Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Procedures
Focused ultrasound ablation of fibroids
How focused ultrasound ablation of fibroids destroys fibroid tissue through the skin without cuts, who is and is not suitable after an MRI, what the evidence says about symptom relief and repeat treatment, how it compares with embolisation and myomectomy, approximate costs in Turkey against the UK, US and Germany, recovery and how to choose a centre.
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Prof. Dr. Zehra Neşe Kavak
GynaecologyVerified
- 36+years exp.
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What is focused ultrasound ablation of fibroids and how does it work?
Focused ultrasound ablation of fibroids (also called MR-guided focused ultrasound, MRgFUS, or HIFU for fibroids) destroys fibroid tissue using sound waves aimed through the abdominal skin, with no incision. You lie face down inside an MRI scanner, and a transducer in the table sends many beams of ultrasound that cross at a small target point inside the fibroid. At that point the tissue heats to roughly 60 degrees or more for several seconds, which kills the cells by heat. The surrounding tissue, where the beams are still spread out, is not heated enough to be damaged. The MRI measures temperature in real time, so the team can see the treated area and stop or adjust. The dead tissue is left in place and the body gradually reabsorbs it.
The aim is to relieve symptoms such as heavy periods, pressure, pelvic pain and frequent urination, not to remove the uterus. This guide covers who is suitable, what the evidence says, how it compares with other fibroid treatments, what focused ultrasound ablation of fibroids costs in Turkey, recovery and risks. For the full range of women's health care see our gynaecology treatments in Turkey.
Does focused ultrasound for fibroids actually work?
For women who qualify, yes: studies show significant reduction in symptom scores, and the fibroid volume that is treated usually shrinks by a third to a half over six months. The National Institute for Health and Care Excellence (NICE) guidance on MRgFUS for fibroids says the procedure appears safe and effective in the short term, and recommends that it be done in specialist centres with audit. The honest limits are important. Results depend on how much of the fibroid volume is actually heated (called the non-perfused volume): the more that is treated, the greater the symptom relief. Long-term studies show that some women need further treatment, such as another procedure or surgery, within a few years, and the rate is higher than after myomectomy or hysterectomy. There is also much less evidence on pregnancy outcomes than for surgery.
Who is suitable for focused ultrasound ablation, and who is not?
Suitability is decided on an MRI, and many women are turned down. Often suitable are women with a small number of symptomatic fibroids that can be reached by the ultrasound beam, who are not pregnant and who do not want surgery or want to keep the uterus. Reasons that make treatment difficult or unsafe include:
- many fibroids, or very large ones, which are hard to treat in one session;
- fibroids high behind the uterus or far from the front of the abdomen, or bowel lying in the beam path;
- significant abdominal scars, mainly after caesarean or other surgery, which can reflect the beam;
- fibroids that are very bright on certain MRI sequences, which absorb little heat;
- metal implants in the beam path, a contraindication to MRI, or an intrauterine device with metal (some must be removed);
- suspected cancer, since treating a fibroid that is really a rare uterine sarcoma would be harmful, so the MRI and clinical features are assessed carefully.
Fibroids that grow into the cavity of the uterus (submucosal) are poor targets for this method, and a hysteroscopic myomectomy is usually the more suitable approach.
Focused ultrasound, embolisation or myomectomy: how do the options compare?
Fibroid treatment spans a wide range. The right choice depends on the number and location of fibroids, whether you want children and how you weigh recovery time against the chance of repeat treatment. The table gives a general comparison; a gynaecologist will tailor it to your scan.
| Option | Best suited to | Typical limits |
|---|---|---|
| Focused ultrasound ablation | A few accessible fibroids; wish to avoid incisions and keep the uterus | Strict MRI eligibility; higher repeat-treatment rate; limited pregnancy data |
| Uterine artery embolisation | Several or larger fibroids; keeping the uterus without surgery | Hospital stay for pain control; fertility effect less clear |
| Laparoscopic myomectomy | Wish to conceive; removes fibroids and repairs the uterine wall | Surgery under general anaesthetic; fibroids may regrow |
| Hysterectomy | Definitive treatment when childbearing is complete | Major surgery; the uterus is removed |
If you are comparing options generally, our overview of fibroid removal sets out how they relate.
What happens during the treatment session?
You usually have an MRI a few days before to confirm eligibility; the team may ask you to shave the lower abdomen, fast on the day and wear no metal. A urinary catheter is placed and an intravenous line gives light sedation and pain relief. You are awake and lie face down on the table, with a gel pad between skin and transducer. You hold a safety button and can stop the session if the heat feels too intense. The team treats the fibroid in many sonications of about 20 seconds each, taking cooling breaks in between. Each session takes about three to four hours, of which the treatment itself is the largest part. Some sessions are ended early if the doctor judges that you have felt pain or that bowel is too close.
