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Myoma Treatment with Hifu


  • 100 % non-invasive procedure – there are no incisions and cuts on the skin
  • Uterine sparing treatment
  • Woman’s fertility is preserved Does not require general anesthesia
  • No blood loss
  • Harmless and “green” treatment - a non –ionizing procedure for the doctor, the patient and the environment
  • Fast recovery of the patients – 1-2 days
  • Out-patient treatment – the patients can go home after HIFU procedure


Before approving of the patient for ultrasound ablation of uterine fibroids, planning of the treatment (the so called “simulation”) has to be carried out by the certified HIFU doctors at the “Saint Marina” HIFU – Center, Pleven, Bulgaria.

It is necessary for the planning that the patient has a current (within 1 month before the examination) MRI (magnetic resonance imaging) of the pelvis with contrast enhancing agent!

The purpose of the planning is a selection of the appropriate cases, observation of the target zones, taking the needed parameters and saving the data for the actual treatment.

The accuracy of the planning ensures the desired effect.


There are strict criteria for the myoma patient to be approved for HIFU treatment. However, according to over 10 years statistics almost 99% of the patients have proved to be appropriate.
During the ablation (treatment) the patient is not under general anesthesia but only sedated. It means that she is in constant verbal contact with HIFU team of specialists. It is normal to feel certain discomfort in the pelvis area while the ablation is carried out – when the pain is stronger, the patient indicates it to the doctors and they take necessary measures so that the patient feels more comfortable.
The duration of the procedure is strictly individual. Usually, it does not take more than 3 hours. The duration of the treatment depends on the size, location and intensity of the blood supply to the fibroid nodule.
As a result of the ultrasound ablation a coagulative necrosis is formed in the tumor and the symptoms gradually disappear. Typically, the size of the tumor is decreased by 1 to 3 cm per month. The treated nodule usually shrinks most intensively between the third and sixth month after the HIFU-treatment.

After HIFU-ablation the patient can experience a temporary menstrual pain. If necessary, standard painkillers could be taken.
One to three menstruation cycles after the ablation might be expected to be heavier and more prolonged.
The only limitation is abstinence from sexual contacts until 1 month after the procedure. There are no restrictions on food and movements.
The patients should not become pregnant within 6 months after HIFU-treatment. The same
period is required after the conventional and laparoscopic Myomectomy.

N.B. Obligatory follow-ups are carried out by the certified HIFU-specialists in 1, 3, 6, 12 and 24 months after the procedure to evaluate the recovery of the uterus.

Criteria for HIFU therapy for Fibroids


  • clinically proven fibroids
  • Symptoms include abnormal menstrual cycle, dysmenorrhea, secondary anemia, infertility
  • D >2.0sm. D >4.0 sm - for fibroids junction of rear wall
  • Fibroids unit sees good ultrasound
  • Volunteered for treatment with HIFU
  • Save the uterus (refusal to hysterectomy)

relative contraindications:

  • Gynecological infection (inflammation of the pelvic organs)
  • IUD (intrauterine device)
  • Fibroids unit off more than 12 cm from the surface of the skin
  • Thickness of the abdominal crease> 7 cm
  • cervical fibroids
  • More than 6 knots Fibroids
  • Requirements for procreation
  • Surgery on the lower floor of the abdomen in the last 3 months


  • Near menopause.
  • Submucosal (subserous) fibroids with pedikul
  • endometriosis
  • Great postoperative scarring of the abdominal wall(during which it can not pass ultrasound)
  • Radiation dose of 60 Gray pelvis
  • Foreign body implanted along the acoustic path
  • Endemic with other bodies / rectum /
  • Malignancy such as sarcoma of the uterus, endometrial Ca, Ca cervical etc.