Health
No surgery, no scars: How HIFU is changing fibroid care in Nigeria
Angela Onwuzoo
As technology continues to transform healthcare delivery worldwide, High-Intensity Focused Ultrasound is emerging as a non-invasive treatment option for women with uterine fibroids in Nigeria.
For decades, a diagnosis of uterine fibroids in Nigeria has often been followed by an uncomfortable conversation about surgery.
But the introduction of HIFU treatment in Nigeria’s healthcare system is changing that narrative, demonstrating what can be achieved when medical expertise, advanced technology, and investment converge.
So far, about 1,000 Nigerian women have reportedly been treated with the technology without surgical cuts, stitches, or the blood loss associated with conventional surgery.
For many women with fibroids, particularly those hoping to have children, the prospect of surgery can be frightening.
Concerns about losing the uterus, difficulty conceiving, blood transfusion, and prolonged hospital stays have discouraged many women from seeking treatment.
Fibroids are tumour-like, non-cancerous growths in the uterus that can sometimes stop a woman from becoming pregnant because they can create problems for the fertilised egg attaching to the lining of the uterus.
The quality of life of women with fibroids is disturbed by the symptoms they encounter. The symptoms come in the form of heavy bleeding and anaemia. The bleeding can be irregular depending on the location of these fibroids, and there might be a bump that is mistaken for pregnancy.
Over the years, the main treatment options for uterine fibroids have included invasive procedures such as myomectomy, which removes the fibroids, and hysterectomy, which involves removing the uterus.
HIFU, however, offers a different approach. HIFU is a modern, non-invasive medical treatment used to manage uterine fibroids without the need for surgery.
It uses focused ultrasound waves to target and destroy fibroid tissue deep within the body without affecting surrounding organs.
Unlike traditional surgical procedures such as myomectomy or hysterectomy, HIFU does not involve cuts, stitches, blood loss, or a prolonged hospital stay.
The Managing Director of Nordica Fertility Centre and Fibroid Care Centre, Dr Abayomi Ajayi, said the completion of the 1,000th HIFU treatment at the fibroid treatment centre represents more than just a numerical milestone.
Ajayi said HIFU is now used in more than 37 countries and has successfully treated over 500,000 women with fibroids without surgery.
“It is an important marker of what becomes possible when new medical technology is introduced, local expertise is deliberately developed, and women are given greater choice in how their reproductive health conditions are managed”, he said.
Introduced in 2002 at the University of Oxford, HIFU is now available in five African countries, including Nigeria.
It was first introduced in South Africa, followed by Egypt, Nigeria, and later Kenya, with thousands of women embracing the procedure.
From open surgery to treatment without incision
According to the gynaecologist, uterine fibroids are benign tumours of the uterus and one of the most common gynaecological conditions affecting women during their reproductive years.
“They can cause heavy menstrual bleeding, pain, pressure symptoms and, depending on their characteristics, may be associated with reproductive difficulties. For generations, surgery has played a central role in treating symptomatic fibroids. It remains an important and sometimes necessary treatment, and myomectomy continues to have a particularly important place in the management of fibroids.
“But surgery is not without consequences. Any operation brings potential risks associated with anaesthesia, bleeding, infection, postoperative pain, adhesions and recovery”, he explained.
Giving insight into the benefits of HIFU treatment in fibroid management in Nigeria, Ajayi said its adoption was essential to expand women’s access to quality care and safer treatment options amid the challenges confronting the health sector.
The Nordica boss noted, “In a healthcare environment where access to safe blood products, specialist surgical expertise, operating theatre capacity and high-quality postoperative care can vary considerably, technologies that allow appropriately selected patients to avoid an operation deserve particular attention. HIFU represents one such innovation.
“Instead of making an incision, HIFU concentrates ultrasound energy at a precisely identified target within the body. The energy generates heat that ablates the targeted fibroid tissue while surrounding structures are protected. The treated tissue is subsequently broken down by the body, and the fibroid progressively shrinks.
“There is no abdominal incision. There is no surgical removal of the fibroid. The uterus remains in place. That distinction matters enormously to women.”
What 1,000 treatments represent
He noted that when the first ultrasound-guided HIFU system was introduced at the Fibroid Care Centre at Nordica in 2021, the technology was still relatively new to the African region.
“At the time, HIFU systems were present in only a handful of African countries, including South Africa and Egypt. Nordica’s program became the first ultrasound-guided HIFU facility dedicated to fibroid treatment in Nigeria and West Africa.
“What was then a relatively unfamiliar technology has since become part of a growing global movement towards non-invasive treatment. Today, HIFU technology is available in 37 countries worldwide and has been used in more than 350,000 cases of fibroids and adenomyosis,” he added,
Against this backdrop, Ajayi said completing 1,000 HIFU treatments in Nigeria represents much more than an institutional milestone.
For the fertility specialist, achieving this feat demonstrates that advanced, non-invasive reproductive health technology can be successfully introduced, adapted and delivered at scale within our healthcare system.
“ More importantly, it represents 1,000 women who were able to consider an additional treatment option for conditions that can profoundly affect their everyday lives”, he said.
Challenges of women living with fibroids
The true value of medical technology is not measured by how sophisticated the machine is, but by what it changes for the patient.
For a woman living with debilitating heavy periods, chronic pelvic pain or pressure, fibroids can affect far more than the uterus. They can disrupt work, relationships, sexual wellbeing, emotional health and everyday quality of life. The ability to treat selected fibroids without an incision changes that experience.
For appropriately selected women, the maternal health expert said HIFU offers a completely non-invasive, uterus-preserving treatment option.
He further noted, “There is no surgical incision and no physical removal of the fibroid. Instead, focused ultrasound energy precisely ablates the targeted tissue, which is gradually broken down by the body as the fibroid shrinks over time.
“Compared with conventional surgery, this can mean less disruption and a faster return to normal activities. Not every fibroid is suitable for HIFU, and not every woman needs the same treatment. That is why the future of fibroid care is not about replacing surgery with HIFU. It is about moving away from a one-size-fits-all approach and giving women access to a broader range of appropriate choices.”
For him, the question should increasingly become not simply, “How do we remove this fibroid?” but “What treatment best addresses this woman’s symptoms, circumstances and future reproductive goals?”
The next thousand
Ajayi pointed out that celebrating 1,000 treatments is therefore not simply about looking backwards.
“It should provoke a larger conversation about what comes next”, he added.
He said Nigeria needs greater investment in medical technology, stronger partnerships between Nigerian healthcare institutions and global centres of innovation, deliberate transfer of clinical knowledge, and locally generated research that tells us how technologies perform in African populations.
“We should be collecting and publishing our outcomes. We should be training the next generation of clinicians. We should be developing centres of excellence capable of serving the wider region. And we should increasingly expect that Nigerian women can access world-class reproductive healthcare without leaving the country.
“The most meaningful measure of progress will not be how many machines we import. It will be how much expertise we build around them, how much evidence we generate from them, and how many lives are improved because they are here”, he said.
1,000 women treated, personal milestone
He described 1,000 women treated as a milestone that is personal and also represents something larger for Nigeria.
“For Nigeria, it represents something larger: proof that we can adopt sophisticated medical technology, build local expertise around it, and begin changing the direction in which patients travel for care.
“And for the woman who has just been told she has fibroids or adenomyosis, perhaps the most important message is the simplest: You may have more options than you think”, he said.
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