Abdominal wall endometriosis (AWE) is a condition in which tissue similar to the lining of the uterus (endometrium) grows in the abdominal wall, such as within muscle tissue or surgical scars, for example after a cesarean section. Although relatively rare, this condition can cause uncomfortable symptoms, including a lump in the abdominal wall, pain that becomes more intense during menstruation, swelling in certain areas, and recurring discomfort during each menstrual cycle. In some cases, pain may also occur during physical activities or when the affected area is pressed.
Traditionally, abdominal wall endometriosis is commonly treated through surgery. This procedure typically involves surgical resection of the endometriosis tissue with a clear margin of at least 1 cm of healthy tissue to prevent recurrence. However, this approach may cause additional surgical trauma and leave new scars. In cases with larger lesions—especially those involving both muscle and fascia—doctors may also need to place a synthetic mesh to strengthen the abdominal wall and prevent postoperative hernia, which can add further pain and financial burden for patients.
As a less invasive alternative, High-Intensity Focused Ultrasound (HIFU) is now available at Mandaya Royal Hospital Puri and may offer a potential solution for treating abdominal wall endometriosis.
Contents
How Does HIFU Work for Abdominal Wall Endometriosis?
High-Intensity Focused Ultrasound (HIFU) is a non-invasive treatment method that works by directing high-intensity ultrasound waves precisely to targeted tissues inside the body. The ultrasound energy generates heat that causes coagulation necrosis in the targeted tissue, allowing the abnormal tissue to be destroyed without harming the surrounding healthy tissue.
In recent years, HIFU technology has been increasingly used to treat various gynecological conditions, including uterine fibroids and endometriosis. Because it can precisely target abnormal tissue without requiring open surgery, this method may help reduce tissue trauma and support faster recovery.
When Can HIFU Be Used for Abdominal Wall Endometriosis?
Conditions that are generally suitable for HIFU include:
- Abdominal wall endometriosis has been diagnosed through ultrasound or MRI examination
- The patient can communicate well with doctors and nurses during treatment
- No abdominal wall surgery within the past 3 months, especially procedures such as liposuction
- The patient does not have severe comorbidities, such as heart disease, severe hypertension, or uncontrolled diabetes
- The patient is able to lie in a prone position for approximately 2–3 hours during the procedure
Please note that the criteria above are only general references. The final decision on whether a patient can undergo HIFU therapy must be determined by a HIFU specialist after further examination and diagnosis.
Conditions where HIFU is not recommended (contraindications):
- Inflammation or wounds on the skin around the lump or nearby area
- Suspected or confirmed malignancy (cancer)
- Unsafe acoustic pathway for ultrasound waves to reach the target tissue
- Unstable vital signs or medical conditions that make the procedure unsafe
Advantages of HIFU for Abdominal Wall Endometriosis
Some of the key advantages of HIFU for treating abdominal wall endometriosis include:
- Non-invasive procedure, which generally allows faster recovery compared with surgery
- Only sedation is required, without general anesthesia
- Precise ablation, minimizing damage to surrounding tissues
- Lower treatment risks compared with more invasive procedures
Clinical Studies: Effectiveness of HIFU for Abdominal Wall Endometriosis
Several clinical studies in recent years have shown that HIFU can be a safe and effective treatment option for abdominal wall endometriosis. The therapy not only helps shrink endometriosis tissue but may also significantly reduce or even eliminate pain, which is one of the most common symptoms experienced by patients.
1. Relief of Pain Symptoms
One study involving 51 patients with abdominal wall endometriosis reported promising results. After undergoing HIFU therapy and being monitored for 48 months (4 years), none of the patients experienced recurring periodic pain. Pain levels measured using the Visual Analog Scale (VAS) continued to decrease over time. At one and six months after the procedure, pain scores were already very low, and from month 24 to month 48, the pain score reached 0, indicating that patients no longer experienced pain.
2. Shrinking of Endometriosis Tissue
In addition to relieving symptoms, HIFU has also been shown to effectively reduce the size of endometriosis tissue. In the same study, the average lesion size had already decreased by about 25% within one month after treatment. The reduction increased to about 82% within six months, more than 96% within twelve months, and in the 48-month follow-up, the lesion had shrunk by up to 100%.
Similar findings were reported in another study involving 30 patients with abdominal wall endometriosis who underwent HIFU therapy and were followed up for 24 months. In this study, all patients reported that the pain they previously experienced had completely disappeared. Pain scores also gradually decreased from the first month until they reached 0 by month 24.
