What are fibroids?
Fibroids in the womb (uterus) are harmless (benign) tumours. They are made from muscle similar to the womb and tend to form ‘round’ swellings. Fibroids are common and are found in one out of every two or three women.
Small fibroids often do not cause problems but occasionally they can:
- Cause heavy periods
- Put pressure on other organs like the bowel or bladder
- Put pressure on nerves occasionally causing pain
- Affect fertility and childbirth
- If they are large enough, can be felt as a swelling in the lower part of the abdomen.
The chance of a fibroid being cancerous (malignant) is very rare (about 1 in 2,000 in women before the menopause).
What is Sonata fibroid ablation?
Sonata (Sonography-Guided Transcervical Fibroid Ablation) is a treatment for fibroids. A small ultrasound probe is passed through the neck of the womb and is used to identify the fibroid. A special kind of energy (radiofrequency) is used to target the fibroid which results in a gradual shrinking of the fibroid therefore reducing symptoms.
Sonata is an alternative to an operation to remove the fibroids and can be done under sedation, therefore avoiding a general anesthetic. As no operation is needed, there are no cuts (incisions) on the abdomen.
Sonata involves inserting a device through the cervix (the opening of your womb). The device has two parts: the first is a thin camera which allows the surgeon to see and guide the procedure. The second is a probe that uses radiofrequency energy to treat the fibroid. The fibroid will shrink over several months, which will reduce or eliminate your symptoms.
Before your procedure
Sonata is done under conscious sedation. This is not a general anaesthetic so you will be awake for the procedure. The anaesthetist will ensure that you are comfortable throughout.
You should
- Not eat any food from midnight the day of your procedure. You can drink water and take your regular medications the morning of your procedure.
- Please remove any abdominal or genital piercings
- Be aware that you will be asked to provide a urine sample when you arrive at the Women’s Health Unit. If there is any possibility that you may be pregnant, your procedure will be cancelled. If you are sexually active, you must use reliable contraception or have refrained from sexual intercourse for at least four weeks.
- Please take pain relieving medication as discussed during your consultation. If you are able to take Paracetamol, we recommend two tablets approximately 60 minutes before your appointment. Please arrive 30 minutes before your appointment as you will be offered further pain-relief and anti- sickness medication before your procedure. If you are on regular pain relief medication for another condition, please continue with this; do not take both. Failing to take adequate pain relief may lead to delays or cancellation of your appointment.
What to expect during the procedure?
Sonata is performed at The Women’s Health Unit (WHU). During the procedure there will usually be six members of staff. This includes the doctor performing the procedure, two members of our nursing team, the anaesthetist, their anaesthetic assistant and the technician.
As we are a teaching hospital, it is possible that a resident doctor or student doctor may also be in clinic.
How will I feel after the procedure?
Before you go home the nurse will tell you the times that you can take further doses of pain relieving medication if needed.
During the first 24 hours, you might experience cramping pain, nausea, and a brown vaginal discharge.
Most women will feel back to normal within two days of the procedure.
To avoid the risk of infection, you should avoid activities such as swimming, taking a bath (you can shower), sexual intercourse and using tampons for at least two weeks.
Please contact staff at the Women’s Health Unit, Ward 40 or your GP if you feel unwell and/or
develop any of the following symptoms.
Symptoms
- Persistent nausea or vomiting
- Excessive bleeding (greater than four pads in two hours)
- Severe abdominal pain
- Fever of 38°C or above
- Green or offensive vaginal discharge.
What are the main side effects of the procedure?
There is a small possibility that the procedure cannot be completed. For example, if the fibroids are found to be too large or too close to other organs outside the uterus.
Any operation inside the uterus carries a small risk of injury (perforation) to the uterus (estimated to be 1 in 200 risk). If this happens, you may need to be admitted to hospital for a camera check (laparoscopy) inside the abdomen
There is a very small risk of a burn injury to the bladder or bowel. Additional checks are undertaken during the procedure to minimise this risk
Any procedure inside the uterus carries a small risk of infection
You may have period-like bleeding whilst the uterus heals after surgery which can last up to four weeks.
What are the results expected from the procedure?
Your consultant or their team would have discussed your suitability for the procedure as well as
the other options available.
Can I get pregnant after Sonata treatment?
The evidence of safety of Sonata in future pregnancy is not yet fully established however women wishing to conceive can have a Sonata procedure after discussion of all available options with their consultant.
Contact
Ward 40
24 hours – Please note that if clinic staff are busy, they may arrange to call back later in the day
What if I cannot attend my appointment?
If you are unable to attend your appointment, please call our waiting list officer with 48 hours’ notice in Women’s Services for your appointment to be rescheduled.
Women’s Services waiting list officer (RVI)
For further information
PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services.
You can contact them on freephone 0800 032 02 02, email [email protected]
Useful website
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS website at www.nhs.uk
If you would like to find accessibility information for our hospitals, please visit www.accessable.co.uk
