Transcervical Fibroid Ablation with the Sonata® System in an Ambulatory Setting with Local Anesthetic Is Highly Tolerable

Abstract

<h3>Study Objective</h3> To assess the adequacy of pain control in women symptomatic uterine fibroids undergoing transcervical fibroid ablation (TFA) under multimodal local anesthesia in an ambulatory care setting. <h3>Design</h3> Prospective single center study. <h3>Setting</h3> Single hospital in the UK. <h3>Patients or Participants</h3> Women undergoing TFA with the Sonata® System. <h3>Interventions</h3> After oral premedication (generally diclofenac or other NSAID, paracetamol and ondansetron), cervical block and intramyometrial local anesthesia, TFA was used to ablate fibroids under integrated real-time intrauterine sonography. Patients were eligible for discharge 20-30 minutes post-procedure. <h3>Measurements and Main Results</h3> Thirteen women, five (38%) of whom desired fertility, have been treated to date. Up to 4 fibroids 2.6 cm-7.7 cm in maximum diameter were ablated in a single treatment session. The duration in the treatment room were all <50 minutes. The mean pain score (0-10 range) was 0.5. Nine women had pain scores of 0, two had scores of 1 and the remaining two patients reported scores of 2. No procedure was terminated early due to pain, and no patient had a recovery room length of stay >60 minutes. There were no patients admitted or readmitted for any reason, and 100% of patients would recommend the procedure to others. <h3>Conclusion</h3> Transcervical fibroid ablation with the Sonata System may be performed under multimodal local anesthesia with a high degree of tolerability and low pain scores.