Additionally, the size of the endometriosis tissue decreased significantly. On average, lesion size was reduced by about 40% within one month, increased to more than 92% within six months, nearly 98% within twelve months, and by 24 months, the endometriosis tissue had completely disappeared.
These findings suggest that HIFU may be an effective treatment option for abdominal wall endometriosis, particularly for patients who wish to avoid major surgery. With this technology, abnormal tissue can be treated more precisely without surgical incisions, making the recovery process generally more comfortable for patients.
HIFU Specialists at Mandaya Royal Hospital Puri
Mandaya Royal Hospital Puri is not only equipped with advanced medical technology for treating abdominal wall endometriosis but is also supported by an experienced team of obstetricians and gynecologists specializing in women’s reproductive health.
These doctors have strong educational backgrounds and clinical experience in managing various gynecological conditions, including abdominal wall endometriosis, fertility issues, and pregnancy care.
1. dr. Gracia Merryane R.G. Rauw, Sp.OG
dr. Gracia Merryane R.G. Rauw, Sp.OG is an Obstetrics and Gynecology specialist focusing on women’s reproductive health, pregnancy care, and gynecological conditions. She completed her medical and specialist education at the Faculty of Medicine, Sam Ratulangi University.
In her practice, dr. Gracia provides a wide range of women’s health services, including routine check-ups, pregnancy planning consultations, lactation counseling, and contraception planning. She also performs procedures such as ovulation induction, normal delivery and cesarean section, as well as gynecological procedures including hysterectomy, sterilization, laparoscopy, Pap smear, SIS, and LEEP.
dr. Gracia Merryane R.G. Rauw, Sp.OG is available at Mandaya Royal Hospital Puri on:
- Monday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
- Tuesday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
- Wednesday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
- Thursday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
- Friday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
- Saturday: 08.00 – 11.00 WIB & 13.00 – 18.00 WIB
2. dr. Doddy F.P. Gultom, Sp.OG (K), M.Kes
dr. Doddy F.P. Gultom, Sp.OG (K), M.Kes is a consultant Obstetrics and Gynecology specialist with extensive experience in reproductive health and gynecology. He completed his medical degree at Trisakti University, his specialist training at Hasanuddin University, and obtained his consultant qualification at the University of Indonesia.
His services include preconception care, prenatal diagnosis, fetal imaging, contraception counseling, management of pregnancy complications, benign gynecological conditions, and various minimally invasive procedures.
dr. Doddy F.P. Gultom, Sp.OG (K), M.Kes is available at Mandaya Royal Hospital Puri on:
- Tuesday: 17.00 – 20.00 WIB
- Thursday: 13.00 – 16.00 WIB
- Saturday: 08.00 – 12.00 WIB
3. Dr. dr. Unedo Hence Markus Sihombing, Sp.OG, Subsp. Onk
Dr. Unedo Hence Markus Sihombing is an Obstetrics and Gynecology specialist with a subspecialty in gynecologic oncology. He completed his medical education at Sriwijaya University, his specialist training at Sebelas Maret University, and later obtained both his consultant and doctoral degrees from the University of Indonesia.
Dr. Unedo specializes in treating cancers of the female reproductive organs, including cervical cancer, uterine cancer, ovarian cancer, vulvar cancer, and vaginal cancer. He also manages benign conditions such as uterine polyps and tumors. His careful and communicative approach helps patients feel more comfortable throughout the treatment process.
Dr. dr. Unedo Hence Markus Sihombing, Sp.OG, Subsp. Onk is available at Mandaya Royal Hospital Puri on:
- Tuesday: 16.00 – 20.00 WIB
- Thursday: 16.00 – 20.00 WIB
- Saturday: 13.00 – 16.00 WIB
4. dr. Edward Tony Ngantung, Sp.OG
dr. Edward Tony Ngantung, Sp.OG is an Obstetrics and Gynecology specialist who provides comprehensive women’s healthcare, from pregnancy preparation to the treatment of various gynecological conditions. He completed his medical degree at Sam Ratulangi University and his obstetrics and gynecology specialist training at San Juan de Dios Educational Foundation. He also completed an obstetrics and gynecology adaptation program at Udayana University to meet Indonesian medical practice standards.
