What Is Hysteroscopy Fibroid Resection?

It is a procedure of removing fibroids that occur on the inside of the womb (uterus), in the uterine lining via the vagina using an instrument called hysteroscope.

Why is it done?

Fibroids are ball-like swellings in the wall of your uterus. They are created from an overgrowth of muscle fibres. You may have one or more fibroids. They are common, forming in three to four in 10 of all women (30-40%). Most fibroids do not cause problems and do not require treatment. They are benign but can sometimes be troublesome.

You have fibroids in your uterus. These can cause a number of symptoms including:

• Pain
• Heavy periods, called menorrhagia
• Pressure on your bladder, bowel or spine.

Fibroids can cause miscarriages and problems when trying to become pregnant.

What to expect after surgery?

Duration of procedure: varied around 30 minutes to 1 hour, depending on the size of the fibroid.

If your reason for the operation is heavy periods or irregular menstrual bleeding, then your periods will be likely lighter and more regular afterwards. You will see improvements over the next 2-3 months. If you received Endometrial Ablation at the same time of your hysteroscopic resection, reduction in bleeding will be even more pronounced.

If your fibroids had made conceiving difficult then your chance of getting pregnant is improved after hysteroscopic resection. Please remember that the ability to conceive depends on many factors and therefore it is difficult to predict who will be successful after TCRF.

You will be moved to the recovery room to be cared for by a specialist nurse until you are stable and then transferred to the ward.

You may have some cramping abdominal pains and pain relief is given for this. Some vaginal blood loss may occur but not too much to cause concern. Once you are fully recovered, you will be given a drink and a light meal.

What are the risks of the surgery?

• You may get adverse reaction with anaesthetics.
• Excessive bleeding during the operation: If bleeding is not controlled by diathermy coagulation, it may be necessary to use pressure from an inflated catheter that is inserted into the womb.
• Infection of the womb: Small risk and usually presented as offensive vaginal discharge. This is treatable with antibiotics.
• Organ perforation: Risk of puncture of the uterus occurs in 1-2 per 1000 operations. Sometimes, when this happens, there is a small risk of bowel injury at the same time.
• Excessive fluid absorption: Occurs in 1-5% operations.

What are the alternatives to the surgery?

• Drug treatment - You can take drugs to make the fibroids smaller, but this is unlikely to be permanent and the fibroids may grow back.
• Keyhole surgery - We can sometimes remove smaller fibroids using keyhole instruments passed through tiny cuts in your abdomen. This is more commonly used for serosal or intra-mural fibroids.
• Embolisation - This is a method of shrinking single fibroids by cutting off their blood supply.
• Hysterectomy - This is an operation to remove your uterus. If you never want to become pregnant and do not mind losing your uterus then this will stop your bleeding problems permanently.