•Now You Can Treat FIBROIDS Without Surgery
•Dr. ABAYOMI AJAYI Explains How
Fibroids are not new to an average Nigerian woman and the men too share in the emotional effects of this condition. It is one of the biggest problems of many African women and some have attached infertility to this condition. Research revealed that one out of every 10 women on the street has fibroids. There have been different kinds of treatments but the most common one is the surgical operation where this growth is being cut off. Many women have shared painful experiences of going under the knife just to get rid of the fibroids; however, the growth keeps occurring.
The good news is that there is a new technology in town that can help get rid of this condition without surgery. It is called HIFU. HIFU is High Intensity Focus Ultrasound and it is a non evasive way of treating conditions like fibroids and adenomyosis and it is based on the principle of converting ultrasound to heat.
Let’s quickly tell you that this machine is the first in West Africa, there are just three of these machines in Africa, one is in Egypt, another in South Africa and the third is here in Nigeria.
In this interview, City People’s DAMILARE SALAMI (08155134152) spoke with Dr Abayomi Ajayi, the MD of Nordica Fertility Center via a zoom chat and he laid it all bare on what HIFU is all about, the merits, demerits and why every African woman with a fibroid condition should consider giving HIFU a trial. Below are excerpts from the interview, enjoy.
To start with sir, how does the technology work since you observe that the technology does not involve cutting and taking blood samples?
The principle is that the machine converts ultrasound to heat. It is this heat that burns off where you have set it to burn. It works like the way a magnifying glass burns off a paper when it is rightly positioned. If you can remember in those days as children, that’s one of the ways we catch fun. So simply put, the technology converts ultrasound energy to heat. It is the machine that does all the work, all the doctor will have to do is to set the distance and direction rightly. It is just as if you are slicing the fibroid and burning it. There is no cutting done to the patient. The only thing required is for her to lie flat and the procedure goes on.
In the process of trying to burn off the fibroid, will other organs in the body not be affected?
Wonderful question, that’s where training comes in because the heat is target at where it is expected to burn, if there are other things there and the heat continues over a long period of time, it might as well affect them. For example, the intestine might be affected if it is not properly directed but that is the essence of training those who will be using the machine, they will be able to properly displace the intestine. And that is why some patients who have had previous surgeries especially these up and down surgeries may not be selected for this process because their intestine may not be freely mobile.
Talking about the training sir, how many people are you looking at so that anyone who comes for fibroid removal doesn’t go home with intestinal damages?
The only machine that is available in West Africa is here with us at Nordica. That means anyone that wants to work on the machine has to be trained. And then we are going to train some doctors who probably don’t have the machine from other hospitals. So that they can come with their patients to use the machine here but they must undergo training before using the machine.
What are the side effects of using this technology?
One of them is what we just mentioned now, there could be a damage to the intestine but that rarely occurs and that is why we choose the patients that we administer the machine on. The fibroid could be very close to the nerve and as you are firing, the wave could affect the nerve which may cause very minimal pains on the leg. But of course, that would go after a few days. Some patients can also have minimal skin burns. That is why it is not done under Anastasia so that the patient can tell us where there is pain. In the process, we also monitor the patient so that she can tell us when the pain is getting intense, we can stop. These are the few things that can happen but the majority of these things never really happens. There could also be a vagina discharge if the burnt fibroid drops in the uterus but those are just minor issues that can be taken care of. That is why we have a doctor here with us from China to train our doctors so that we can have a mastery of the facility before they leave us alone. Every facility usually has a side effect, we cannot promise that there is 100 per cent no side effect. According to the data available after treatments in a paper that was published, there were 27,000 patients that were treated and there were only 0.2 side effects. It is much safer than traditional surgeries.
Doctor, how many HIFU sessions will a fibroid patient require, how successful is this process and how long does the result lasts?
You’ve asked very interesting questions but very alarming also. Once you’ve killed the fibroids, you’ve killed it. Other fibroids can grow what you sis was to burn the fibroid off with the blood supply. If you have a very big fibroid, then you might need a repeat of the process because you may not be able to burn everything off at once. But if you are the perfect patient for HIFU, then you’re good. So I don’t understand the question about how long it lasts. Just as I said earlier, if you’ve killed it, then you have but it doesn’t prevent a re-growth just like after surgery, some are real recurrent while some are because the doctor cannot take out everything at once. Does it really work? Of course, it does. Why should we waste our time if it doesn’t work? HIFU is also being used in cosmetics surgery, it is the same electricity but different applications. It is the same technology but with different applications. It’s not about asking whether it works or not because it does, what you should ask is if you are the ideal candidate. If you want to do HIFU and you expect the fibroid to disappear the next day, then you are the person, you don’t understand what it is. Because once that fibroid has been burnt off, it’s going to take your body a few months to absorb the fibroid because the mass is still there but it is dead. So if you go and do a scan, they will still see the fibroid there but that fibroid has been killed. We know that we need to do a lot of patient information and education because it is the people who don’t know about something that will make a lot of noise about it.
What should the patient expect before and after each treatment session?
Patients should expect to have an assessment whereby we know whether you are an ideal patient for HIFU, this also will include a screening for cervical cancer, a check on the cervix and once we are sure that the patient is qualified, she does MRI to help us localize the fibroid so that the machine can be appropriately set to know where to fire. Once that is done, we have to prepare the bowel of the patient because HIFU doesn’t like gas. The patient will also have to train or learn how to lie down still for about two hours because that is the average length of the process. It could be shorter or slightly longer. On the day of the surgery, the patient is expected to the hospital with someone to accompany her. It will be done under sedation so she has to come fasting. The treatment can be stopped in-between to allow the patient some time to rest. It really is like doing an ultrasound but the difference is that this is longer so you are going to be lying down for quite a while.
What size should the fibroid be before it can be due for HIFU treatment?
The fibroid shouldn’t be bigger than 10 cm but as we go on and gather more experience, we can do bigger. Don’t forget that most of the time, the fibroid is not just one single mass, there are many of them. So what we are saying is that the biggest shouldn’t be more than 10 cm so that we can have enough time and we don’t spend forever with it. It’s like you are slicing the fibroid and burning it so if it is too big, it might take the whole day to complete the process. Any woman of any age can take HIFU treatment.
How affordable is this HIFU treatment?
It’s technology so it is not cheap but it’s not too expensive also.
Is HIFU the best way to remove uterine fibroids?
There is no best way for the treatment of fibroids. That’s why the patient has to be assessed and look for what is best for her or the options available to her. We have told you the advantages of HIFU, so the patient has to ask if it is important to her not to be subjected to Anastasia. Is it important to her that there is no risk of blood transfusion; is it important to her that her recovery is faster, is it important to her that her fertility might be better unlike in surgery where you have to cut through the muscles and therefore weaken the musculature of the uterus? HIFU doesn’t do that, it just goes to the fibroid pinpoint and burns it off so the muscle of the uterus is still intact. So those are the things that we are looking at.
