While doing your research, it’s very natural that you have questions regarding your fibroids and the best way to cure them. These days women with fibroids have a variety of treatment options to choose from ranging from minimally invasive to more intensive. This comparison blog post can explain the key differences between uterine fibroid embolization (UFE) and Sonata treatment and help you make an informed decision.
What Is Sonata vs UFE?
Sonata is a new treatment that was FDA approved in the United States in 2018 and is used to address fibroids under 5 centimeters (less than 2” in diameter) and alleviate their associated symptoms. The treatment is minimally invasive and like uterine fibroid embolization (UFE) does not require abdominal incisions.
The Sonata treatment uses a combination of ultrasound technology to locate the fibroids and then treats them one at a time with radiofrequency ablation. Radiofrequency ablation has been used to treat fibroids since 2012, i.e. the Acessa procedure. However, Acessa is a laparoscopic surgical procedure and access to the fibroids to be treated is gained through very small abdominal incisions. The Sonata procedure utilizes a transvaginal and transcervical approach. Therefore, the Acessa and Sonata procedures basically use the same radiofrequency ablation treatment, only with different points of entry.
Uterine fibroid embolization (UFE) is a minimally invasive procedure that is performed in an outpatient setting and can address fibroids of any size or number.
A Comparison of Sonata Treatment vs UFE Chart
| Sonata | UFE | |
|---|---|---|
| Medical procedure type | Minimally invasive but nonsurgical | Minimally invasive but nonsurgical |
| How do the fibroids die? | Radiofrequency energy is used which uses heat to kill the fibroids | Blood flow to fibroids is cut off causing them to die, soften, and shrink |
| Who performs the procedure? | An OB/GYN | An Interventional Radiologist, like Dr. Lipman or Ermentrout |
| Where the procedure is performed? | Outpatient center or hospital | Outpatient center or office, like the Atlanta Fibroid Center |
| How much time does the procedure take? | The procedure takes less than an hour | At Atlanta Fibroid Center it takes about 30 minutes |
| Is general anesthesia used? | Yes | No, intravenous and local (which is safer) |
| Is the procedure covered by insurance? | No, in most cases | Yes, UFE is covered by ALL insurance companies, including Medicare & Medicaid |
| What is the recovery period? | 10-14 days | 5-7 days |
| Can this procedure treat adenomyosis? | No | Yes |
| Can this procedure treat multiple fibroids? | Not easily, best utilized for 1-3 fibroids | Yes |
| If interested in future fertility can you have this procedure? | No | Yes; births are typically full-term and vaginal. |
| Can this procedure treat large fibroids (5-10cm)? | No | Yes |
| Can this procedure treat huge fibroids (>10cm) | No | Yes |
| Are there long-term data on the procedure? | No, it is considered experimental/investigational. No long-term (> 10 years) research was presented | Yes, there are numerous long-term studies and a 25-year track record of safety & efficacy |
As with any medical procedure, there are risks associated with Sonata and UFE. Complications occur in <1% of UFE patients.
Potential risks of Sonata and fibroid ablation include:
- Reactions to anesthesia,
- Allergies to materials used,
- Perforation of bowel or bladder,
- Tear of vaginal or cervical tissue,
- Electrical shock,
- Hemorrhaging,
- Local infection,
- Systemic infection,
- Infection in the uterus,
- Skin burns,
- Device fragments remaining inside patients,
- Skin burns from radiofrequency energy,
- Blood clots,
- Injury to nearby tissue, organs, cervix, or uterus,
- A risk to future pregnancies is unknown,
- Other complications including death.
UFE vs Sonata: Which Should I Choose?
UFE has a long, 25-year proven track record for safety and efficacy. There are no long-term studies on Sonata. With UFE, all fibroids can be addressed at once regardless of their size or location. With Sonata, there are size limitations as well as number limitations.
Quite frankly, patients typically have way more fibroids (and often much bigger fibroids) than is feasible to treat with Sonata. Therefore, why would a woman want only some of her fibroids treated when there is a non-surgical, outpatient procedure that will treat all of her fibroids regardless of size and number, i.e. UFE?
A publication, written in April 2019 from the University Hospitals of Leicester, UK, and referring to the Sonata procedure, states,
“There is a 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 to make it safe.”
Choosing a medical professional that has expertise in the procedure is also a very important decision and will help to mitigate possible complications or risks. Dr. John Lipman has one of the nation’s largest UFE experiences. He has been performing Uterine Fibroid Embolization for over 25 years and has done more than 9,000 procedures with a success rate of 90%. The Sonata procedure was approved by the FDA in the last several years and therefore, potential Sonata patients should keep in mind that their doctor may have very limited experience in that procedure. It is our belief that the Sonata procedure should be reserved for patients that have a limited, small fibroid burden and that are not interested in UFE until we have long-term data on Sonata.
If you suffer from uterine fibroid symptoms, contact Atlanta’s fibroid experts, Dr. John Lipman and Dr. Mitchell Ermentrout of the Atlanta Fibroid Center for a consultation. We are here to help you get your life back without any surgery and without losing your uterus!
