Already used against certain prostate cancers, HIFU technology is entering the treatment of digestive endometriosis. Although it will not replace traditional surgery, this minimally invasive approach could offer a new option to carefully selected patients.
When endometriosis reaches the intestine, everyday life can become a struggle
Endometriosis is much more than a gynecological disease. For almost 2 million French womenit is present in all aspects of life: pelvic pain, fatigue, infertility, professional or social difficulties… And for many, this journey is made worse by a diagnosis that is still slow to be made: seven years on average In France.
In one in five casesthe disease extends to the rectum. The lesions then infiltrate the digestive tissues, causing constipation, diarrhea, urgent urge to have a bowel movement or even pain during sexual intercourse.
When drug treatments are no longer sufficient, patients often have to consider particularly major surgery.
Until now, this intervention could last two to three hours. Its objective: to remove the lesions responsible for the pain. But this surgery is not trivial. It exposes you to complications and can, in certain situations, require the temporary installation of a stoma in order to give the intestine time to heal.
It is precisely this reality that the Toulouse University Hospital teams hope to change.
An intervention of a few minutes… without scalpel or scar
The Toulouse University Hospital has become the second French establishment to use the high intensity focused ultrasound (HIFU) to treat certain forms of digestive endometriosis, after work carried out at the Hospices Civils de Lyon on more than 150 patients.
The principle is very different from traditional surgery.
A probe is inserted endorectally. The ultrasound passes through healthy tissue without damaging it, then focuses its energy only on the endometriosis lesion. The heat thus produced gradually destroys diseased cells and prevents their development.
The gesture is quick and does not require no incision or opening of the abdomen.
The first results are encouraging.
“The procedure lasts only a few minutes and does not require any incision or major surgery. We have already been able to treat the first three patients: no urinary or digestive complications have been observed and recovery was rapid, with no impact on fertility. This minimally invasive technique opens up very promising prospects. Even if surgery remains an often necessary therapeutic solution, it is important to be able to offer an alternative to patients who can benefit from it. Indeed, patients must be selected according to precise indications and validated in a multidisciplinary meeting. according to Professor Élodie Chantalat, gynecological surgeon, and Dr Marie-Charlotte Delchier, radiologist, Toulouse University Hospital.
However, specialists remain cautious: this innovation does not concern all patients. It is only intended for well-defined situations, evaluated on a case-by-case basis by a multidisciplinary team.
Beyond technique, a new way to support women
This innovation is part of a broader strategy carried out by the Toulouse University Hospital to improve the management of endometriosis.
Since 2022, the course FastTrack coordinates patient monitoring using around fifteen hospital specialties. From the period of conception until menopause, women benefit from personalized support, combining specialized consultations, appropriate examinations and pain management.
The University Hospital is also developing a therapeutic education programintended to help patients better understand their illness and live with its consequences on a daily basis. At the same time, the research project
Endotreat aims, over three years, to develop new study models in order to identify the treatments of tomorrow.
A breakthrough that nourishes hope… without promising a miracle
The arrival of HIFU ultrasound marks an important step in the management of digestive endometriosis. It shows that research continues to explore less invasive treatments that may reduce complications and speed recovery.
However, this technique will not replace conventional surgery. Specialists insist on the need to carefully select patients likely to benefit from it.
But for women faced with an illness that has long been downplayed, whose pain is rated on average at 7.8 out of 10 when they present at least one symptom of endometriosis, each new therapeutic option represents concrete hope. Not that of a miracle treatment, but that of a medicine capable of offering more personalized solutions, less burdensome and more respectful of their quality of life.