Fibroids Without Surgery: How Ultrasound Waves Are Giving Women Hope

For years, a diagnosis of uterine fibroids has often meant one thing for many Nigerian women: surgery.

Depending on the size, number and location of the fibroids, women may undergo myomectomy or, in severe cases, hysterectomy. For women who still desire children, the prospect of surgery can come with anxiety over fertility, recovery time, complications and the possibility of recurrence.

But a technology that allows fibroids to be treated without making a surgical incision is gradually changing that narrative.

Known as High-Intensity Focused Ultrasound (HIFU), the non-invasive treatment uses focused ultrasound energy, guided by real-time imaging, to heat and destroy targeted fibroid tissue while leaving surrounding organs largely unharmed.

HIFU is a minimally invasive medical procedure that uses ultrasound waves to treat certain conditions, such as tumors, uterine fibroids and tremor. The very high-intensity and highly focused sound waves interact with targeted tissues in your body to modify or destroy them.

The technology is now being used to offer Nigerian women an alternative to conventional surgery, particularly those seeking to preserve their fertility.

HIFU works by concentrating ultrasound waves on a specific area of the fibroid. The energy generates heat at the target, causing tissue destruction, after which the body gradually absorbs the treated tissue.

Unlike conventional surgery, the procedure does not require an incision into the abdomen or uterus.

The chief medical director of Nordica Fertility Centre, Dr. Abayomi Ajayi, said  the technology represents an important development in the management of fibroids and adenomyosis, particularly for women who wish to retain their reproductive potential.

“Fibroid is a known cause of infertility. With this technology, we can treat fibroids without affecting a woman’s ability to conceive,” he said.

According to Ajayi, more than 100 women have undergone HIFU treatment at the centre’s Abuja facility since July 2024, with no deaths, blood transfusions or major complications recorded.

“We’ve seen women who conceived naturally after treatment, and others whose quality of life improved significantly. HIFU has proven that fibroids don’t have to mean surgery or infertility,” he said.

Why Fibroids Matter

Fibroids are non-cancerous growths that develop in or around the uterus. Although many women may have fibroids without experiencing symptoms, the condition can become debilitating for others.

Symptoms can include heavy or prolonged menstrual bleeding, pelvic pain or pressure, abdominal enlargement, frequent urination and pain during sexual intercourse.

Depending on their location and size, fibroids can also interfere with conception and pregnancy.

For some women, repeated heavy menstrual bleeding may contribute to anaemia, while severe symptoms can affect work, relationships, confidence and overall quality of life.

Ajayi therefore said that fibroid treatment should not be viewed solely as a surgical or medical issue, but as one with wider social and economic consequences.

“Fibroids affect confidence, relationships, and mental health. HIFU helps restore not just the body but the mind,” he said.

The Fertility Question

For women of reproductive age, one of the major concerns surrounding fibroid treatment is fertility.

Surgical removal of fibroids can preserve the uterus, but it is still an invasive procedure requiring recovery and carrying surgical risks. HIFU offers another option for appropriately selected patients because it does not involve cutting into the uterus.

However, the availability of HIFU does not mean every woman with fibroids is automatically a candidate.

The suitability of treatment depends on factors including the number, size and location of fibroids, their relationship with surrounding structures and the patient’s reproductive plans. Proper imaging and specialist assessment are therefore essential before treatment.

HIFU has been in clinical development and use for decades and is now used in a number of countries for the treatment of selected tumours and other conditions.

Nordica introduced HIFU in Nigeria in 2021 and subsequently expanded the service to Abuja in 2024.

Ajayi said the centre is part of a global HIFU network spanning about 40 countries, with research and clinical outcomes shared with centres in countries including China and the United Kingdom.

He said Nordica currently has the only two HIFU machines in Nigeria, both located within its facilities.

The development places Nigeria among countries where women can access a treatment that avoids the traditional operating-room approach to fibroid management.

The Cost Barrier

Availability alone does not necessarily translate into access. For all its promise, HIFU remains financially out of reach for many Nigerian women.

Ajayi said the capital-intensive nature of the technology makes it difficult for private providers to offer treatment at prices affordable to the majority of patients.

“At Nordica, we took loans to acquire the HIFU machines and continue to subsidise the treatment. We are the cheapest provider worldwide,” he said.

According to him, HIFU treatment in some other countries can cost between $5,000 and $8,000, while Nordica charges considerably less and has occasionally treated patients free of charge.

But he stressed that private-sector subsidies cannot provide a sustainable solution for a population-level health problem.

“Access to quality and affordable healthcare is ultimately a government responsibility. This technology is quite capital-intensive, but we have the expertise,” Ajayi said.

He called  for the National Health Insurance Authority (NHIA) to consider including HIFU in health insurance coverage.

For him, expanding access would require government intervention, particularly because women constitute a substantial proportion of the population and workforce and can bear a disproportionate burden from fibroid-related complications.

He said the success of HIFU should be measured by the improvement in patients’ quality of life. “Success here is measured by the improvement in quality of life, and in that sense, all our patients have benefited,” he said.

For women who have lived with prolonged bleeding, pain, abdominal discomfort or anxiety over fertility, avoiding surgery can represent a significant psychological as well as physical benefit, he explained.

The emotional dimension is particularly important because fibroids can affect how women perceive their bodies, their relationships and their reproductive future.

Though the technology itself is not a cure-all as not every fibroid can or should be treated with HIFU, and specialist assessment remains critical, Ajayi said the ultimate goal is to prevent women from suffering unnecessarily from a condition that can now be managed through less invasive means.

“We hate hearing that women are dying from fibroids when safer, non-surgical options exist. No woman should die from fibroids,” he said.

The biggest question now is whether HIFU can move from being an impressive technological option available to a relatively small number of women to becoming a more accessible component of Nigeria’s healthcare system.