Treatment of uterine myoma through HIFU procedure
Uterine myoma is a tumor that occurs in smooth muscle, and according to statistics from the National Health Insurance Service, the number of uterine myoma patients has increased by 50% over the past five years. It is a tumor that is commonly found in 20 to 40% of women of childbearing age, and Korea's hysterectomy is the No. 1 among OECD countries. Amid the recent HIFU procedure to treat uterine myoma while preserving the uterus, I met Sung Young-mo, director of Suwon Gangnam Women's Hospital, who took office as the first president of the university's ultrasound society.
Q. Medieus Queen: Hello. It is great to meet you, Dr. Sung Young-mo, director of Suwon Gangnam Women's Hospital. You won the grand prize for three consecutive years in the category of non-surgical HIFU treatment for uterine myoma at the 2022 Korea Medical Health Care Awards. Suwon Gangnam Women's Hospital is taking the lead in improving women's health by focusing on gynecological diseases instead of obstetrics and gynecology. Please introduce yourself.
A. Director Sung Young-mo of Gangnam Women's Hospital in Suwon (hereinafter referred to as Sung Young-mo): Hello, our hospital is the first women's hospital in Suwon with a history of 38 years. Until 2018, we operated obstetrics and gynecology together, delivering about 63,000 newborns over 20 years. As of 2010, 120 to 150 babies were delivered a month, but as the number of births is gradually decreasing, the gynecological field which mainly treated patients in their 20s and 30s was found to be important for the health of mothers in their 40s, 50s, and especially after childbirth. Therefore, since 2010 the gynecology department has been steadily strengthened and has been operated as a gynecology specialized hospital since 2018 after the obstetrics department was closed.
Q. Medieus Queen: Suwon Gangnam Women's Hospital is known to have various experiences and excellent technology through 8,000 incontinence surgeries. I heard there's a special surgery method, so what kind of surgery is it?
A. Sung Young-mo: In the case of TVT incontinence surgery, it was a very difficult surgery that produced many bladder perforations and many hematomas. So a surgical method called TOT was devised. However, this TOT surgery fails almost 100% without grasping the incontinence occurring in the upper part of the pubis. To compensate for these shortcomings, the Gold Standard TVT specified in the European Society was devised, and the success rate was increased through TOT surgery, which was made into a TVT. TOT urinary incontinence surgery itself is a surgery to hang a tape in the middle of the urethra, but when you hang it in the middle of the drooping urethra, it looks like a "w" shape. Then, when women urinate and wake up again, a little leaky side effect occurs. So we improved this side effect by applying a surgical method that places the tape inside more than the middle of the urethra.
In addition, most people who have undergone urinary incontinence surgery often have a drooping bladder. Even if the tape was fixed well at first, the tape might be pushed back during the operation, so we even introduced a skin anchoring technique that fixes the table to the skin to prepare for such a situation. In particular, the most common cause of recurrence after urinary incontinence surgery is the leakage of urine as the tape twists in the middle and the ground area becomes thinner. So I made silicon so that the tape wouldn't get twisted. The tape has been applied since 2012, and the recurrence rate reduced to less than 2% from 5-10%, and the patent has been registered. Through continuous improvement, our hospital has made a remarkable achievement that the recurrence rate is only 18% after three years, and we are performing urinary incontinence surgery with fewer side effects and a higher success rate. Through these data, we are preparing to publish it in overseas papers.
Q. Medieus Queen: Statistics from the National Health Insurance Service show that uterine myoma cases have increased by 50% over the past five years. Uterine myoma is a tumor that occurs in smooth muscle, and it is said to be so common that nearly 20 to 40 percent of women of childbearing age have it. However, the recent development of HIFU technology to treat uterine myoma non-invasive has improved the treatment for complications and success rates. Please explain the treatment of Haifu.
A. Sung Young-mo: I first came across HIFU in 2015, and at that time, it was a method of slicing myoma while burning myoma with heat. It was introduced to our hospital for the first time in 2019, and we had a hard time trying for two years. In principle, 80 to 90 percent of them were treated, but when I did it, it was only 30 to 40 percent. So I went on a field trip to the company that made this, met the doctor who is using it the best in the world, and practiced it myself to upgrade it a lot.
Now with a volume treatment, by which you continue to heat one place you can burn the center completely and burn the surroundings with radiant heat, it takes 14 to 15 minutes to burn the 5cm myoma, which used to take 40 to 1 hour and 20 minutes in the past. When it used to take a lot of time, it was supposed to produce a lot of heat. As a result, there were many side effects or complications such as burns, back pain, and numbness in the legs, but now it is being treated with few complications. Our hospital has achieved great results in the HIFU area with 3,000 to 4,000 treatments. We are grateful to them for the safe HIFU treatment through the patients who came to our hospital.
