HEALTH: Hysterectomy or Endometrial AbLation Trial for Heavy menstrual bleeding. A multicentre randomised controlled trial comparing laparoscopic supra-cervical hysterectomy with second generation endometrial ablation trial for the treatment of heavy menstrual bleeding
One woman in five in the UK experiences HMB, which can have a major impact on her quality of life. It is the fourth most common reason for women to attend gynaecology outpatient clinics and accounts for 20% of all gynaecology outpatient referrals. The NICE guideline on HMB recommends EA as well as hysterectomy as options for women with HMB. However, up to a quarter of women who undergo EA require subsequent gynaecological surgery and despite the demonstrated clinical and cost-effectiveness of hysterectomy, concerns remain about its invasiveness and the risks of short- and long-term morbidity associated with the procedure.
Unlike conventional hysterectomy, the more recent approach of laparoscopic supra-cervical hysterectomy (LASH) is minimally invasive, quick, relatively easy to learn and associated with low morbidity, short hospital stay (under 24 hours) and rapid recovery time. HEALTH is a multicentre randomised controlled trial (RCT) comparing LASH with second-generation EA (the current first line surgical treatment for HMB).
The Centre for Healthcare Randomised Trials (CHART) project site.
The trial is registered at the ISRCTN Registry: ISRCTN49013893
HERU researchers involved in this research project: Graham Scotland
External collaborators: S Bhattacharya (Other Applied Health Sciences, University of Aberdeen) K Cooper (NHS Grampian); J Clark (Birmingham Women’s Hospital); J Hawe (Countess of Chester NHS Foundation Trust); K Phillips (Hull and East Yorkshire Hospitals NHS Trust); R Hawthorne (NHS Greater Glasgow and Clyde); J Norrie and J Cook (HSRU, University of Aberdeen)
Cooper, K., McCormack, K., Breeman, S., Wood, J., Scott, N.W., Clark, J., Hawe, J., Hawthorn, R., Phillips, K., Hyde, A., McDonald, A., Forrest, M., Wileman, S., Scotland, G., Norrie, J. and Bhattacharya, S. (2018) 'HEALTH: laparoscopic supracervical hysterectomy versus second-generation endometrial ablation for the treatment of heavy menstrual bleeding: study protocol for a randomised controlled trial', Trials, 19(1), 63.
Bhattacharya, S., Scotland, G., McCormack, K., Scott, N., Hawthorn, R., Hawe, J., Phillips, K., Norrie, J., Cooper, K. and Clark, J. (2018) A multicentre randomised controlled trial comparing laparoscopic supra-cervical hysterectomy with second generation endometrial ablation for the treatment of heavy menstrual bleeding (HEALTH). Final project report to National Institute for Health Research (NIHR) Health Technology Assessment Programme (Project Number 12/35/23).
Cooper, K., Breeman, S., Scott, N.W., Scotland, G., Clark, J., Hawe, J., Hawthorn, R., Phillips, K., MacLennan, G., Wileman, S., McCormack, K., Hernández, R., Norrie, J. and Bhattacharya, S. (2019) 'Laparoscopic supracervical hysterectomy versus endometrial ablation for women with heavy menstrual bleeding (HEALTH): a parallel-group, open-label, randomised controlled trial', The Lancet, 394(10207), 1425-1436.
Cooper, K., Breeman, S., Scott, N.W., Scotland, G., Hernández, R., Clark, T.J., Hawe, J., Hawthorn, R., Phillips, K., Wileman, S., McCormack, K., Norrie, J. and Bhattacharya, S. (2019) 'Laparoscopic supracervical hysterectomy compared with second-generation endometrial ablation for heavy menstrual bleeding: the HEALTH RCT', Health Technology Assessment, 23(53).