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Heavy menstrual bleeding interferes with a woman's physical, social and emotional quality of life. The National Institute for Health and Clinical Excellence (NICE) guideline on heavy menstrual bleeding provides the most up-to- date evidence-based recommendations both on provision of care and the areas that need to be researched further. All health professionals undertaking surgical or radiological procedures to diagnose and treat heavy menstrual bleeding should demonstrate their technical and counselling competence, either during their training or during subsequent practice. Clinical governance policies should be able to monitor treatment complications, patient choice, patient satisfaction and uptake rate. Staff involvement in risk management exercises should be monitored to ensure that appropriate incident forms have been completed and that the staffs involved have received feedback. NICE has suggested several research recommendations in this important aspect of women's health.
The Royal College of Obstetricians and Gynaecologists (RCOG)'s clinical standards for urogynaecology have been jointly developed with the British Society of Urogynaecology (BSUG) to provide a framework that should ensure best and evidence-based practice. The initial assessment and management of women with urinary incontinence is detailed in the National Institute for Health and Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) guidelines and these are equally applicable to all pelvic floor disorders, including prolapse, anal and faecal incontinence, with a specific NICE guideline being available for the latter. Subspecialty training allows the development of more clinical, surgical, analytical and research skills and experience in all aspects of urogynaecology. Patient-reported outcomes are strongly recommended for assessing the success of treatments. Data can be collected confidentially through the BSUG surgical audit database for urinary incontinence and prolapse, which provides validated instruments to assess outcome.
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