Trust awarded £250,000 government funding to launch pioneering endometriosis trial

University Hospitals of North Midlands (UHNM) has secured £250k to trial a dye-based technique in endometriosis surgery aimed at reducing pain and surgical complications.

The two-year ICE trial will compare the use of indocyanine green (ICG) dye with standard ureter stenting, aiming to better protect urinary structures during deep endometriosis procedures.

Funded by the NIHR Research for Patient Benefit Programme, the feasibility study will explore whether this method can improve outcomes, reduce complications, and support recovery.

Mr Gourab Misra, consultant gynaecologist at UHNM and chief investigator, said: “Surgery for deep endometriosis is complex and carries a risk of damaging the ureters, the delicate tubes connecting the kidneys to the bladder.

“Traditionally, surgeons use stents to identify and protect these structures, but these can cause significant pain, bleeding, and require a second procedure to remove.

“As a group of surgeons, we saw the challenges our patients faced and worked hard to design this proposal.

“Our aim is to minimise complications and improve the patient journey, reducing pain and morbidity associated with these complex procedures.”

Endometriosis is a condition where tissue similar to the womb lining grows outside the uterus, often causing chronic pelvic pain and infertility.

In severe cases, surgery may be required, which carries a risk of injuring the ureters—tubes that transport urine from the kidneys to the bladder.

Currently, surgeons often use plastic tubes called stents to protect the ureters during surgery.

These are typically left in for two to four weeks but can cause pain, blood in the urine and require removal through an additional procedure.

The new approach uses a small catheter to deliver ICG dye into the ureters, making them visible under a special light during surgery—potentially avoiding the need for stents.

The trial will recruit 70 patients across UHNM and Birmingham Women’s and Children’s NHS Foundation Trust, with participants randomly assigned to receive either the conventional stent method or the dye-based technique.

It will assess feasibility, including whether patients and surgeons are willing to participate, with the goal of informing a future full-scale trial that could lead to wider adoption across the NHS and internationally.

Professor Justin Clark, consultant gynaecologist leading the study at Birmingham Women’s and Children’s NHS Foundation Trust, said: “Deep endometriosis affects and causes significant pain adversely affecting quality of life.

“Whilst surgery is effective, it is highly complex.

“This trial uses a novel dye called ICG that identifies the ureters, which are pipes that transport urine from the kidney to the bladder.

“We hope that this study will show that using ICG can reduce complications, speed up surgery, and reduce pain following the operation, as well as enhance recovery.”