Unimaid Expertis: Curing Fibroid Without Surgery
Ionce shared my experience on this page about my encounter at an international conference on medical ultrasound, held in Lagos, sometimes in 2012, where one high point of the conference was the presentation by Prof Hamidu Ahidjo, then Professor/Consultant Diagnostic cum Intervention Radiologist and now Provost at the University of Maiduguri/University of Maiduguri Teaching Hospital (UMTH), Bornu State. In the presentation of note on “The journey and practice of intervention radiology in Nigeria – the University of Maiduguri Teaching Hospital experience, he went to town on what the practice of intervention radiology is all about, the challenges and its promises.
For the Professor from off-Sahel region of Bornu, it was a pleasant presentation to share with colleagues on how the sub-discipline of interventional radiology has encroached meaningfully into other aspects of medical discipline whilst making treatment easier and more pleasant for the patients.
And for us, the listening audience, it’s a pleasant surprise to know that the practice of intervention radiology has firmly taken root in close-by Maiduguri, while unbeknown to many of us we continue to refer patients to hospitals and centers outside the country to access related procedure directed to curing/ managing the likes of fibroids, other benign tumours and some tumourous cancers. What’s more we subjected patients and relative to these ventures that cost some much in hard currency with the associated risk of long flying time and the unpalatable experience of being away, thousands of kilometers, from loved ones.
The bottom line and center point of interventional radiology is the use and application of the radiological tool of angiography. Angiography is basically the mapping of blood vessels and the study of the blood supply to body organs with use of contrast media, which outlined the blood vessels with X-rays.
With the knowledge of which blood vessel supplies a particular organ and its abnormal appendages, it is enough to realize that if these vessels are blocked by plugging them with special materials developed for this purpose, then the concerned organ’s abnormal outgrowth – tumor (both benign and cancerous growth) can get its blood supply blocked. This deprived them necessary oxygen and nutrient supplies which will ultimately lead to shrinkage and ‘evaporation’ of the tumour or growth.
A direct and common application of the wizardry of interventional radiology is in the treatment of Fibroid in women, without resulting to direct surgical cutting of the fibroid growth or excising the womb (uterus) as a whole as it is done in myomectomy and hysterectomy surgical operations respectively.
This interventional radiology procedure is called uterine fibroid embolization, also known as uterine artery embolization. It is a relatively new uterine fibroid treatment approach. It is a minimally invasive procedure that involves blocking the fibroid’s blood supply which would have been well mapped out doing an angiography of the uterus earlier performed by Interventional Radiologists.
The procedure is done through an incision, less than one-quarter of an inch in size; a ting tube (catheter) is placed into the femoral artery at the thigh; the interventional radiologist guides the catheter into the uterine artery, with the aid of a fluoroscopic ‘x-ray’. Subsequently, tiny plastic or gelatin sponge articles, the size of sand grains, are slowly injected into the uterine artery blocking the blood supply feeding the fibroids. As a result of the blockage, fibroids begin to shrink and die.
Another related confession I pause to make here is that I definitely got it wrong two years ago, when a respondent to my column, in the Saturday title of this newspaper, on uterine fibroid and embolisation asked if uterine embolisation can be done in Nigeria, unfortunately my answer was in the negative. I definitely goofed; I wish I had been in contact with the Maiduguri folks earlier, the lady would been saved the millions of Naira and the associated ‘wahala’ involved with making the trip to access treatment outside Nigeria for something readily available in the country.
My recent search actually revealed that the University of Maiduguri Teaching Hospital Interventional Radiology project was muted in 2005; after acquiring necessary expertise and infrastructural upgrading, it got kicked-started fully in the year 2008 with Dr Hamidu Ahidjo as the arrow-head and the Lead Interventional Radiologist.
Ahidjo, is an Alumnus of the College of Medicine, University of Maiduguri, he got his Fellowship of Radiology of the West African College Surgeons (FWACS) and Fellowship of Radiology of the National Postgraduate Medical College of Nigeria (FMCR) in October, 2002 and November, 2002 respectively. He had Post-Fellowship Training in Interventional Radiology at Medical University of ViennaAKH, Austria, in 2007-2008 and was awarded the RSNA Derek Harwood Nash International Fellowship in Interventional Radiology in Washington University - 2009. An intimidating credential it is from the team leader of the Interventional Radiology unit, where the science of radiology has been raised higher from just disease diagnosis to the height of diagnosis and intervening with definitive treatment in disease condition.
So far, the Maiduguri center has become a reference center for all such cases that could benefit from diagnostic angiography and arterial embolisation treatment. These include but not limited to certain class of fibroids (especially those that are not complicated from calcification etc) and soft tissues benign tumours.