Q. Medius Queen: I heard that Suwon Gangnam Women's Hospital has “Hera Health School” which provides health lectures under the theme of "Hera is happy when she is healthy." Please introduce the reason that you opened the school, the goal, and detailed activities
A. Sung Young-mo: Hera Health School was first started by me in 2017. The motivation I started with was one of my patients, a college student who had a vagina, pelvic inflammation, and even three to four sexually transmitted diseases. While treating the patient, I thought I should provide preventive education in advance. So I applied for an opening professor at Suwon University. Hera Health School started targeting women in their 40s and 50s to apply the vast amount of data collected while lecturing to our hospital patients.
After failing to produce students for about two years due to COVID-19, more than 80 students have completed recently, which made a total of more than 500 graduates. It usually runs courses for about eight weeks on physical health such as menopause and urinary incontinence, and programs that establish women's identity and ego. As there are many students, the chairman leads the alumni of Hera Health School to volunteer in Suwon. We are doing various activities such as collecting 1 million won each to donate, collecting clothes, providing side dishes, and supporting briquettes and rice. The hospital is also engaged in various fruitful activities through support such as giving scholarships at the end of the year. I hope that the charity body of Hera Health School becomes an example of society. The more lectures we give in Suwon, the more women will come, right? Then I think it would be nice to help them find meaning in their own life and can comfort those who are tired of living.
Q. Medieus Queen: You recently took office as the first president of the Korean Society of Ultrasound, and also announced guidelines for intensive ultrasound (HIFU) procedures for the treatment of uterine myoma and uterine adenomyoma. Please let me know if you have any future goals.
A. Sung Young-mo: Previously, there was no meeting of hospitals that performed Haifu procedures. For the first time this year, I established the Korean Society of Ultrasound with the directors, and about 50 directors are registered. We are working hard to share our experiences and know-how to make the public aware that HIFU treatment is a good treatment and to develop it. In addition, as uterine myomas or adenomyomas occur a lot in the late 20s and early 30s, we are pushing for a voucher system for women of that age. For example, we are promoting the prevention and treatment of uterine myoma through ultrasound, such as a biennial cervical cancer medical examination.
Korea's uterine extraction rate is the world's fixed number one in the OECD. Therefore, I think the best treatment is to prevent it in advance or preserve the uterus through HIFU treatment. That's why our medical association is conducting “a campaign to protect the uterus”. A treatment called HIFU has caused many side effects and complications in the past. But as time passes and medicine progresses, it's gradually moving toward safety. According to a recent paper, it has been introduced as a safer, no complication, and faster recovery treatment than a hysterectomy. Therefore, we're going to work hard to establish HIFU as a good treatment method that can take care of women's health in case of observation therapy, medication, maintenance therapy, and in the middle of surgery for uterine myoma.
A. Director Sung Young-mo of Gangnam Women's Hospital in Suwon (hereinafter referred to as Sung Young-mo): Hello, our hospital is the first women's hospital in Suwon with a history of 38 years. Until 2018, we operated obstetrics and gynecology together, delivering about 63,000 newborns over 20 years. As of 2010, 120 to 150 babies were delivered a month, but as the number of births is gradually decreasing, the gynecological field which mainly treated patients in their 20s and 30s was found to be important for the health of mothers in their 40s, 50s, and especially after childbirth. Therefore, since 2010 the gynecology department has been steadily strengthened and has been operated as a gynecology specialized hospital since 2018 after the obstetrics department was closed.
Q. Medieus Queen: Suwon Gangnam Women's Hospital is known to have various experiences and excellent technology through 8,000 incontinence surgeries. I heard there's a special surgery method, so what kind of surgery is it?
A. Sung Young-mo: In the case of TVT incontinence surgery, it was a very difficult surgery that produced many bladder perforations and many hematomas. So a surgical method called TOT was devised. However, this TOT surgery fails almost 100% without grasping the incontinence occurring in the upper part of the pubis. To compensate for these shortcomings, the Gold Standard TVT specified in the European Society was devised, and the success rate was increased through TOT surgery, which was made into a TVT. TOT urinary incontinence surgery itself is a surgery to hang a tape in the middle of the urethra, but when you hang it in the middle of the drooping urethra, it looks like a "w" shape. Then, when women urinate and wake up again, a little leaky side effect occurs. So we improved this side effect by applying a surgical method that places the tape inside more than the middle of the urethra.
