Women in York now have access to a new treatment for fibroids, thanks mainly to the determination of one woman. JO HAYWOOD reports on Fiona Buckton's battle against unnecessary hysterectomies

When Fiona Buckton was told she would have to have a hysterectomy at York District Hospital, she was horrified. The prospect of undergoing such a major operation, with all its physical and psychological connotations, was a serious blow.

But her horror was further compounded when she realised that a less invasive technique for solving her fibroids problem was available - just not in York.

Her gynaecologist told her that uterine artery embolisation (UAE) - a procedure that lasts less than 90 minutes and leaves just a 2mm puncture mark in the groin - was available at Hull Royal Infirmary.

"I was lucky because I had private health insurance," she says.

"Otherwise it would have cost £2,500."

She had the UAE treatment in Hull in April 1999. After one night in hospital and just two weeks off work from her job as a solicitor at Munby & Scott in Blake Street, York, Fiona felt fighting fit again.

So fit in fact that she felt ready to take on the health authorities to ensure that UAE was made available on the NHS in York.

"I was very angry that other women didn't have access to this treatment; that they were, in effect, having unnecessary hysterectomies," she says.

In August 1999 she wrote to York MP Hugh Bayley to ask if he could aid her lobbying campaign. He immediately got on board, button-holing the relevant health ministers, local health authorities and the Royal College of Gynaecologists to press for UAE to be made available on the NHS.

Three years later, with his help and support, Fiona has finally won.

"Selby and York Primary Care Trust has confirmed that it is now offering UAE at York District Hospital," she says.

"I am very grateful that justice has been done.

"My skills as a lawyer have certainly helped in terms of lobbying. I am also very persistent - although I'm sure some people think I should just go out an get a life."

Mr Bayley was also buoyed by her victory.

"No woman would want to have a hysterectomy and this operation provides an alternative," he said. "It is a big step forward. The woman does not have to spend anything like as long off work and she can still have children if she wants to.

"I'm very pleased the treatment is now available in York."

The procedure works by reducing the blood supply to the womb, effectively starving the fibroids - benign growths in the smooth muscle of the womb - to death.

A catheter is inserted through the femoral artery in the groin up into the uterine artery. Small particles are then injected in to silt up the blood supply to the uterus or womb.

After the procedure, which can last between 40 minutes and an hour and a half, the patient can experience quite severe pain as the fibroid shrinks, but the hospital pain team are on hand to give pain-relieving medication and instructions on how to administer it at home.

Doctors try to ensure that the ovaries are not damaged during the procedure, although there is a possibility that the tiny particles used to silt up the blood can affect them, causing premature menopause.

But that, according to Dr Tony Bowker, consultant radiologist and clinical director of radiology at York District Hospital, is a very small possibility.

He is part of the team now offering UAE at the hospital.

"In appropriate situations," he says, "I am perfectly convinced that it is a very effective method of treating fibroids. There is a lot of evidence out there to suggest that that is the case."

The battle might be over for Fiona Buckton, but now she has a war to win. Not satisfied with achieving her goal here in York, she is now lobbying to ensure that UAE is available on the NHS to women across the country.

"I have already lobbied every single one of the 47 or so members of the relevant Department of Health committee and they are now funding an assembling of statistics in respect of all of the UAE procedures carried out to date in the UK," she says.

"This should provide the necessary safety and efficacy evidence to enable UAE to be offered as a matter of course to women throughout the country who have fibroids and are eligible for the procedure."

If nothing else, using UAE instead of carrying out a full hysterectomy saves the NHS a lot of time and money.

"A hysterectomy is a serious operation involving a four-night stay in hospital and three months off work," says Fiona. "UAE is minimally invasive, involves one night in hospital and a maximum of two weeks off work. Approximately 23,000 women in the UK have a hysterectomy as the result of fibroids each year. The cost of a hysterectomy to the NHS is about £1,750. The cost of UAE is £600."

In March next year she will be travelling to London to talk to a joint conference of the British Institute of Radiologists and the Royal College of Gynaecologists aimed at raising awareness about UAE among the professions.

One thing is certain: if they don't know about the procedure now, they soon will.

Fiona will make sure of that.

Updated: 09:05 Monday, September 30, 2002