Management of uterine fibroids: opinions on interventions and the future of services in the United Kingdom-a pilot survey.

BACKGROUND

Uterine fibroids are the most common tumour of the female genital tract and represent a major cause of gynaecological morbidity. Management options have expanded in recent years, including minimally invasive surgical techniques and emerging medical and incisionless therapies. However, access to these treatments may vary geographically. This study aimed to explore current practice patterns, availability of interventions, and clinician perspectives on the future organisation of fibroid services in the United Kingdom.

METHODS

A pilot survey of UK gynaecologists was conducted using an online questionnaire developed by a focus group of clinicians with expertise in fibroid management. The survey assessed availability of treatment modalities, imaging preferences, surgical practices, and opinions on service organisation. The questionnaire was disseminated through the British Society for gynaecological endoscopy newsletter and at the society's 2024 annual scientific meeting. Responses were analysed using descriptive statistics.

RESULTS

Fifty UK-based clinicians were included in the analysis. Established surgical interventions, including abdominal, laparoscopic, and hysteroscopic myomectomy, were widely available. However, access to newer technologies varied between regions. Radiofrequency ablation was available in five of nine regions represented, while high-intensity focused ultrasound was not available to any respondents. Most clinicians reported access to MRI for fibroid mapping, although specialist ultrasound availability was more variable. Minimally invasive myomectomy was performed by 60% of respondents. The majority supported referral to specialised centres when local expertise was unavailable. Most respondents favoured multidisciplinary discussion for complex cases and supported a more centralised model of fibroid care.

CONCLUSION

This survey highlights variation in access to fibroid treatments across the UK and identifies support among clinicians for more structured and centralised fibroid services. These findings support the need for further national evaluation and service development to improve equitable access to comprehensive fibroid care.