Hifu technology - a solution that mitigates the risk women may face in the treatments of fibroid and adenomysis

September 22, 2021
Mahkota Medical Centre became the first medical facility in the country to introduce the high-intensity focused ultrasound (HIFU) technology, for the treatment of uterine fibroids and adenomyosis. With the establishment of this HIFU technology, Mahkota Medical Centre is changing the treatment landscape for women nationwide, offering a non-invasive, cutting-edge treatment option with clinically proven positive outcomes, that also preserves their fertility.
 
Uterine fibroids and adenomyosis are two common benign gynaecological tumours that deteriorate women’s quality of life during their reproductive years. Although both tumours are found in the uterus, they are very different gynaecological conditions. Fibroids are benign muscular tumours that grow in the uterine wall, whereas adenomyosis is a condition in which the inner lining of the uterus (endometrium) is found in the muscular wall of the uterus (myometrium). Uterine fibroids and adenomyosis can cause many symptoms such as heavy and painful menstrual cramps, lower abdomen discomfort or tenderness, back pain, a sensation of fullness or pressure in the pelvic area, stomach bloating, and pain during intercourse.

Common treatments for uterine fibroids and adenomyosis, are hysterectomy removal in the uterus, myomectomy, and removal of the adenomyomectomy (removal of adenomyosis). Most women do not want to undergo a hysterectomy. Myomectomy and adenomyomectomy may lead to complication during pregnancy.
 
The HIFU technology uses focused sound energy to heat and destroy targeted tissues. It is being used to treat many medical conditions, such as renal stones, cataracts, neurological disorders, benign thyroid nodules, prostate diseases, solid tumours, and it is also used in palliative therapy. In gynaecology, the HIFU technology can be used to treat uterine fibroids, and adenomyosis.
 
The HIFU technology offers a completely non-invasive approach for the ablation (shrinkage) of adenomyoma and an alternative to surgical removal of uterine fibroids. A high-intensity ultrasound transducer directs sound waves to a specific location, raising local temperature of tissues from 60°C to 80°C, resulting in coagulative necrosis of the tissues. HIFU is performed with the guidance by either Magnetic Resonance Imaging (MRgFUS) as the imaging modality or Ultrasound (USgHIFU), which uses ultrasound scan as the imaging modality to target treatment to a specific focal area in the tissue while avoiding damage to intervening tissues.
 
The key advantages of USgHIFU over MRgFUS are:
  • It offers real-time imaging, which enables the doctor to look at the tissue while the procedure is done.
  • It uses a larger and more powerful transducer, which shortens the duration and increases the efficacy of the treatment.
  • It offers greater accessibility to patient and flexibility in patient positioning, making patients feel more comfortable.
  • It is less costly.
 
As HIFU utilises a technology that is a non-invasive procedure, patients do not require general anaesthesia during the procedure and are able to walk-away scar-free. The procedure also has the upper hand on recovery time when compared with surgeries such as myomectomy or hysterectomy. Women with the desire to conceive benefit the most from HIFU treatment because the procedure can precisely ablate the lesion, preserving the surrounding uterine muscles and tissues. The HIFU technology also causes less scar formation in the uterus wall, and so the expansion of the uterus to accommodate pregnancy and the contractility during labour can be retained. 
 
“HIFU procedure is a game-changer as it will be able to provide a solution that mitigates the scaring, and the fertility impact patients may face in typical treatments for fibroid and adenomyosis removal. Additionally, this non-invasive state-of-the-art technology will also benefit patients with a short recovery duration, allowing them to return to their daily routine in no time,” said Dr S. Selva, Obstetrician & Gynaecologist, and Reproductive Medicine Specialist of Mahkota Medical Centre.
 
He added, 'Ultrasound based HIFU treatment session ranges between 1 to 4 hours and in most cases, the treatment can be done in a single session. Only patients with multiple or large diameter fibroids, may require several sessions. It is also worthwhile to note that patients will not have any blood loss during the procedure, hence eliminating the need for blood transfusions'.

HIFU also reduces the risks of potential complications that may arise from surgeries to remove adenomyoma or uterine fibroids.​ Most importantly, patients who wish to get pregnant do not have to wait for their uterus to heal completely before trying to conceive. They can resume having sexual intercourse after completion of the next menstrual cycle. Studies have shown successful pregnancy within months after HIFU treatment for fibroids either by natural pregnancy or assisted reproductive treatment.

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