The Procedure
The Day of the Procedure
On the day of the procedure you will be admitted and clerked in by the nursing staff. A pregnancy test is routinely performed prior to the procedure. It is routine to insert a bladder catheter. This is for your own comfort as you will need to lie flat for a few hours during but also because filling of the bladder with urine during the treatment would displace the uterus and move the fibroids.
Before the procedure you will be given a suppository of a long acting anti-inflammatory pain killer. The MRgFUS procedure is not particularly painful and we aim to prevent pain rather than wait until it happen. Paracetamol is also given by intravenous infusion during the treatment.
Great care is taken to ensure that you are in a comfortable position before the treatment starts. For the treatment you will lie on your tummy with the fibroid positioned directly over the ultrasound transducer. A gel pad is placed on the table to establish direct contact with the skin. A coil is placed over the pelvis to aid imaging and you slide into the MRI scanner feet first.
Some initial MRI scans are performed and the treatment is planned by the radiographer and interventional radiologist on the workstation in the control area. The area to be treated is plotted on the scans with markers to avoid any encroachment of the ultrasound energy on other organs, particularly bowel. Treatment or sonication is then commenced.
During the treatment you may experience a mild heating sensation in the pelvis. If you are uncomfortable you can at any time stop the sonication by pressing a button that will be given to you at the start of the treatment. The duration of the treatment depends on the size and number of fibroids being treated and also on other factors such as the blood supply. For larger fibroids treatment can take up to 3-4 hours. Throughout this time staff in the MRI control room will be in touch with you via an intercom and will come into the scan room periodically.
On completion of the treatment a final MRI scan is obtained and you will then be assisted off the scanner table and back to your room. You can then have something to eat or drink and will be kept in the hospital for a few hours to ensure the sedation has fully worn off. You should not drive yourself home and should arrange to be collected.
