Outpatient Transcervical Ultrasound-guided Radiofrequency Treatment of Uterine Fibroids
What are fibroids?
Fibroids are benign (non-cancerous) smooth muscle growths in the wall of the womb. They can cause symptoms such as heavy periods, painful periods and pressure symptoms.
What is Sonata?
Sonata is an incisionless (no cuts on the tummy) treatment for fibroids. A probe or handpiece is inserted into the womb, allowing your doctor to visualise the fibroid using a miniature ultrasound device, then treat it using radiofrequency ablation. The procedure is usually carried out while you are awake, using local anaesthetic. The Sonata trial showed that 95% of women experienced a reduction in menstrual bleeding.
You cannot have this procedure if you have had a hip replacement, are pregnant, have a pelvic infection, or have intratubal implants for sterilisation (Essure).
Before your operation
We will carry out a pregnancy test on the day of the procedure. However, we ask that you avoid unprotected intercourse for the month beforehand.
Your procedure will be booked in the Early Pregnancy Unit at West Middlesex Hospital, located on the 2nd floor of the East Wing in the main hospital building. You may bring someone with you, and our nurses will be happy to support you.
Before the procedure, a member of the gynaecology team will explain the process, discuss potential complications, and take a medical history. You will be asked to sign a consent form to confirm you understand the procedure and its risks.
You will be advised to take some pain relief before coming to hospital to help reduce any cramping. If you are not allergic, we recommend Paracetamol 1g and Ibuprofen 400mg by mouth.
On the day of your operation
Please eat and drink as normal beforehand, and take your pain relief 1–2 hours before your appointment.
If you are having the procedure under local anaesthetic, you will be awake. You will receive injections to numb the cervix (neck of the womb), which will then be gently widened before the probe or handpiece is inserted.
We have Virtual Reality headsets and music speakers available if you would like to listen to music of your choice during the procedure.
Side effects
Common side effects include bleeding, spotting, cramping, post-ablation inflammation and/or discharge.
There is currently no evidence regarding the impact of this procedure on fertility or future pregnancies. The treatment uses a safety margin around the fibroid to minimise heat damage to healthy womb tissue.
After your operation
You will be monitored for a short time following the procedure. Some abdominal pain or cramping is expected, and pain relief will be provided.
Once you are comfortable and recovered, you will be able to go home. A short course of antibiotics will be given to help prevent infection. You may continue to take regular paracetamol and ibuprofen if needed.
If you are unable to arrange for someone to collect you, please inform the Early Pregnancy Unit in advance. We do not recommend patients go home alone after the procedure. The Sonata trial showed that 50% of women returned to normal activities the following day.
Recovery
You may experience some vaginal bleeding or discharge after the operation. Please use sanitary towels rather than tampons and avoid sexual intercourse during this time. If the bleeding is heavy or continues for more than two weeks, contact your doctor at caw-tr.westmindadmin12@nhs.net.
If you develop severe abdominal pain, a fever, or bleeding/discharge with an unpleasant smell, please attend hospital immediately. Your next period should arrive as expected.
Contact information
Early Pregnancy Unit
West Middlesex University Hospital
2nd Floor, East Wing
West Middlesex Hospital
Twickenham Road
Isleworth
Middlesex
TW6 7AF
T: 020 8321 5114
T: 020 8321 6070/6506 (on day of procedure)
E: caw-tr.westmidadmin12@nhs.net