Many women facing fibroid condition grapple with the fear of hysterectomy, a procedure that removes the uterus and ends their fertility.
According to a survey by the Department of Gynecology and Obstetrics at the University Hospital Erlangen in Germany, (2017 )Over half of the women surveyed feared that treating their fibroids would lead to this outcome. Concerns about potential complications, side effects, and lengthy recovery times also weigh heavily on their minds, making them hesitant to undergo invasive surgery.
Negative experiences or stories of complications and even deaths further amplify these fears. Adding to this challenge, fibroid symptoms often develop gradually, making it hard for women to recognize when they need medical intervention.
Despite the prevalence of fibroids, many women are not aware of the range of treatment options available, including minimally invasive procedures that can effectively manage symptoms while preserving the uterus, providing a welcome alternative to surgical approaches like hysterectomy.
One such woman, Comfort, understands the pain and discomfort of living with fibroids all too well. For years, she suffered from heavy menstrual bleeding, painful periods, and constant fatigue.
But her life took a turn for the better when she discovered Nordica Centre and their innovative High-Intensity Focused Ultrasound (HIFU) treatment.
Comfort’s journey with heavy menstrual flow began in her teenage years, causing concern for her mother and making her feel isolated as her siblings experienced normal periods.
After getting married, her focus shifted to infertility issues, leading her to Nordica, a fertility center she had been following for over a decade.
In 2018, Comfort was inspired by a testimonial from Victoria about HIFU, a non-invasive treatment for fibroids. Her fear of traditional surgery was intensified by the stories of two neighbors who had died from fibroid complications and colleagues who had undergone multiple surgeries, with one tragically passing away.
Determined to find relief, Comfort reached out to Nordica. The staff were supportive and informative, guiding her through the process. In October of the previous year, she underwent the HIFU procedure, which brought a dramatic change to her life. Her periods became painless and manageable, lasting only three days without the debilitating cramps and excessive bleeding she had endured for years.
The transformation was profound. Comfort no longer felt the constant threat of heavy bleeding, which had previously affected her ability to work and socialize. She shared her positive experience widely, encouraging others to consider HIFU for fibroid treatment. Once burdened by depression and isolation, Comfort emerged happier and more hopeful, attributing her new lease on life to the successful HIFU procedure.
Similarly, Mary Daniel’s battle with fibroids and endometriosis began 18 years ago when a scan revealed a tiny abnormality that seemed inconsequential. By 2019, her periods had become unbearably painful, often causing her to miss work due to severe cramps, nausea, and vomiting. Despite taking pain relief, her condition worsened, leading her to seek medical intervention in 2020.
Doctors diagnosed her with fibroids and endometriosis, informing her that surgery wasn’t an option and that her condition could only be managed with pills. The medications provided little relief, prompting Mary to consider a hysterectomy due to the intense pain.
In 2023, a doctor friend introduced Mary to HIFU. She traveled to Lagos for the procedure, and the results were remarkable. Her first post-HIFU period arrived unnoticed, free from the debilitating pain that had plagued her for years. Now 44, Mary experiences pain-free periods, can continue working during her cycle, and no longer needs to take time off.
Mary, like Comfort, eagerly shares her positive experience with friends and family, recommending HIFU to anyone suffering from similar conditions. Both women have found a new lease on life thanks to the advanced treatment available at Nordica Center.
Surgical Treatment Challenges
Uterine fibroids are highly prevalent among Nigerian women, with rates ranging from 6.83% to 48%, and most studies reporting around 45%. A population-based study using transvaginal ultrasound confirmed a prevalence of 45.1% in Nigerian women.
Compared to other populations, African women, including Nigerians, have some of the highest prevalence rates of uterine fibroids in the world, resulting in significant morbidity, economic and health systems costs, and occasional mortality. In high-income countries, the cumulative incidence of fibroids by age 50 ranges from 70-80%.
In Nigeria, surgical treatment for fibroids faces several challenges, including lack of access to healthcare, high costs, and a shortage of skilled surgeons. Myomectomy and hysterectomy are the main surgical options, but these procedures are often delayed due to financial constraints and fear of complications.
