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Thu 1 Feb 2007 12:00 AM

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UAE fibroid care “substandard”, claims UK gynaecologist

A visiting UK consultant has called for UAE gynaecologists to broaden their skills base, after finding hysterectomy still offered as a first-line treatment for patients with submucous fibroids.

A visiting UK consultant has called for UAE gynaecologists to broaden their skills base, after finding hysterectomy still offered as a first-line treatment for patients with submucous fibroids.

Dr Martin Farrugia, a consultant obstetrician and gynaecologist at East Kent NHS Trust, expressed his concern over patients receiving “substandard” treatment at hospitals, and called for improved cross-referrals between hospitals to encourage best practice.

“In the UAE, in severe cases a hysterectomy is offered, but in less severe cases, the fibroids tend to be left there and the patient is infertile and stays infertile or suffers recurrent miscarriages or has pain,” he said. “The patient often refuses to have a hysterectomy, especially if she is young, and therefore the problem persists.”

Dr Farrugia, who is also a preceptor for the Royal College of Obstetricians and Gynaecologists, holds regular training modules at Welcare Hospital, Dubai, for local gynaecologists to promote the hysteroscopic resection of submucous fibroids, a procedure he calls “fertility sparing”. However, he adds, to date, no hospital has committed to independently offering the procedure to patients.

“Unfortunately the resection of fibroids is skill-related, so there has to be a certain amount of training, and a minimum of equipment required to carry out these procedures safely,” he said. “In most hospitals here you cannot find this equipment or the expertise to use it.

“Although we have been to various hospitals in the UAE, to date nobody has seemed to want to pick this up and carry it further.”

Dr Farrugia is keen to establish a regional gynaecologist as a referral point for resection, adding that few other techniques are as effective in resolving submucous fibroids.

“Essentially, I have been trying to establish a contact person in the UAE,” he said.

“It would be ideal to have someone who could do this regularly, but what tends to happen is that most doctors, not having someone they can refer to immediately, means that the patient tends to be treated in an alternative, dare I say, substandard way.

“The patients are offered a hysterectomy and they refuse and move on.”

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