Fibroids are non-cancerous tumours of the uterus (womb) that grow in 25% of the women, they can be as small as a few centimetres or grow very large. Many women with fibroids do not have any symptoms but as they grow, they may cause heavy menstrual bleeding, abdominal pain or discomfort, change in bladder and bowel habits, lump in abdomen and in some cases infertility.
What is the treatment for fibroids?
The conventional way to treat symptomatic or very large fibroids is to remove them surgically. This is done under anesthesia and removed through an abdominal incision where patients may require 5 - 7 days of hospitalization and adequate post-operative rest for recovery. Or they can be treated by laparoscopic myomectomy where recovery is faster and hospitalization for 1 day. Here a Laparoscope (telescope) is inserted through a tiny opening in the abdomen, two or three other small opening are made to insert instruments that can separate and remove the fibroids. This highly skilled surgery is done under general anesthesia and the patient needs to be in hospital for only a day: the latest treatment modality for management of fibroids is HIFU.
What is HIFU (High Intensity Focused Ultrasound)?
It is the only non invasive procedure to treat uterine fibroids. Ultrasound waves are high frequency sound waves that the human ear cannot hear. When they are focused, similar to how a magnifying glass focuses light waves, heating of tissue occurs, using this principle highly focused ultrasound waves are directed into the body and at the focal point the ultrasound waves raise the temperature of the fibroid tissue leading to its destruction. Continuous imaging of the target tissue during treatment helps to ensure a postive therapy outcome. This is non invasive out patient procedure to manage fibroid symptoms or prevent symptoms from starting.
What are the benefits of HIFU?
(1) It is an effective alternative to surgery and hormonal treatment.
(2) Completely non-invassive: no surgery, no anaesthesia and no blood loss, no hospital stay.
(3) Preserves the uterus and cervix.
(4) Significant improvement in the quality of life and quick return to normal activities.
What types of fibroids can be treated with the HIFU?
HIFU can be used for most type i.e. submucosal, subserosal, and intramural uterine fibroids. These are terms that are used to describe the location of the fibroids within the uterus. More than one fibroid can be treated. Fibroids in a location inaccessible by the focused ultrasound may not be treatable.
What is the treatment like?
The entire procedure takes place on a specialised treatment table where the doctor takes images to the uterus and the fibroid(s). Then these images are used to develop a treatment plan. When the treatment begins, a small beam of focused ultrasound is directed at the target for a short period of time and heats the tissue. Images are taken of the target tissue during the cycle. The system then moves to the next treatment point, and the process is repeated until the entire volume has been treated. HIFU is performed as an outpatient procedure without any anesthhesia and takes approximmately 30 minutes after which the patient can be sent home. The number of sittings varies according to the size of the fibroid.