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High Intensity Focused Ultrasound (HIFU)

Obstetrics and GynaecologyReproductive Medicine

HIFU, which stands for High-Intensity Focused Ultrasound, is a non-invasive treatment technique for uterine fibroids. It focuses high-intensity ultrasound waves outside the body onto the uterine fibroids. The focal area generates high temperatures, destroying the uterine fibroid cells without harming the surrounding normal tissue, achieving non-invasive fibroid ablation.

The principle of High-Intensity Focused Ultrasound (HIFU) technology is to generate high heat at the focal point in the target tissue using focused ultrasound waves, achieving temperatures that cause coagulative necrosis. It precisely destroys tumour tissue without damaging surrounding healthy tissue. This process involves the high-precision positioning and focusing of ultrasound energy, making it a non-invasive treatment method, especially suitable for non-malignant conditions such as uterine fibroids.

Here's how HIFU works:

  1. Ultrasound Focus: HIFU employs high-intensity ultrasound waves focused on the target tissue inside the body, such as uterine fibroids, generating highly concentrated energy vibrations within a small area.
  2. Heat Generation: When ultrasound reaches the target tissue, the energy is converted into heat energy, causing an increase in temperature in that area. It creates a high-temperature focal point within uterine fibroids.
  3. Cellular Destruction: The high temperature causes damage to the cells of uterine fibroids, leading to coagulative necrosis. This process, known as thermal coagulation, can destroy the cellular structure of the fibroids.
  4. Protecting Surrounding Tissue: HIFU technology allows for precise control of the focal area to ensure that only the target tissue is affected while surrounding healthy tissue remains undamaged.
  5. Natural Absorption: The damaged fibroid cells are naturally absorbed and eliminated by the body, gradually reducing the size of the uterine fibroids.

Advantages

  • Non-invasive: High-Intensity Focused Ultrasound (HIFU) is a non-invasive treatment that does not require surgical incisions, reducing the risk of infection.
  • Non-radiation: HIFU does not use electromagnetic radiation but utilizes high-intensity focused ultrasound to generate heat energy for tissue treatment. This means that, unlike traditional radiation therapy, it does not involve the use of radioactive substances or ionizing radiation.
  • No General Anaesthesia: HIFU treatment is performed under sedation or analgesia, eliminating the need for general or local anaesthesia and reducing the risks associated with traditional surgery.
  • Preservation of Fertility: When treating uterine fibroids with HIFU, it can precisely locate and target the affected tissue, directly treating it without harming surrounding healthy tissue. This precision allows for preserving the uterus's structure and function, maintaining a woman's fertility. This is an essential advantage for women planning future pregnancies.
  • Quick Recovery: Since no incisions are made during the treatment process, patients typically experience a faster recovery compared to other treatment methods.

Comparison of Treatment Methods for Adenomyosis and Uterine Fibroids

 HIFUTraditional SurgeryLaparoscopic SurgeryUterine Artery Embolization
PrincipleFocused UltrasoundSurgical RemovalMinimally Invasive Surgical RemovalBlocking Blood Supply to Uterine Fibroids
Surrounding Healthy TissuesAlmost No DamageSignificant DamageMinor DamageAlmost No Damage
Uterus PreservationPreserves Uterus and FunctionPossibly Removes UterusPossibly Removes UterusPreserves Uterus and Function
Incision
No Incision
(Non-invasive Treatment)

Large Incision
(10-15 cm)

Small Incisions
(3-4 units)

Small Incision
(1 cm)
Treatment DurationShorterLongerLongerShorter
Tissue AdhesionNone90%30%None
AnaesthesiaNo Anaesthesia. Use Sedation or AnalgesiaGeneral Anaesthesia with IntubationGeneral Anaesthesia with IntubationRequires Anaesthesia
Recovery Period7-10 Days2-4 Months4-8 Weeks8-14 Days

Suitable for HIFU

  • For individuals who do not wish to undergo surgery or are not suitable candidates for surgery 
    Due to factors such as age, health, or psychological reasons, non-invasive treatment with High-Intensity Focused Ultrasound (HIFU) can be considered. HIFU minimizes the chances of affecting other organs in the body and reduces psychological burdens.
  • For those planning to become pregnant
    HIFU can preserve the uterus and its functions. It offers the advantages of a short post-treatment pregnancy waiting period and the option for natural childbirth in the future.
  • Individuals who need a quick recovery to return to their daily lives
    Such as working professionals, homemakers, individuals who prioritize appearance, and athletes, can benefit from HIFU. It has a short post-treatment recovery period, minimal pain, and leaves no scars.

Not Suitable for HIFU

High-Intensity Focused Ultrasound (HIFU) treatment has very few absolute contraindications, which include a history of abdominal liposuction, current pregnancy, and the presence of an Intrauterine Device (IUD).

In certain situations, such as severe anaemia, pelvic inflammatory disease, recent artificial abortion or childbirth, or during menstruation, HIFU treatment may need to be temporarily postponed. It is because patients may require prioritized therapy for other health issues or wait for their bodies to recover to a better condition.

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