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Mahkota Medical Centre today, became the first medical facility in the country to introduce the high-intensity focused ultrasound (HIFU) technology, for the treatment of uterine fibroids and adenomyosis. With the establishment of this HIFU technology, Mahkota Medical Centre is changing the treatment landscape for women nationwide, offering a non-invasive, cutting-edge treatment option with clinically proven positive outcomes, that also preserves their fertility. Mahkota Medical Centre's High Intensity Focused Ultrasound (HIFU) Machine. About Uterine fibroids and Adenomyosis Uterine fibroids and adenomyosis are two common benign gynaecological tumours that deteriorate women’s quality of life during their reproductive years. Although both tumours are found in the uterus, they are very different gynaecological conditions. Fibroids are benign muscular tumours that grow in the uterine wall, whereas adenomyosis is a condition in which the inner lining of the uterus (endometrium) is found in the muscular wall of the uterus (myometrium). Uterine fibroids and adenomyosis can cause many symptoms such as heavy and painful menstrual cramps, lower abdomen discomfort or tenderness, back pain, a sensation of fullness or pressure in the pelvic area, stomach bloating, and pain during intercourse. The Treatments for Uterine fibroids and Adenomyosis Dr. S. Selva explaining the mechanisms of HIFU treatment. Common treatments for uterine fibroids and adenomyosis, are hysterectomy removal in the uterus, myomectomy, and removal of the adenomyomectomy (removal of adenomyosis). Most women do not want to undergo a hysterectomy. Myomectomy and adenomyomectomy may lead to complication during pregnancy. The HIFU technology uses focused sound energy to heat and destroy targeted tissues. It is being used to treat many medical conditions, such as renal stones, cataracts, neurological disorders, benign thyroid nodules, prostate diseases, solid tumours, and it is also used in palliative therapy. HIFU technology Dr. S. Selva explaining the techniques of HIFU treatment. In gynaecology, the HIFU technology can be used to treat uterine fibroids, and adenomyosis. The HIFU technology offers a completely non-invasive approach for the ablation (shrinkage) of adenomyoma and an alternative to surgical removal of uterine fibroids. A high-intensity ultrasound transducer directs sound waves to a specific location, raising local temperature of tissues from 60°C to 80°C, resulting in coagulative necrosis of the tissues. HIFU is performed with the guidance by either Magnetic Resonance Imaging (MRgFUS) as the imaging modality or Ultrasound (USgHIFU), which uses ultrasound scan as the imaging modality to target treatment to a specific focal area in the tissue while avoiding damage to intervening tissues. The key advantages of USgHIFU over MRgFUS are: It offers real-time imaging, which enables the doctor to look at the tissue while the procedure is done. It uses a larger and more powerful transducer, which shortens the duration and increases the efficacy of the treatment. It offers greater accessibility to patient and flexibility in patient positioning, making patients feel more comfortable. It is less costly. Dr. S. Selva explaining the benefits of HIFU treatment. As HIFU utilises a technology that is a non-invasive procedure, patients do not require general anaesthesia during the procedure and are able to walk-away scar-free. The procedure also has the upper hand on recovery time when compared with surgeries such as myomectomy or hysterectomy. Women with the desire to conceive benefit the most from HIFU treatment because the procedure can precisely ablate the lesion, preserving the surrounding uterine muscles and tissues. The HIFU technology also causes less scar formation in the uterus wall, and so the expansion of the uterus to accommodate pregnancy and the contractility during labour can be retained (1,2,3,4). Dr. S. Selva - Consultant Obstetrician and Gynaecologist, Mahkota Medical Centre “HIFU procedure is a game-changer as it will be able to provide a solution that mitigates the scaring, and the fertility impact patients may face in typical treatments for fibroid and adenomyosis removal. Additionally, this non-invasive state-of-the-art technology will also benefit patients with a short recovery duration, allowing them to return to their daily routine in no time,” said Dr. S. Selva, Obstetrician & Gynaecologist, and Reproductive Medicine Specialist of Mahkota Medical Centre. He added, “Ultrasound based HIFU treatment session ranges between 1 to 4 hours and in most cases, the treatment can be done in a single session. Only patients with multiple or large diameter fibroids, may require several sessions. It is also worthwhile to note that patients will not have any blood loss during the procedure, hence eliminating the need for blood transfusions. HIFU also reduces the risks of potential complications that may arise from surgeries to remove adenomyoma or uterine fibroids. Most importantly, patients who wish to get pregnant do not have to wait for their uterus to heal completely before trying to conceive. They can resume having sexual intercourse after completion of the next menstrual cycle. Studies have shown successful pregnancy within months after HIFU treatment for fibroids either by natural pregnancy or assisted reproductive treatment.” “As a medical centre that prioritises high-quality medical services, we strive to find new ways to deliver improved outcomes for the best interest of our patients. The introduction of HIFU service brings us one step closer to enhancing our patients’ journey towards achieving greater outcome. Ultimately, we are committed to continue keeping up with the latest trends in the industry by bringing in many more state-of-the-art facilities to offer the finest care for our patients,” said Chin Wei Jia, Group CEO of HMI Group. Chin Wei Jia - Executive Director and Group Chief Executive Officer of Health Management International Group References: Pregnancy outcomes in patients with uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound. Zou M, Chen L, Wu C, Hu C, Xiong Y. s.l. : BJOG, 2017, Vol. 3, pp. 30-35. Vaginal delivery outcomes of pregnancies following ultrasound-guided high-intensity focused ultrasound ablation treatment for uterine fibroids. Liu X, Xue L, Wang Y, Wang W, Tang J. 1, s.l. : Int J Hyperthermia, 2018, Vol. 35, pp. 510 – 517. Pregnancy outcomes in nulliparous women after ultrasound ablation of uterine fibroids: A single-central retrospective study. Shu LJ, Wang Yong, Chen J, Chen W. 3977, s.l. : Scientific Reports, 2017. Pregnancy and Natural Delivery Following Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery of Uterine Myomas. Yoon SW, Kim KA, Kim SH, Ha DH, Lee C, Lee SY. 3, s.l. : Yonsei Med J, 2010, Vol. 51, pp. 451 – 453. About Mahkota Medical Centre Founded in 1994, Mahkota Medical Centre (Mahkota) is one of the largest and most comprehensive tertiary private hospitals in South Malaysia. The hospital offers state-of-the-art diagnostic, therapeutic and quality medical services. It is one of the most comprehensive hospitals focusing on medical sub-specialties with high surgical workloads. Licensed with 305 beds in eight wards and housing over 120 practising consultants across a wide range of medical and surgical disciplines, it is supported by a dedicated team of management, doctors and allied healthcare staff. Mahkota Medical Centre is a top medical tourism destination in Malaysia and an elite member of the Malaysian Healthcare Travel Council serving some 100,000 foreign patients annually. It is the first private hospital in Melaka to become Joint Commission International (JCI)-accredited, in addition to earning the 5th edition Malaysian Society for Quality in Health (MSQH) accreditation. Mahkota is the flagship hospital of Health Management International Pte Ltd (HMI Group) with more than 25 years track record. For more information on Mahkota Medical Centre, please visit http://www.mahkotamedical.com.

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