(No change) Severe anaemia, unresponsive to transfusion or other treatment The Mirena® device is effective in whilst a Mirena trial is in progress the treatment of menorrhagia and Genital malignancy or active trophoblastic disease are rare causes is considerably cheaper than a of menorrhagia hysterectomy, even if required for many years (for contraception NICE Guidance costs estimated at £207 including consultation; removal cost £26). Other effective conservative treatments are available as second line treatment after failure of Mirena or where Mirena is indicated A Cochrane systemic review showed that the Mirena® coil improved the quality of life of women with menorrhagia as effectively as hysterectomy. MRI guided ultrasound WELC CCGs do not routinely fund MRgFUS for uterine fibroids for: There is a routinely funded (MRgFUS) for uterine surgical option (uterine artery fibroids embolisation) for women with fertility preservation because of lack of evidence of effectiveness symptomatic fibroids who wish to avoid relief of symptoms because other, equally effective, better (No change) surgery. established interventions are available. cysts Significant infection and/or rapid growth causing significant pain that is Bartholin’s unresolved by non-surgical treatment. (No change) Non-medical Non-medical circumcision is not routinely funded. Circumcision is funded for medical circumcision indications, including: A service for boys aged between 6 weeks and 5 months is available at (No change) a cost to the parent or guardian of the patient. Patients must be phimosis seriously interfering with resident in either Tower Hamlets, City & Hackney or Newham and urine flow and/or associated with registered with a local GP. recurrent infection
(No change) Severe anaemia, unresponsive to transfusion or other treatment whilst a Mirena trial is in progress Genital malignancy or active trophoblastic disease are rare causes of menorrhagia NICE Guidance The Mirena® device is effective in the treatment of menorrhagia and is considerably cheaper than a hysterectomy, even if required for many years (for contraception costs estimated at £207 including consultation; removal cost £26). Other effective conservative treatments are available as second line treatment after failure of Mirena or where Mirena is A Cochrane systemic review showed that the Mirena® coil improved the quality of life of women with menorrhagia as effectively as hysterectomy. MRI guided ultrasound (MRgFUS) for uterine fibroids (No change) WELC CCGs do not routinely fund MRgFUS for uterine fibroids for: fertility preservation because of lack of evidence of effectiveness relief of symptoms because other, equally effective, better established interventions are available. There is a routinely funded option (uterine artery embolisation) for women with symptomatic fibroids who wish to avoid surgery. Bartholin’s cysts (No change) Significant infection and/or rapid growth causing significant pain that is unresolved by non-surgical treatment. Non-medical circumcision (No change) Non-medical circumcision is not routinely funded. A service for boys aged between 6 weeks and 5 months is available at a cost to the parent or guardian of the patient. Patients must be resident in either Tower Hamlets, City & Hackney or Newham and registered with a local GP. Circumcision is funded for medical indications, including: phimosis seriously interfering with urine flow and/or associated with recurrent infection surgical indicated