Research has showed that over 70 per cent of women below 50 years are at risk of developing fibroid, a non-cancerous growth in the uterus that can develop during a woman’s childbearing age.
While some may not have symptoms, majority of women with the condition are dealing with symptoms like heavy bleeding, painful periods, a feeling of fullness in the lower stomach and frequent urination.
“The quality of life of women with fibroids is disturbed by the symptoms they encounter. The symptoms come either in the form of heavy bleeding and anaemia. The bleeding can be irregular depending on the location of these fibroids and there might be a bump that is mistaken for pregnancy,” the medical director, Nordica Fibroid Care Centre, Dr. Abayomi Ajayi told LEADERSHIP, during a virtual media dialogue, to mark the second anniversary of the facility.
Yet, majority of these women with these symptoms are reluctant to remove the fibroids, and their reason is not far-fetched, as many women have lost their lives, in the process of undergoing fibroids surgery.
Mrs Amaka Okafor, a business woman in Lagos, who was diagnosed with fibroids five years ago, said, “I have been suffering from severe bleeding, painful menstruation and the insult from people due to my protruded tummy, all these years.”
When asked why she had refused to remove it, she said, “The case of the Lagos chef, Peju Ugboma, who died while trying to remove her fibroid, made me give up. Though, the pain is excruciating, i don’t want to die,” she stated.
A lot of women do not understand how risky fibroids surgery is, Ajayi said, adding that, “The uterine artery blood flow rises exponentially from 50 ml/min in a nonpregnant state to 600 ml/min during pregnancy. That means, a patient can bleed the whole blood volume in about 10 minutes. So, fibroids surgery is a risky surgery and one of the things doctors are looking out for is to minimize loss of blood during the surgery.”
Ajayi averred that, a surgical treatment called myomectomy can remove the fibroids, while saving the uterus and the ability to get pregnant; but the majority of people who have fibroids are afraid of surgery because they don’t want to see blood. “Although a myomectomy can treat the fibroids and allow you to retain your fertility, it is invasive and may have undesirable side effects which includes scarring in the uterus (endometrium) which further prevents pregnancy,” Ajayi stated.
Ajayi disclosed that for some years, he has been looking for a safer fibroids procedure, one that won’t require surgery, adding that, “a non-invasive way to treat uterine fibroids is now available in Nigeria and it is known as High-Intensity Focused Ultrasound (HIFU). Bringing HIFU to Nigeria, was one of my greatest achievements.”
How HIFU fibroid treatment avoids surgery is quite straightforward, Ajayi said, adding that, “The machine produces sound waves, which your doctor focuses on one small section of a fibroid. This process is like using a magnifying glass to focus the sun’s rays on a dry leaf to start a fire. Targeted areas heat up and this thermal ablation safely destroys the fibroid while sparing healthy tissues nearby. Throughout treatment, your doctor can instantly see the temperature at the targeted area and use the reading to make sure the target gets hot enough but doesn’t harm other tissues.
“Before treatment, you are given medication to help you relax and get comfortable as you lie down on the treatment table. You can communicate with your team throughout the entire treatment duration. During treatment, it is normal to feel a warming sensation in your pelvic region. You are conscious the entire time and can provide feedback to the team. At the end of your treatment, you rest in the clinic for a few hours so the sedative can wear off. You can go home once you are cleared by the nursing staff.”
HIFU has so many advantages particularly as it eliminates the need for surgery, the medical director said, even as he disclosed that the recovery time is short, there is no risk of blood loss, no damage to organs, and tissue and patients can return to normal life within 24 to 48 hours.
Unlike other treatments, HIFU offers a low rate of complications even as the use of general anaesthesia is eliminated, Ajayi assured, adding that, “Most importantly HIFU preserves fertility and you are able to conceive and have normal pregnancies after treatment. The commonest reason people avoid surgeries is because they are afraid of bleeding, but fibroids treatment without surgery is novel and now available in Nigeria in the form of HIFU.”
Two years after, Ajayi disclosed that not less than 324 women in Nigeria have undergone fibroid removal without surgery, through HIFU. The procedure was carried out between July 2021 and July 2023 by physicians at the Nordica Fibroid Care Centre, Lagos, he stated.
“Since two years ago, a lot of women have embraced HIFU. One of the Nigerian banks has been quite supportive in that it has been sponsoring the treatment of women with fibroids. In a country like Nigeria, where many doctors have turned their back on Nigerians, HIFU is a technology that has a big role to play, not only in Nigeria, but all over west Africa,” he stated.
On acceptance of HIFU in Nigeria, Ajayi said that education is the immediate thing to be tackled, both for patients and doctors.
“Some doctors don’t know so much about HIFU and some of the things that they say about it is not true. For instance, they tell you that size of the fibroids is an issue, but really the issue of fibroids is more about the location.”
Towards enabling more women to benefit from the fibroid removal without invasive surgery, Ajayi said more HIFU outlets are to be opened in Nigeria. “We are taking this to other parts of the country by the end of this year or in early 2024. This is not a service that access should be limited now that travelling around the country and even abroad is becoming difficult,” he averred.
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