Uterine Fibroids


Myoma uteri is one of the most common diseases of  women in reproductive age. The symptoms are: heavy menstrual bleeding, frequent and painful menstruation, discomfort in the pelvis, secondary anemia and infertility. 

Usually the patient is diagnosed with uterine fibroids by the ultrasound examination. Sometimes uterine fibroids are detected incidentally in patients without symptoms at the time of the medical check-ups.                                                                                                                                                                                                                    

The traditional treatment of uterine fibroids is surgical (invasive or minimally invasive):

  • Conventional Myomectomy (surgical removal of  the uterine fibroids through abdominal access – open surgery)
  • Laparoscopic Myomectomy (minimally invasive surgery through small cuts on the abdomen)
  • Histeroskopic Myomectomy (minimally invasive procedure with vaginal access, which is only suitable for sub mucosal fibroids); 


The HIFU treatment is the completely new extracorporeal (without surgical excision and scars on the skin) approach to the treatment of uterine fibroids. This is a 100 % non-invasive and organ-sparing procedure which does not require general anesthesia; there is no blood loss and postoperative stress. 

It is very important that the HIFU procedures are completely harmless (non-ionizing) for the patient, the doctor and the environment. Nowadays HIFU treatment of myoma uteri is the first choice of  modern women around the world – it is the uterus (womb) and, respectively, fertility sparing treatment and the recovery is fast and easy - within 1-2 days the woman can return to her usual routine and active lifestyle.

It is expectedthat the extracorporeal ultrasound ablation (HIFU) would become the most popular and most frequently practiced non-invasive treatment of uterine fibroids globally!


  • 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.