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High Intensity Focused Ultrasound (HIFU) for Fibroid Uterus Treatment

High intensity focused ultrasound is a non-invasive, extremely precise procedure that uses ultrasound to heat and destroy uterine fibroid.

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What is High Intensity Focused Ultrasound?

HIFU or high intensity focused ultrasound is a non-invasive, extremely precise procedure that uses ultrasound to heat and destroy uterine fibroid.

Ultrasound beams are focused on fibroid, and accumulative energy of the beam at a focal point increases the temperature over 65°C and destroys the outgrowth.

HIFU therapy has been enhanced through the use of Magnetic Resonance Imaging (MRI) to direct and monitor the overall procedure. The therapy is therefore termed as MR guided focused ultrasound (MRgFUS). The focused ultrasound solution offers many advantages over traditional treatment of uterine fibroid. These include no scarring, no radiation or anaesthesia, a short recovery period of one day, and greater precision in targeting fibroid.

Why do you need High Intensity Focused Ultrasound?

HIFU treatment for fibroid is a completely non-invasive procedure that allows you to resume your normal activities within a day. It is proving to be a quick resolution of fibroid symptoms. Consult with your doctor if HIFU is suited to your condition and will provide necessary relief from fibroid symptoms.

Which Specialist should you Consult if you have any of the Signs and Symptoms?

Visit your gynaecologist if you experience symptoms of uterine fibroid like prolonged menstrual periods, heavy menstrual bleeding, pelvic pain or pressure, backache, constipation and leg pain.

What are the Screening Tests and Investigations before the Surgery?

Prior to the focused ultrasound therapy, a pelvic MRI scan is conducted to determine if you are a good candidate for the ultrasound therapy. The MRI will identify the number, position and size of fibroid to be treated.

What is the Procedure for HIFU?

HIFU can be performed as an outpatient procedure and you will be able to leave the hospital on the same day. You will be asked to remove all jewellery and metallic objects from your body as those interfere with the quality of images in the MRI. A contrast dye material will be injected intravenously, along with medication to help you relax. You will lie on your stomach on the examining table that slides through into the MRI scanning machine. Focused ultrasound waves are released to target the fibroid from different angles. Simultaneous MRI scans the fibroid to determine the exact temperature reached and the condition of the fibroid under treatment. The sonication process is repeated till the fibroid tissue is destroyed, and number of sonication used depend on the size of the fibroid. An MRI scan is performed immediately after the HIFU treatment to evaluate the success of the treatment.

What are the Known Complications of the Procedure?

Some rare complications of HIFU are burns on the skin of your abdomen, blood clots in legs, tissue damage around the targeted area, and nerve stimulation leading to back or leg pain. Further, the procedure may not be able to destroy all fibroid in one sitting and re-treatment may be required. Since the treatment is relatively new, there is not much substantial data available to verify the long-term effects of HIFU on safety, effectiveness, and effect on fertility and pregnancy as compared to other treatments for fibroid.

What Precautions or Steps are Necessary to Stay Healthy and Happy Before and After HIFU?

The MRI scan conducted before the HIFU treatment determines your physical readiness towards the treatment. You can resume your normal activities within a day after the procedure.

What is the Dietary and Physical Activity Requirements Before and After High Intensity Focused Ultrasound (HIFU)?

You can resume your normal daily activities the same day after the procedure. Your doctor will administer anti-inflammatory medication that will provide you relief for any discomfort experienced by you.

As a Caregiver, how can you Support and Help the Patient Cope with the Surgery?

The medications administered as part of the procedure necessitate some assistance to the patient in driving to and from the hospital.
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--Sources: "Apollo Hospitals launches treatment of uterine fibroids," The Hindu, 2 February, 2012, https://www.thehindubusinessline.com/companies/apollo-hospitals-launches-treatment-of-uterine-fibroids/article2854208.ece, "High intensity focused ultrasound (HIFU)," Cancer Research UK, cancerresearchuk.org,  https://www.cancerresearchuk.org/cancer-help/about-cancer/treatment/other/high-intensity-focused-ultrasound-hifu, Latest therapy to treat uterine fibroids," Timeswellness.com, Zoha Tapia, 17 February, 2012, https://www.timeswellness.com/article/110/2012021720120217145146281394ffb7/Latest-therapy-to-treat-uterine-fibroids.html, "MRI-HIFU - Non-Surgical treatment of Uterine Fibroids," Apollo Hospitals, apollohospitals.com, apollohospitals.com, "Philips Launches Breakthrough Technology For Treatment Of Uterine Fibroids," Philips.com, 26 March, 2011, https://www.newscenter.philips.com/in_en/standard/about/news/press/pressinformation_2011-03-26_healthcare.wpd#.Uk6OrxYzmlI, "Uterine fibroids," Mayoclinic.com, Mayo Clinic Staff, https://www.mayoclinic.com/health/uterine-fibroids/DS00078, Image source: alternativesurgery