His expertise includes preconception care, prenatal diagnosis, fetal imaging, and contraception counseling. He is also experienced in managing pregnancy complications, benign gynecological disorders, and performing minimally invasive procedures when medically indicated.
dr. Edward Tony Ngantung, Sp.OG is available at Mandaya Royal Hospital Puri on:
- Monday: 14.00 – 16.30 WIB
- Tuesday: 11.00 – 14.00 WIB
- Wednesday: 17.00 – 20.00 WIB
- Thursday: 17.00 – 20.00 WIB
- Friday: 10.00 – 14.00 WIB
- Saturday: 09.00 – 13.00 WIB
5. dr. Erik Sutandi, Sp.OG
dr. Erik Sutandi, Sp.OG is an obstetrician and gynecologist who manages various women’s reproductive health conditions, including pregnancy, childbirth, and hormonal disorders. He completed his medical degree at Maranatha Christian University in Bandung and his obstetrics and gynecology specialist training at San Juan De Dios Hospital in Manila, Philippines. His academic experience was further strengthened through an adaptation residency program at Sanglah General Hospital in Denpasar and a fellowship in reproductive gynecologic endoscopy and fertility.
His services include pregnancy consultations, fertility programs, lactation counseling, ovulation induction, labor induction, curettage procedures, normal delivery, and cesarean section. He is also skilled in fertility and hormonal examinations, TORCH screening, and diagnostic procedures such as pregnancy ultrasound, transvaginal ultrasound, and prenatal testing. Additionally, he provides contraception services, Pap smear tests, HPV vaccination, and other gynecological procedures.
dr. Erik Sutandi, Sp.OG is available at Mandaya Royal Hospital Puri on:
- Monday: 17.00 – 20.00 WIB
- Wednesday: 14.00 – 16.00 WIB
- Friday: 17.00 – 20.00 WIB
- Saturday: 14.00 – 16.00 WIB
6. dr. Rahmadsyah, Sp.OG(K)FER, M.Kes, MARS
dr. Rahmadsyah, Sp.OG(K)FER, M.Kes, MARS is an Obstetrics and Gynecology specialist with a subspecialty in fertility, focusing on infertility treatment and pregnancy programs. He completed his medical education at Padjadjaran University, continued his obstetrics and gynecology specialist training, and obtained a Master of Health degree at Hasanuddin University. He also earned a Master’s degree in Hospital Management from the University of Indonesia.
In his clinical practice, dr. Rahmadsyah provides fertility consultations, hormonal examinations, ovulation induction, hydrotubation, and IVF procedures. He also manages pregnancy consultations, normal delivery, cesarean section, ectopic pregnancy surgery, curettage procedures, IUD insertion and removal, contraceptive injections, contraceptive implants, Pap smear tests, HPV vaccination, and ultrasound examinations including pregnancy ultrasound, 4D ultrasound, fetal head ultrasound, and transvaginal ultrasound.
dr. Rahmadsyah, Sp.OG(K)FER, M.Kes, MARS is available at Mandaya Royal Hospital Puri on:
- Monday: 13.00 – 16.00 WIB
- Tuesday: 13.00 – 16.00 WIB
- Wednesday: 13.00 – 16.00 WIB
- Thursday: 13.00 – 16.00 WIB
- Friday: 13.00 – 16.00 WIB
- Saturday: 13.00 – 16.00 WIB
7. dr. Sigit Pradono Diptoadi, Sp.OG
dr. Sigit Pradono Diptoadi, Sp.OG is an Obstetrics and Gynecology specialist who completed his medical education at the Faculty of Medicine, Atma Jaya Catholic University of Indonesia. He then continued his residency training in obstetrics and gynecology at Ramon Magsaysay Memorial Medical Center, University of the East.
He is experienced in pregnancy planning consultations, ovulation induction, pregnancy consultations, and labor induction. In addition, dr. Sigit also performs 4D ultrasound examinations and provides comprehensive care for various gynecological conditions.
dr. Sigit Pradono Diptoadi, Sp.OG is available at Mandaya Royal Hospital Puri on:
- Monday: 17.00 – 20.00 WIB
- Friday: 17.00 – 20.00 WIB
- Saturday: 17.00 – 20.00 WIB
To make your visit easier, you can contact Mandaya Royal Hospital Puri through WhatsApp Chat, Book Appointment, or the Care Dokter mobile app, available on Google Play and the App Store, to schedule visits, check queue numbers, and access additional information.