Addressing the high burden of fibroids in Nigeria and other parts of sub-Saharan Africa requires improved knowledge of risk factors and better access to preventive care and treatment. Additionally, more robust epidemiological studies are urgently needed to guide effective interventions.
Pioneering HIFU in Lagos
Obstetrician-Gynecologist and Managing Director of Nordica Fibroid Care Centre, Dr. Abayomi Ajayi, discussed the financial hurdles of implementing HIFU. “Investing in the machine, which is sold in dollars, becomes challenging as the exchange rate fluctuates. The government is the only entity that can truly make it affordable. We strive to keep costs lower than laparoscopy to ensure access, but it’s just a drop in the ocean.”
Since July 2021, 385 HIFU procedures have been performed in Lagos. Dr. Bola noted, “Most challenges are related to patient expectations. The worst issue we’ve encountered is skin burns, which we manage with a few days of dressing. Education is key to managing expectations.”
The process begins with a comprehensive evaluation. “On the first visit, the doctor takes the patient’s history, performs a scan, and assesses the fibroid’s location. An MRI is also required. If everything checks out, the procedure can be scheduled within a week, especially for those traveling from Abuja. Post-procedure, we follow up with another MRI to assess the fibroid’s ablation.”
Ajayi emphasized the importance of tracking patient outcomes. “We use a quality of life form before the procedure and at three and six months after. This helps us monitor improvements and patient satisfaction.”
Addressing the need for broader acceptance of HIFU, Dr. Ajayi mentioned efforts to educate fellow doctors. “We invited skeptical doctors to witness live sessions. Many were trained to see myomectomy as the only solution. It takes time to accept new methods, much like the early days of IVF.”
Despite only having one machine in Lagos, Dr. Ajayi noted their achievements. “We’ve performed 420 procedures so far. South Africa, which had the machine before us, has done around 400. We aim to expand, with a second machine planned for Abuja by the first quarter of next year. We’re open to investors to increase our capacity and reach.”
Dr. Ajayi’s motivation for introducing HIFU stemmed from a personal experience. “As a young doctor, I witnessed a colleague die from fibroid complications in one of Lagos’ best hospitals. This tragic event highlighted the need for a bloodless, anesthesia-free treatment option, leading me to HIFU.”
Through these efforts in Lagos, Dr. Ajayi and his team have laid a solid foundation for expanding HIFU treatment to Abuja, aiming to make non-surgical fibroid treatment more accessible and effective across Nigeria.
Fibroid Treatment: Separating Fact from Fiction
When it comes to fibroids, misconceptions abound, the medical expert said as He sheds light on the realities of fibroid treatment, including the introduction of High Intensity Focused Ultrasound (HIFU) technology as a non-surgical option.
According to him “One of the commonest things that happen is that anesthesia can be a problem. Sometimes, it happens that one of the sutures the doctor uses to control the bleeding slips, and after that, there is further bleeding. But one issue we rarely talk about is that sometimes people form blood clots in their system, which can also be fatal.”
He also emphasized that “removing the fibroid is basically for symptom relief, not for fertility. Sometimes it is the male factor that is wrong. Sometimes the tubes are blocked. I know that many women get pregnant with fibroids and have babies with fibroids.”
Ajayi introduced HIFU as a game-changer in fibroid treatment, stating, “We have been able to introduce a method of symptom relief without surgery, and that is what HIFU is. After HIFU, some people go for a scan and see the fibroid is still there. What we did was kill it, but the fibroid will not give you the kind of problems you had before the procedure.”
He shared a testimonial from a patient who underwent HIFU and subsequently got pregnant, highlighting the effectiveness of the treatment.
Dr. Ajayi addressed common misconceptions about HIFU, saying, “Size is not an issue. Sometimes, because of the size, the doctor can say, let’s treat this two times. Those are the experiences that we have been able to gather.”
With 475 successful treatments in Lagos, he is confident in bringing this technology to Abuja, offering hope to women seeking alternative fibroid treatment options. “We are willing to convert one person at a time until everyone sees that this is the way to go for fibroids,” he concluded.
