During the treatment episode, the patient has to lie on her stomach for 3 – 4 hours and this can be a little uncomfortable. Some mild sedative and pain relieving medication is given to help the patient to relax.

Individual pulses of focused ultrasound energy, each lasting about 20 seconds, will be applied to your fibroids. These may be associated with some cramping discomfort (similar to period pain). The discomfort may be felt when the pulses (sonifications) are applied, and stops as soon as the pulses ends. At any time should the patient finds the discomfort unbearable, she can stop the sonification immediately by pressing a button that is held in her hand.

About 5 - 6 hours in total for the treatment episode.

This comprises:

• approximately 3 - 4 hours for the actual treatment and
• 1 hour for the preparation, and
• 1 hour to rest and recover from sedation

The treated tissue will gradually contract (gets smaller), absorbed and be replaced by scar tissue.

Usually 1 – 2 days rest. We have had experience of patients going to the market the next day after the procedure and even driving home within 1 hour (but we recommend people to be accompanied). Most patients resume normal activity and return to work the next day.

Usually no, although slight discharge is not uncommon for a few days after the treatment.

Approximately 80% of patients have a significant reduction in their symptoms with a corresponding 80% satisfaction rate in the literature. Our limited group of patients have all had improvement, but it is early days yet.

At present, only those ladies who have completed their families and are pre-menopausal are suitable for this therapy. Also, only patients with fibroids that cause symptoms (see introduction) are suitable for treatment. Post-menopausal patients are not suitable for treatment as fibroids normally become smaller on their own after menopause.

As this procedure involves the use of magnetic resonance (MR) imaging (which uses magnetic waves and radio-waves), patients need to be “cleared“ for MR imaging – e.g. they must not have heart pacemakers or ear implant.

The fibroids need to be between 3 and 10 cm in size. A maximum of three (3) fibroids may be treated at a time, subject to a maximum volume (500ml). Repeat treatments would be required if the volume of fibroid(s) exceed the recommended limit.

For patients with a large number of fibroids (more than 6), there is an increased possibility that some fibroids may lie outside the ultrasound-ablation field and therefore, outside the treatable area.

The locations of the fibroids may therefore render the treatment unsuitable.

Approximately, only 30% of patients are suitable to be treated and this can only be confirmed by an assessment MR scan, with contrast injection / enhancement, and performed on the patient lying on the special MRgFUS couch.

The radiologist, who determines the treatment potential, will then be able to advise if you are suitable for treatment.

Some of the main reasons that rendered MRgFUS ablation unsuitable for patients are:

• Patient who are unsuitable for MRI scanning e.g. those with pacemaker or ear implant being inserted. The patient will have to complete a MR safety questionnaire to assess that it is safe to perform the MR scan on her.
• Known adverse reactions to MR contrast agent
• Patient who is pregnant or wanting to become pregnant
• Massive lower abdominal scarring
• Patients who have had IUCDs (intrauterine contraceptive devices) and ESSURE contraceptive devices inserted. These devices can lie in the path of the ultrasound beam and will absorb heat; thereby affecting patient safety and efficacy of the treatment.
  • Patients with IUCDs inserted and found to be suitable for the treatment should have the device removed prior to the treatment.
  • Patients with ESSURE are not suitable for the procedure.
  • Patients who had Filshie clips inserted is safe to proceed with the MRgFUS ablation.

Your consultation with your gynaecologist and radiologist will ensure that you will be assessed properly.

So far, no recurrence rate is known as the procedure has only been performed since 2003. It is certainly possible that new fibroids may occur.

With effect from 1 May 2007, the “A” rate treatment cost has been revised to $5,200 and subsequent treatment, if needed, costs $2,000.

There is also a need to have a pre-treatment MR scan (an assessment MR scan) costing $400. A post-treatment MR scan, to be done about 3 months later, also costs $400.

In total, it is $6,000 for the first treatment.

If you are suitable for the treatment and you wish to proceed, you will be informed of the charges.

Consultation session with either the gynaecologist or the radiologist at the Ultrasound Ablation Clinic will each be charged a fee of up to $80.80 each, per session.

All prices do not include GST and may be subject to change.

Yes, patients can use up to $1,000 from their Medisave to pay for the treatment fees. They will be admitted as a Day Surgery patient.

With effect from 1 July 2007, the MRgFUS ablation treatment will be extended to subsidised patients.

As the patient is undergoing the treatment in an outpatient setting, the patient will be charged at 40% of the prevailing "A" rate for the treatment.

Both the pre-treatment MR and post-treatment MR scans will be charged accordingly at 50% of the prevailing "A" rate.

Prices are subject to change without prior notice.

To know the difference between "private" or subsidised" patients, please click here.

No, the time of treatment is not dependent on the menstrual cycle.

There is a staff nurse accompanying the patient at all times. The patient is constantly under physiological monitoring of her vital signs. The radiographer and the radiologist are in constant communication through a window and intercom.

After the treatment, the MRgFUS resource person (a staff nurse) will also contact you regularly to enquire about your symptoms. You are also encouraged to feedback to her via email: ablate.fibroids@kkh.com.sg or tel: (65) 97362250.

Yes, there are. As the procedure is fairly long and requires patient co-operation, a urinary catheter is inserted. An Intravenous plug is also inserted before the start of the procedure so as to administer medication which is required as part of the treatment.

The MR scan, to be done 6 months later, allows the radiologist to see the effects of the treatment on the fibroids.