 Mar 02  |  Health
Wombs removed 'unnecessarily'
25 Feb 00  |  Health


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