The system, ExAblate 2000, has been highlighted by U.S. FDA as one of the 14 medically significant products it approved during fiscal 2005.
What are Uterine Fibroids?
Fibroids are benign (non-cancerous) tumours most often found in the uterus. They are the most common gynaecological tumour in women and exist in various types. Approximately 20-40% of women aged more than 35 years old have fibroids
Uterine fibroids can affect your quality of life
They can cause
* Cramps
* Abdominal pain
* Heavy menstrual bleeding
* Frequent urination
* Constipation
* Distended stomach
Until now, most treatment options are invasive surgical procedures such as hysterectomy (removal of uterus) or myomectomy (removal of the fibroids).
Alxia and coronal views of the pelvis showing uterine fibroid
MR-guided Focused Ultrasound Ablation:
A Non-Invasive Treatment Alternative
MR-guided Focused Ultrasound Ablation provides a non-invasive treatment alternative for fibroids. It treats Uterine Fibroids without the need for incisions, anaesthesia and hospitalisation.
High intensity focused ultrasound waves are used to heat an area of the fibroid, causing cell death. Pulses of ultrasound energy are repeatedly applied to treat the fibroid.
During treatment, magnetic resonance images are used to enable the doctor to see the fibroid and surrounding organs in 3-D, pinpoint, guide, and continuously monitor the treatment in a non-invasive manner.
Before treatment: View of the uterine fibroids,
without contrast (left picture) and with contrast (right picture)
View of the treated fibroids Preparation for Ultrasound Ablation
As this treatment requires MR imaging, you are required to have a pre–treatment MR scan of your pelvis with an intravenous injection of contrast to assess whether you are suitable for the ablation treatment.
You must also complete a MR safety questionnaire to assess that it is safe to perform the MR scan on you.
Post-treatment scans will also be done a few months later to ascertain the progress of the treatment.
What happens during the procedure?
During the 3-4 hour procedure, you will be required to lie on your stomach. Sedation and pain relieving medication will be given to help you relax. You will be conscious throughout the procedure. You will feel some warm sensation over the abdomen during the treatment. This is a normal occurrence.
The doctor obtains MR images of your uterus and uses these to plan your treatment. Individual pulses of focused ultrasound energy each lasting about 20 seconds will be applied to your fibroids.
Thereafter, MR images are taken to evaluate treatment effectiveness
What happens to me after MR-Guided Focused Ultrasound Ablation?
After the procedure, you need to rest for 1-2 hours for the sedation to wear off. You may experience some abdominal pain, cramping or nausea. If necessary, your doctor will provide instructions for medication to keep you comfortable upon discharge. You may experience some cramps, shoulder or back pain that may last a few days after the procedure. Most women are able to return to work within 1-2 days.
What are the risks of MR-Guided Ultrasound Ablation?
Like any medical procedure, there are risks involved. The incidence of these complications is very low. These complications include:
* Skin burns
* Back or leg pain
* Nerve damage
* Abdominal pain
* Cramping
* Nausea
* Fever
* Vaginal discharge
* Urinary tract infection
* Alternative treatment required if treatment is not successful
* Recurrence of fibroids in the future
How do I know if I'm a candidate for MR guided Focused ultrasound ablation?
Your doctor will be able to assess your suitability for the procedure. Thereafter, a referral can be made to KK Women’s and Children’s Hospital.
Please note that this procedure is meant for women who do not wish to become pregnant in the future. The effects of the procedure on the ability to conceive and to carry a foetus to term have yet to be determined.
Click here for Frequently Asked Questions (FAQs) - Updated 1 July 2007
If you have any further queries or need to talk to a Diagnostic Imaging resource person on this
MR-guided Focused Ultrasound Ablation service, please
email to ablate.fibroids@kkh.com.sg or
call (65) 9736 2250 (hand-phone) during office hours.
