What is Hysteroscopic Resection of Fibroid?
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 Hysteroscopic Resection of Fibroid done?
Fibroids are ball-like swellings in the wall of your uterus. They are created from an overgrowth of muscle fibers. The patient may have one or more fibroids. They are common, affecting 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.
One may have fibroids in the uterus. These can cause a number of symptoms including:
- 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 Hysteroscopic Resection of Fibroid?
Duration of procedure: varied around 30 minutes to 1 hour, depending on the size of the fibroid.
If the patient's reason for the operation is heavy periods or irregular menstrual bleeding, then your periods will be likely lighter and more regular afterwards. The patient will see improvements over the next 2-3 months. If the patient received Endometrial Ablation at the same time of her hysteroscopic resection, reduction in bleeding will be even more pronounced.
If the patient's fibroids had made conceiving difficult then her 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.
The patient will be moved to the recovery room to be cared for by a specialist nurse until she is stable and then transferred to the ward.
The patient 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 the patient is fully recovered, she will be given a drink and a light meal.
What are the risks associated with Hysteroscopic Resection of Fibroid?
- The patient may get an adverse reaction with anesthetics.
- 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 Hysteroscopic Resection of Fibroid?
- Drug treatment - the patient can take drugs to make the fibroids smaller, but this is unlikely to be permanent and the fibroids may grow back.
- Keyhole surgery - doctors can sometimes remove smaller fibroids using keyhole instruments passed through tiny cuts in the patient's abdomen. This is more commonly used for serosal or intra-mural fibroids.