How HIFU can improve fibroid treatment in Nigeria

Faced with the challenge of fibroid with estimated prevalence rate in Nigeria is about 80 percent, however, a non-invasive treatment for fibroids HIFU is less painful, preserves the uterus and allows women to get back to their lives sooner than surgical options, experts say.

Experts suggest that High Intensity Focus Ultrasound (HIFU) offers safer alternatives to surgery and improvements in quality of life, and significant advancements in fibroid treatment.

“Non-invasive procedure, which is based on ultrasound imaging, and that is HIFU has been around for quite a while, it is been around since 1999 and is practiced in more than 26 countries around the world in China and is more than 150 half centres,” said Raymond Setzen, Gynaecologist and clinical director of HIFU unit at Chris Hani Baragwanath Academic Hospital, Soweto, South Africa at the Fibroid Virtual Conference 2021.

The conference held on the 13th, February with the theme ‘Treating uterine fibroid without a knife’, Setzen said that HIFU treatment have gotten to Africa, which was the first one to get the machines fallen by Egypt and Nigeria’s guide to have the third machine what is the principle of after treatment.

Explaining how High Density ultrasound works Setzen said it has a ceramic concave transducer, which produces high intensity ultrasound waves.

He noted that because the transducer is concave in its focuses over ultrasound waves to a focal point, which is about 12 centimetres from the transducer. That is the focal point, the mechanical energy of ultrasound waves is converted into thermal energy and heat produced at this focal point.

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According to him, the focal point is integrated into the fibroids and we keep on depositing energy into the fibroids when temperature reaches in excess of 56 degrees Celsius protein denaturation therefore we get a calculation and crisis and cell death.

“It does not create any damage to other cells in the body, only the damage that is done is inside to fibroid, and that is because you are cooking the fibroid, if you increase the temperature to over 50 to 60 degrees, it will cause the cells that is making the fibroids to grow, to die, and with time, it will shrink on its own.”

“HIFU possibility of offer is used to treat tumours including prostate cancer, liver cancer, breast cancer, pancreatic cancers; it’s used mainly for pain control, not for cure. It is used in cancer renal cases. It’s only used for conditions in the main ones, uterine fibroids and adenomyosis but it’s also used for treating is literature now for treating the centre accreta syndromes and for serious pregnancies. This is a machine that we are using,” said Setzen.

Meanwhile, uterine fibroids are noncancerous tumors that develop in or on the muscular walls of the uterus and are among the most common reproductive tract tumors in women.

In addition to an individual’s genetic predisposition, estrogens are well known to play an important role in the regulation of fibroid growth.

Uterine fibroids are benign tumors; they can cause debilitating symptoms such as abnormal uterine bleeding, heavy or painful periods, pregnancy loss, painful intercourse and, in some cases, infertility.

These symptoms can also lead to loss of productivity at work, limitations in normal activities of daily living, and social embarrassment.

“The treatment of fibroid has transcended from very invasive, to minimal invasive, invasive in that you have to do surgery,” said Abayomi Ajayi, managing director Nordica Fertility Centre “fibroids are benign lumps that grow in the uterus and they are most prevalent benign tumors of the female pelvis, about 70 to 80 percent of women below 50 years will have fibroids.

He explained that the cause of fibroid is not sure but hormones and genetics may play a part noting that the risk factors for uterine fibroids includes age, race, getting your period at a very young age, birth control use, being overweight and other factors.

“Many women are asymptomatic but can be diagnosed through incidental finding and other symptoms including heavy menstrual bleeding, pelvic pain and prolonged menstrual periods usually for more than a week,” he said.

Also speaking Victor Ajayi, an expert from Nordica Fertility centre, said fibroid are the commonest in women of reproductive age group 15- 45 years and it is one of the leading reasons why women present to their gynecologist.

He added that black women are three times more likely to develop fibroids noting that treating fibroid in women need some important consideration in the sense that patient selection is key.

“The size, how large is the fibroid over 24 weeks, number of the fibroids that is if multiple in size, previous open myomectomy, all this should be considered.”

“In as much as fibroid are common, not all fibroid should be removed and when possible, minimally/ less invasive or non- invasive methods are recommended for best outcomes,” he advised.