She was only 22 when she came to see me.
Her complaint sounded simple.
Her abdomen was getting bigger.
Her periods were heavy.
When I examined her, I could feel a large mass in her abdomen. This was not normal.
An ultrasound scan confirmed the diagnosis. She had multiple fibroids.
Her uterus had grown so much that it reached her umbilicus. This is about the size we expect in a woman who is five months pregnant.
We proceeded with an MRI scan to understand the situation better. It showed five large fibroids, along with several smaller ones scattered in the uterus.
There was also a family history. Her mother had fibroids as well, but only after completing her pregnancies.
This case was different. She was only 22.
At this age, any treatment decision must be made carefully. Surgery is often the standard treatment for large fibroids. But surgery involves cutting into the uterus.
Her parents were concerned about this. They were worried about future fertility and the impact of scars on the uterus.
So we discussed another option. HIFU.
High-Intensity Focused Ultrasound is a non-invasive treatment. There are no incisions. No surgical scars.
Instead, focused ultrasound energy is used to destroy the fibroid tissue inside the uterus.
Because her fibroids were large and had a strong blood supply, the treatment took more than three hours. It required careful planning and precise targeting.
We completed the procedure successfully.
After the treatment, we performed another MRI scan. This is an important step.
The results were encouraging. All the fibroids were well ablated.
There was no surgical wound on the uterus. No incision had been made.
Now, the next phase is time.
The fibroids will gradually shrink over the coming months.
Symptoms usually improve as the fibroids reduce in size.
There is another advantage to this approach.
If new fibroids develop in the future, she can undergo HIFU again.
There is no scar tissue to complicate future treatment.
No weakening of the uterine wall from previous surgery.
At 22, preserving the uterus is important.
Not only for fertility, but also for long-term uterine health.
Today, technology gives us more options.
Not every fibroid needs surgery.
Result
The fibroid kept shrinking over time. Her uterus reduced from 18 weeks size to 14 weeks size. She avoided surgery and feels well.
Key message
Not all large fibroids need surgery. In the right patient, HIFU works safely and steadily.