Current evidence on uterine artery embolisation for treating adenomyosis shows that the procedure is efficacious for symptom relief in the short and medium term for a substantial proportion of patients. There are no major safety concerns. Therefore, this procedure may be used provided that normal arrangements are in place for clinical governance, consent and audit.
During the consent process patients should be informed, in particular, that symptoms may not be relieved, that symptoms may return and that further procedures may be needed. Patients contemplating pregnancy should be informed that the effects of the procedure on fertility are uncertain.
Patient selection should be carried out by a multidisciplinary team, including a gynaecologist and an interventional radiologist.
NICE encourages further research into the effects of uterine artery embolisation compared with other procedures to treat adenomyosis, particularly for patients wishing to maintain or improve their fertility.