By Sola Ogundipe

As Nigeria joins the rest of the world in marking Fibroid Awareness Month, women in Nigeria living with uterine fibroids are being encouraged to rethink their treatment options by embracing safer innovations in reproductive health while challenging long-held misconceptions.
The call came amidst the growing demand for patient-centered care as the Fibroid Care Centre, Lagos achieved a milestone of 730 successful treatments through High Intensity Fibroid Ultrasound (HIFU) a revolutionary technology that treats fibroids without surgery, anesthesia, or incisions.
The MD/CEO of the Fibroid Care Centre, Dr. Abayomi Ajayi who made the call in Lagos, emphasised the need for a rethink of fibroid care models that often default to conventional invasive surgery, and adopt available non-invasive options.
Ajayi, whose Centre pioneered HIFU in Nigeria and West Africa, said the technology uses targeted ultrasound waves to destroy fibroid tissue, allowing patients to return home on the same day with minimal discomfort and zero hospital stays.
“HIFU is revolutionizing fibroid care in Nigeria and beyond, offering a non-invasive alternative to traditional surgery. In Nigeria where medical data is scarce, comparisons with nations like France—where 41,996 hysterectomies were done in 2017 with notable complications—underscore the urgency to rethink fibroid care.”
Ajayi said that contrary to widespread belief, fibroids cause infertility in less than 5 percent of cases, with most women able to conceive successfully.
“We know that our Black women have about 70 to 80 percent lifetime risk of developing fibroids by the time they are 50 years old and so this begs the question, should we continue business as usual, or should we start thinking of methods that do not in any way raise the quality of life or even threatening the life of our patients?
“That’s just the question that begs to be answered. And also, all over the years, we’ve seen that sometimes when they say fibroids and a woman is not able to get pregnant, and the first thing be removed are fibroids, that is not right.
“Many studies have shown that very few kinds of fibroids actually affect fertility, and that’s why we say that when fibroids are cause of infertility, it’s less than 5 percent of the time because fibroids that cause infertility are either blocking the junction of the tube and the uterus or occupying the place where the baby should stay, which most of the time won’t result in infertility, but miscarriage.
“So I think we just need to have another look because so many of our women get pregnant with fibroids. We really need to change the way that we see fibroids, especially when it relates to fertility, and that is why now there is a growing trend for non-invasive methods of treating fibroids.
He said among conventional surgery, minimally invasive surgery, and completely non-invasive method, which is HIFU, many people in the world should have access to new options.
“There must be a rule for non-invasive methods. HIFU is high intensity focused ultrasound, and we know it’s a very precise way of treating fibroids because it concentrates ultrasound, that burns only at the point that you want it to burn.
“That’s it’s safe that when you finish, when you do your HIFU treatment, you can, you even go home on that day and you start your normal activities by second day.
“Only two things are absolute contraindications. When we suspect that there might be cancer, the fibroid is undergoing cancerous change or there’s any cancer anywhere in the pelvic region, then we don’t want to do HIFU.
“The second one is if you cannot lie down for at least two hours on your back, then we will not be able to do eye food for you. those are the only two absolute contraindications. The others are relative contraindications. And what we do for relative contraindications is that we do what we call a simulation.
According to Ajayi, many patients have become pregnant after HIFU, and have also delivered normally.
“You have faster recovery, so you can go back to work. Within one week, what we are using is ultrasound, not radiation, which can accompany conventional surgery. HIFU does not affect your ability to conceive at all so it’s very safe for conception.
“The contraindications for HIFU are absolute and relative contraindication. For the absolute contraindications, the only two reasons why a woman might not be able to have HIFU is if we suspect cancer anywhere in the pelvis including in the fibroid itself. If the woman cannot lie down for about two hours, she can do HIFU.
“One absolute contraindication has to do with obesity, because the HIFU has about 12 – 14 cm it can travel through before getting to the uterus, so if you are too fat and have too much subcutaneous fat, you are not eligible.
“If you have a posterior fibroid the HIFU might not be able to get to that and that’s why we do what we call simulation. If you have had a liposuction, because there can be displacements of your pelvic organs, we want to also do a simulation.
“If you cannot communicate, we want to do a simulation, if you have what we call a submucous fibroid, we might not want to use HIFU for you, and that’s why sometimes we combine both HIFU with hysteroscopy so that if you have a submucous fibroid, we can remove that vaginally and that is the best route,” he remarked