Protected: Sonata Treatment

Sonata treatment at Hadley Wood Hospital

Sonata treatment is an incisionless fibroid treatment alternative to hysterectomy and myomectomy. It is intended in treating symptomatic uterine fibroids, including those associated with heavy menstrual bleeding.

What are uterine fibroids?

Uterine fibroids are smooth muscle overgrowths in the uterus womb and are almost always benign. They are made from the muscle tissue of the uterus and tend to form ‘round’ swellings. Fibroids vary in size. Some are very small (like a size of pea to cherry tomato) and others can be as large as an orange size or rarely of a watermelon size. The uterus may develop only one fibroid, but most of the time, there are more than one. Fibroids are very common; about one out of every three women have fibroids.

Fibroids don’t always cause problems. But sometimes they can cause heavy periods, and can affect fertility and childbirth. For women who develop symptoms, they may experience bleeding between periods, pelvic pressure or pain, or difficulty getting pregnant.

Uterine fibroids treatments include:

• medications to either treat the symptoms of fibroids or reduce the fibroids’ size
• surgical treatment, for example, traditional surgical treatments for fibroids includes:
• Removing the whole womb including the fibroids (a hysterectomy). This is an option for women who do not want to have any (more) children.
• Removing the fibroids only (called myomectomy). This type of operation is suitable for women who want to keep their uterus – mainly to preserve the chance for future pregnancy.

There are many important differences between these two options and your doctor can discuss them with you. You can also get information about these options from the NHS website (www.nhs.uk).

More recent surgical treatments for fibroids include:

• Removing the fibroid through keyhole surgery (laparoscopic myomectomy).
• Blocking the blood vessels feeding the fibroids (uterine artery embolization) which does not remove fibroids but can cause them to shrink and reduce heavy periods.
• Some hospitals treat fibroids using focussed ultrasound energy. This option is not available in most UK hospitals.
• Some fibroids that are growing inside the womb can be removed through a hysteroscope passed inside the womb through the cervix ( Transcervical Fibroid resection – TCRF). This procedure is carried out under general anaesthetic.

There are many factors to consider when deciding the best way of removing or treating the fibroids. These include the number of fibroids, their size and exactly where they are in the womb. There can also be other issues to consider like whether you have had any operations on the womb in the past. For example, some of the fibroids that grow inside the womb can be removed by using hysteroscope operations. The fibroids that are more embedded in the womb itself cannot be removed this way. It is common to have more than one fibroid and fibroids vary considerably in size.

What is SONATA?

SONATA stands for Sonography-Guided Transcervical Fibroid Ablation. This type of treatment has been endorsed by National Institute of Clinical Excellence (NICE)

It is a relatively new technique and it has only been recently started being offered at the Royal Free London NHS Foundation Trust.

This treatment has been offered for some years in the United States and in Europe. Currently, only a few UK hospitals are able to offer it. The Royal Free London NHS Foundation Trust is the first one to offer such a treatment in London. SONATA is designed to treat fibroids that are around less than or equal to 8 cm in size and that are embedded in the muscle of the uterus.

For women suffering from severe bleeding ( heavy menstrual bleeding), and has a fibroid of 8 cms and that fibroid is positioned in the wall of the uterus are the most suitable candidates for SONATA.