Hope for women with fibroids as new treatment saves fertility

Fibroids are non-cancerous growths in the uterus that can cause pain heavy bleeding and discomfort in women. It is no surprise, therefore, that a woman might choose to have them removed.

Previously, a woman’s treatment options in Kenya were: drugs to ease the pain or to reduce heavy bleeding; open surgery to remove the fibroids (myomectomy) or the entire womb (hysterectomy); laparoscopic surgery to excise the growths; or Uterine artery embolization (UAE) – a minimally invasive surgery to cut off blood supply to the fibroids.

All of these options – except the drugs – carry the risk of making the uterus unable to carry a pregnancy, says Dr Kireki Omanwa, president of the Kenya Obstetrical and Gynaecological Society (KOGS). “ However, drugs do not treat the fibroid itself, but only manage the symptoms.”

Beryl* underwent surgery to remove fibroids in 2012. “The doctors told me about the risks. The advantage I had was that I was a mother of two already,” she says. She hasn’t been pregnant since but it doesn’t bother her much.

Dr Omanwa spoke to Health & Science on the sidelines of a recent meeting of obstetricians and gynaecologists, held two weeks ago at the Fairview Hotel in Nairobi. The focus of the discussion was a new treatment method for fibroids that preserves the womb and a woman’s future ability to carry a pregnancy.

Known as High Intensity Focused Ultrasound (HIFU) ablation, this non-invasive technology was introduced in Kenya in January 2025.

“This is an incredible technology and a first for Kenya,” Omanwa said. “This meeting is meant to develop guidelines for the utilization of this technology. Guidelines define what the technology is; how it works; who qualifies for this treatment; what are the possible side effects and so on.”

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Wairimu*, 34, a medical doctor by training, was HIFU’s first patient in Kenya on February 17 – two months ago. She first learnt that she had fibroids while she was a student at the University of Nairobi’s Medical School.

She says: “In campus my periods started becoming heavy and painful. One time, in third year, I experienced so much pelvic pain that I had to leave mid-lesson to the students’ clinic. The doctor sent me for a pelvic ultrasound scan. That is how I was diagnosed. But they were still small and the doctor said there was no need to tamper with them at that time.”

Before the fibroids, Wairimu’s periods lasted 3-4 days. “I changed a maximum of 3 pads per day: like every other girl with normal menses.”

As the fibroids developed, her periods got heavier and longer. “Sometimes I would change pads eight times in a day; and bled for as long as seven days.”

She graduated in 2015 and went into employment as a doctor. “The nature of my job is that I am always on the move; up and down.”

There are days – while busy attending to patients – she couldn’t change fast enough and the blood would seep through to her dress.

She got herself an obstetrician and gynaecologist specialist who laid out the possible solutions available locally. None of them felt like an option to consider.

“I would like to be a mother in future. And I would like to give birth normally. The thing is once one has had fibroid surgery (and they can still carry a pregnancy) they cannot give birth normally,” she says. UAE blocks blood supply to the fibroids – and parts of the uterus – which incredibly lowers the womb’s ability to nurture a foetus.

In 2024, when push came to shove, Wairimu was considering all possible solutions when she learned about the arrival of HIFU in Nairobi.

“The bleeding had worsened drastically. One morning, while in the bathroom, I fainted. Thank God my younger brother was home with me.”

“When I went to my doctor and did a scan the fibroids had grown – they were so big with a diameter of 8-10 centimeters. I also had abdominal bloating and back pain,” she says.

Dr Evelyn Muthoka, a trained HIFU specialist and consultant at Nairobi Hifu Centre, conducted the procedure on Wairimu.

She says: “She was referred to us by an ob/gyn who knew about the technology’s availability. She had one big fibroid along the outer layer of the uterus and a few in the muscular layer. We performed additional tests such as pelvic contrast enhanced MRI to confirm the exact size and location of the fibroids.

“During the procedure, the patient is sedated and monitored by an anesthetist while the specialist operates the machine; manipulating it to target the fibroids with pinpoint precision.”

 The technology can be likened to focusing sunlight through a magnifying glass to burn something.

“It focuses ultrasound waves to create a thermal lesion within the fibroid. This localized heat, reaching temperatures of 65-100° Celsius or higher, kills the fibroid without damaging the surrounding healthy tissues,” Dr Muthoka says.

The non-invasive nature of the procedure translates to same-day hospital discharge and faster recovery; allowing patients to resume work within 10-14 days.

“Once the fibroids are burned, the body’s immune system begins to ‘clean up’ the dead tissue,” says Dr Muthoka.

HIFU is similar to the CyberKnife technology, which arrived at Kenyatta University Teaching Referral and Research Hospital (KUTRRH) in 2023.

“They are alike, but different in that HIFU uses ultrasound waves converted into heat energy, while CyberKnife uses radiation. Additionally, CyberKnife is specifically used for cancerous tumors,” Dr Muthoka explains. The doctor says that in many instances, a single treatment session is sufficient.

The downside to the technology is that it is best suited for patients with few (approximately 1-15 fibroids). Those with more may need a combination of treatment methods.

HIFU was developed by Chongqing Haifu Medical Technology Company located in the city of Chongqing, in China. The machine was first used in 1997.

Kenya is the fifth country – after Egypt, South Africa, Nigeria and Tanzania – in Africa to have the technology within its borders.

Apart from fibroids it has also been used to treat adenomyosis (endometriosis localized inside the wall of the uterus) and specific localized cancers such as prostate and pancreatic cancers.