Before the procedure
Focused ultrasound surgery is performed as an outpatient procedure in an MRI scanning room.
Shortly before the procedure begins, you'll:
- Have an intravenous line placed in one of your veins to inject contrast material for MRI and to give you medication for relaxation and pain
- Be offered earplugs because the internal part of the magnet produces repetitive tapping, thumping sounds and other noises
- Have special stockings to prevent blood clots put on your legs
- Have a urinary catheter inserted into your bladder to keep the bladder stable during your treatment and improve visibility of the uterus
During your treatment, MRI allows doctors to evaluate the effects and define areas that need additional treatment.
During the procedure
Treatment time varies, depending on the size and number of fibroids you have. Here's the procedure.
- You lie on your stomach on a movable table that slides into the opening of the MRI scanner. A doctor monitors you from an adjoining room and can talk to you and hear you by microphone.
- Using focused ultrasound waves (sonications), each portion of the fibroid is heated. MRI is used to monitor tissue temperature and determine if the fibroid has been heated enough to achieve the desired results. The process is repeated until most of the fibroid has reached a temperature that should destroy the tissue.
- Each sonication lasts approximately 20 to 30 seconds. Typically it takes up to 100 sonications during a treatment session to destroy a fibroid. However, depending on the size and number of fibroids you have, more sonications or a second treatment may be necessary.
- Throughout the treatment, you'll be asked about your level of discomfort so that your medication can be adjusted or other necessary changes can be made.
After the procedure
You'll need a friend or family member to be with you and drive you to and from your treatment due to the medications you receive during treatment.
When you get home, you can resume your normal daily activities. Usually you'll need only over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others), or acetaminophen (Tylenol, others), for discomfort.
April 30, 2016
- Zupi E, et al. Nonsurgical alternatives for uterine fibroids. Best Practice and Research Clinical Obstetrics and Gynaecology. In press. Accessed March 20, 2016.
- Kong CY, et al. MRI-guided focused ultrasound surgery for uterine fibroid treatment: A cost-effective analysis. American Journal of Roentgenology. 2014;203:361.
- Jacoby VL, et al. PROMISe trial: A pilot, randomized, placebo-controlled trial of magnetic resonance guided focused ultrasound for uterine fibroids. Fertility and Sterility. 2016;105:773.
- Magnetic resonance imaging (MRI): Body. RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=bodymr. Accessed March 20, 2016.
- Kim HK, et al. Three cases of complications after high-intensity focused ultrasound treatment in unmarried women. Obstetrics and Gynecology Science. 2015;58:542.
- Mindjuk I, et al. MRI predictors of clinical success in MR-guided focused ultrasound (MRgFUS) treatments of uterine fibroids: Results from a single centre. European Radiology. 2015;25:1317.
- Stewart EA. Uterine fibroids. New England Journal of Medicine. 2015;372:1646.
- Coakley FV, et al. Pelvic applications of MR-guided high intensity focused ultrasound. Abdominal Imaging. 2013;38:1120.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. April 1, 2016.
Focused ultrasound surgery for uterine fibroids