Focused ultrasound ablation of fibroids cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for one session, not hospital quotes. The focused ultrasound ablation of fibroids price depends on the machine, the number and size of fibroids, the sedation used and whether pre-treatment MRI and follow-up scans are included. Few centres in Turkey own the equipment, so availability and prices vary widely.
| Country | Approximate cost range |
|---|---|
| Turkey | €4,000 – €9,000 |
| United Kingdom | €7,000 – €14,000 |
| United States | €9,000 – €18,000 |
| Germany | €6,000 – €12,000 |
A package usually covers the consultation, the treatment MRI, the session with sedation and monitoring, one night's observation if the team wants it and transfers. A follow-up MRI at three to six months is rarely included. Ask for each item in writing and for how many fibroids the quote applies to, since a second fibroid may need a second session.
What is recovery like after focused ultrasound?
Recovery is the strongest point of this method. Most women go home the same day or the next morning and walk straight away. Afterwards you may feel cramping similar to period pain, lower back ache, mild nausea and a warm or sore patch on the abdominal skin; these usually settle within a few days with simple painkillers. Many women return to light work in two or three days and to full activity within a week, which is much quicker than after surgery. You may see a vaginal discharge or spotting for a few days. Heavy exercise and sex are normally avoided for a week or so, as advised by your team.
Symptom relief is gradual: fibroid shrinkage takes months, and periods may lighten over two to three months rather than at once. A flight home is generally fine the next day after the team has checked you, though a longer stay of three to four days gives time for the MRI, the session and a follow-up check. Plan a follow-up scan and a gynaecology appointment at home.
What results can I realistically expect?
There is no before-and-after photograph for this treatment: the result is on the scan and in how you feel. The MRI after treatment shows the treated fibroid as an area with no blood flow, and over months the fibroid slowly shrinks. The outcome that matters is whether heavy bleeding, pressure and pain improve. Most women who have a good proportion of the fibroid treated report improvement within three to six months, but it is not a guarantee. If symptoms return, options include a repeat session, embolisation or surgery, and a clinic should explain this before you start. Fibroids may also shrink naturally after menopause.
What are the risks of focused ultrasound ablation of fibroids?
Common effects are pain or cramping during and after treatment, skin redness or a mild burn at the sonication site, and fatigue. Less common problems include nerve irritation in the leg or buttock (sciatic nerve pain), bowel or bladder injury from heat, bleeding or infection, and skin blistering, mostly in the early years of the technique. Rarely a part of a fibroid can pass out through the vagina as it breaks down. Because a missed uterine sarcoma is the most serious risk, any rapid growth, post-menopausal bleeding or unusual MRI appearance should be investigated first, as the Royal College of Obstetricians and Gynaecologists and NICE guidance both note. Ask the team how they handle pain and what happens if the session is stopped early.
How to choose a centre, and red flags
Because the equipment is specialised, choose a hospital that can show it uses an MRI-guided system, that a radiologist and gynaecologist both review your scan and that you receive a written plan and price before you pay a deposit. A trustworthy centre will tell you honestly if your fibroids are unsuitable. Red flags include a quote before any MRI, promises that fibroids will disappear, no mention of repeat treatment rates, no named doctor and no aftercare plan. Read how our process works and send your MRI report through our free quote page so a hospital can tell you whether it is suitable.
What should I ask the centre before booking?
- Will my MRI be reviewed before I travel, and what makes a fibroid suitable?
- What percentage of the fibroid is usually treated, and what if only part can be?
- How many sessions might I need, and are extra sessions included?
- What is the chance I will need another treatment within five years?
- Does the quote include the MRI, sedation, a night's stay and follow-up?
- What do you advise if I want to become pregnant?
Hospitals with Gynaecology in Turkey
Frequently asked questions
It is a non-surgical treatment in which focused ultrasound waves, guided by MRI, heat and destroy fibroid tissue through the abdominal skin without any incision. The uterus is left in place, and the body gradually absorbs the treated tissue.
In suitable women it reduces symptoms such as heavy bleeding and pressure, and treated fibroid tissue shrinks over months. Some women need further treatment later, and the repeat rate is higher than after surgery.
Approximate ranges are €4,000 to €9,000 in Turkey, against roughly €7,000 to €14,000 in the UK. The price depends on the number and size of fibroids and what the package includes, and the hospital confirms it in a written quote.
Women with many or very large fibroids, fibroids out of reach of the beam, bowel in the path, large abdominal scars or suspected cancer may not qualify. An MRI decides suitability.
Most women go home the same or next day and return to light work within two or three days, with full activity in about a week. Symptom relief develops over the following weeks and months.
You are lightly sedated and can stop the session at any time. Many women feel heat, pressure or deep cramping during sonications, and period-type pain afterwards that usually settles in a few days.
Pregnancies have been reported after treatment, but the evidence is smaller than for myomectomy. If you want children, discuss this with a gynaecologist before choosing this method.
They suit different fibroids. Focused ultrasound avoids needles and catheters but has stricter MRI eligibility, while embolisation can treat several or larger fibroids. A gynaecologist should advise from your scan.
Treated tissue does not regrow, but new fibroids can appear and untreated parts can grow. Follow-up scans show whether symptoms and fibroid volume are under control.
Most centres suggest three to four days: one for the MRI check, one for the treatment and time to rest and be reviewed before flying. Confirm the schedule with the hospital.
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