The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Uterine Artery Embolisation for treating adenomyosis, in December, 2013.
Adenomyosis is a benign condition characterised by the presence of ectopic endometrial glands and stroma within the myometrium. It frequently occurs coincidentally with fibroids. Adenomyosis may cause no symptoms but some women with adenomyosis experience heavy, prolonged menstrual bleeding with severe cramps, pelvic pain and discomfort.
Treatment for symptomatic adenomyosis includes anti-inflammatory medications, hormone therapy and endometrial ablation. For severe symptoms that do not respond adequately, hysterectomy has been the conventional surgical treatment. Uterine artery embolisation may be an alternative option for women who do not wish to have hysterectomy and/or who wish to preserve their fertility.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.