High-Intensity Focused Ultrasound (HIFU)

High Intensity Focused Ultrasound (HIFU) or Focus Ultrasound Surgery (FUS) is the latest technique in treating certain cancers, adenomyosis and fibroids. This is a non-invasive therapeutic technique which is an alternative to hysterectomy for women who want to preserve their uterus. Benign or malignant tumors are destroyed using focused ultrasound which uses acoustic lenses to generate heat at one point.

What is HIFU?

Uterine fibroids and adenomyosis are common gynaecological conditions that affect women during their reproductive age and can affect their quality of life. There has been tremendous advances in the management of fibroids and adenomyosis and now we have moved from invasive to non-invasive type of treatment and that is HIFU.

HIFU is ultrasound-guided high-intensity focused ultrasound treatment for uterine fibroid & adenomyosis. HIFU treatment can be performed on an outpatient basis and it requires no incision, and this procedure can result in just minimal discomfort, fewer complications and allows rapid recovery as compared to open or laparoscopic surgery.

The main principle how this method works is analogous to using the magnifying glass to focus beams of sunlight on a single point to concentrate heat. Similarly, with focused ultrasound, an acoustic lens is used to concentrate multiple beams of ultrasound waves on to a target tissue deep in the body with extreme precision. When each individual beams of ultrasound rays passes through the abdominal tissue, there is no effect. But, at the focal point where the convergence of the multiple beams of focused ultrasound energy results in many biological changes in the tissue. This is a real time imaging focused treatment which helps in targeting the tissues with more precision. This is NOT MRI guided HIFU but ultrasound real-time HIFU. MRI guided HIFU had various side-effects and has not been recommended now

What is HIFU?

You will be advised to have some blood test, a physical exam and an MRI. MRI is required to do planning of the procedure. You may be advised to go on liquid food diet for about 3 days before the procedure and also you would be advise to have complete bowel preparation the night before the procedure. The skin preparation would be done on the day of the procedure, the hair of the anterior abdomen was shaved from the umbilicus to the superior border of the symphysis pubis. You will be advised to sleep prone (on your belly) on to the HIFU machine. There would be some cold water touching your belly. The procedure can take time depending up to the size of fibroid / adenomyosis to treat. Following the procedure you would be under observation for some time and then would be allowed to go home. Repeat MRI would be advised to see the response.

What are the benefits of HIFU procedure?

In gynaecology ultrasound guided HIFU is mainly used to treat fibroid and adenomyosis. Benefits are:

It’s completely noninvasive — no surgery, no blood loss, no pain during or after the procedure, and fewer side effects.

Open surgery

Laparoscopic surgery

HIFU

No hospital stay (can be done as day care procedure) and a quick return to normal activities, full recovery possible in hours and, at most, within a few days.
Fertility preservation of the uterus, cervix and ovaries.
Surround tissues are not damaged.

Compared to surgery, significant improvement in quality of life - less menstrual bleeding and relief from urinary problems, pelvic pain and pressure.

Where is HIFU procedure not recommended?

There are cases when the HIFU treatment may not be appropriate to you such as fibroids that are:

Pedunculated (hanging from the uterus through a thin strip called a stalk)
Very close to sensitive organs or other critical body parts (such as the bowels or nerves)
Situated in an area where the ultrasound waves can’t reach

After HIFU if I become pregnant are there any complications?

No, there are not added complication during pregnancy because of HIFU procedure.