In addition, most people who have undergone urinary incontinence surgery often have a drooping bladder. Even if the tape was fixed well at first, the tape might be pushed back during the operation, so we even introduced a skin anchoring technique that fixes the table to the skin to prepare for such a situation. In particular, the most common cause of recurrence after urinary incontinence surgery is the leakage of urine as the tape twists in the middle and the ground area becomes thinner. So I made silicon so that the tape wouldn't get twisted. The tape has been applied since 2012, and the recurrence rate reduced to less than 2% from 5-10%, and the patent has been registered. Through continuous improvement, our hospital has made a remarkable achievement that the recurrence rate is only 18% after three years, and we are performing urinary incontinence surgery with fewer side effects and a higher success rate. Through these data, we are preparing to publish it in overseas papers.
Q. Medieus Queen: Statistics from the National Health Insurance Service show that uterine myoma cases have increased by 50% over the past five years. Uterine myoma is a tumor that occurs in smooth muscle, and it is said to be so common that nearly 20 to 40 percent of women of childbearing age have it. However, the recent development of HIFU technology to treat uterine myoma non-invasive has improved the treatment for complications and success rates. Please explain the treatment of Haifu.
A. Sung Young-mo: I first came across HIFU in 2015, and at that time, it was a method of slicing myoma while burning myoma with heat. It was introduced to our hospital for the first time in 2019, and we had a hard time trying for two years. In principle, 80 to 90 percent of them were treated, but when I did it, it was only 30 to 40 percent. So I went on a field trip to the company that made this, met the doctor who is using it the best in the world, and practiced it myself to upgrade it a lot.
Now with a volume treatment, by which you continue to heat one place you can burn the center completely and burn the surroundings with radiant heat, it takes 14 to 15 minutes to burn the 5cm myoma, which used to take 40 to 1 hour and 20 minutes in the past. When it used to take a lot of time, it was supposed to produce a lot of heat. As a result, there were many side effects or complications such as burns, back pain, and numbness in the legs, but now it is being treated with few complications. Our hospital has achieved great results in the HIFU area with 3,000 to 4,000 treatments. We are grateful to them for the safe HIFU treatment through the patients who came to our hospital.
Q. Medius Queen: I heard that Suwon Gangnam Women's Hospital has “Hera Health School” which provides health lectures under the theme of "Hera is happy when she is healthy." Please introduce the reason that you opened the school, the goal, and detailed activities
A. Sung Young-mo: Hera Health School was first started by me in 2017. The motivation I started with was one of my patients, a college student who had a vagina, pelvic inflammation, and even three to four sexually transmitted diseases. While treating the patient, I thought I should provide preventive education in advance. So I applied for an opening professor at Suwon University. Hera Health School started targeting women in their 40s and 50s to apply the vast amount of data collected while lecturing to our hospital patients.
After failing to produce students for about two years due to COVID-19, more than 80 students have completed recently, which made a total of more than 500 graduates. It usually runs courses for about eight weeks on physical health such as menopause and urinary incontinence, and programs that establish women's identity and ego. As there are many students, the chairman leads the alumni of Hera Health School to volunteer in Suwon. We are doing various activities such as collecting 1 million won each to donate, collecting clothes, providing side dishes, and supporting briquettes and rice. The hospital is also engaged in various fruitful activities through support such as giving scholarships at the end of the year. I hope that the charity body of Hera Health School becomes an example of society. The more lectures we give in Suwon, the more women will come, right? Then I think it would be nice to help them find meaning in their own life and can comfort those who are tired of living.
Q. Medieus Queen: You recently took office as the first president of the Korean Society of Ultrasound, and also announced guidelines for intensive ultrasound (HIFU) procedures for the treatment of uterine myoma and uterine adenomyoma. Please let me know if you have any future goals.
A. Sung Young-mo: Previously, there was no meeting of hospitals that performed Haifu procedures. For the first time this year, I established the Korean Society of Ultrasound with the directors, and about 50 directors are registered. We are working hard to share our experiences and know-how to make the public aware that HIFU treatment is a good treatment and to develop it. In addition, as uterine myomas or adenomyomas occur a lot in the late 20s and early 30s, we are pushing for a voucher system for women of that age. For example, we are promoting the prevention and treatment of uterine myoma through ultrasound, such as a biennial cervical cancer medical examination.
Korea's uterine extraction rate is the world's fixed number one in the OECD. Therefore, I think the best treatment is to prevent it in advance or preserve the uterus through HIFU treatment. That's why our medical association is conducting “a campaign to protect the uterus”. A treatment called HIFU has caused many side effects and complications in the past. But as time passes and medicine progresses, it's gradually moving toward safety. According to a recent paper, it has been introduced as a safer, no complication, and faster recovery treatment than a hysterectomy. Therefore, we're going to work hard to establish HIFU as a good treatment method that can take care of women's health in case of observation therapy, medication, maintenance therapy, and in the middle of surgery for uterine myoma.
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