Renowned gynaecologist and obstetrician, Dr. Abayomi Ajayi, MD and founder of Nordica Fertility, recently surprised his audience during a webinar where he talked about a new procedure for removing fibroids without going under the knife. In this brief interaction, Dr. Ajayi expatiates further on the symptoms of fibroid and the new procedure:
What are the common symptoms that tell a woman she has fibroids?
The symptoms often are in the form of menstrual bleeding, which can be heavy and sometimes leave women anaemic. Some women do bleed for two weeks in a month. Sometimes, the bleeding can be irregular depending on the locations of these fibroids. Sometimes, they feel like they have a bump in their abdomen and people might even mistake it for pregnancy. This also can affect some organs that are nearby. It can affect the kidneys, and you might even have urinal backflow and if it is allowed to go on for a long time, and nothing is done about it, it can lead to renal failure. These symptoms of fibroids often lead affected people to book for surgeries. The commonest reasons they do surgeries is because they’re bleeding. Now, you can get rid of these symptoms without surgeries.
How efficient and convenient is this non-invasive treatment of fibroids?
About 50 to 80 per cent of women before they reach the age of 50 will have fibroids, therefore, it is a common thing in this environment. The new technology to treat fibroid is called High-Intensity Focused Ultrasound (HIFU). But it is not everyone that can benefit from HIFU. There are people to whom we can apply this technology. First, because ultrasound travels best without gas, we try not to use it on people who have done previous surgeries, that is, the midline incisions. It is possible that the intestine has acquired a scar and that will make it impossible for the rays to go through where we want it to. So we avoid such people.
Second, we want to avoid people who are grossly obese. Anyone above 130kg, we will probably not do this for her because the radius of the skin might not allow that. The way it works is that you must focus at a particular radius and that’s where you fire. If the skin is too thick and it is difficult to get to where the fibroid is, then we cannot use this kind of technology. For these two categories of people―grossly obese and people who have had previous midline incisions and scars―the new technology is not for them. We also don’t want to use it when the fibroids are too big, the largest about 10cm. This is how the procedure goes: the doctor does a scan; when he thinks that the patient qualifies, then a second test follows, which is through MRI to enable us to locate the fibroid and that is what we use to set the machine on the day of the treatment. The patient must lie face down for at least one or two hours; that is all that is required. She lies down on the table and we set the machine. The machine sorts of slices the fibroids across levels, and she will hardly know that anything is going on. That is why the procedure is not done under local anaesthesia. If the patient starts feeling any pains, we can stop the procedure and reposition her, and in one or two hours, we are through. The most important thing is concentrating it to burn away the fibroids.
Is such a procedure possible in Nigeria?
The majority of women who have fibroids are afraid of surgery. Many people don’t want to see blood. Many people have heard stories about fibroids. Some of the deaths can come from the surgery, some from anaesthetics. In a place like Nigeria, there is a shortage of anaesthetics. Again, COVID-19 makes this procedure very appropriate now; you don’t want as much as possible to send anybody to sleep. These are things that make HIFU appropriate for this environment.
