What is a Transcervical Resection of Fibroids?
Transcervical Resection of Fibroids (TCRF) is a way of
treating fibroids that occur on the inside of the uterus, in
the uterine (womb) lining. It is usually performed under
a general anaesthetic and may involve an overnight
stay. A small camera is inserted into the womb through the cervix and
the fibroid, which is bulging into the womb cavity, is cut away in strips to
try to make the inside surface of the womb more regular. After the
fibroid is cut away, a coil is normally left inside the womb for 4-6 weeks.
The coil holds the womb cavity slightly open so that the womb walls do
not stick together. This coil is removed 4-6 weeks after the procedure.
Why is it performed?
It is generally performed to remove fibroids that are
causing menstrual problems or that may be interfering
with ability to conceive.
Risks of the procedure
There is a small risk of making a hole in the womb (perforation occurs
6/1000 cases). If this happens, the procedure will have to be
rescheduled. Fluid is used to hold the cavity of the womb open during
the procedure. Sometimes too much of the fluid is absorbed in the body,
and if this happens you will need to be monitored. If it appears that your
body is absorbing too much fluid the procedure will be stopped. There is
a small risk of infection, and I would normally screen you for chlamydia
before the procedure or cover you with antibiotics to lessen this risk.
Sometimes you can get extremely heavy bleeding during this type of
procedure, and whilst there are many ways to stop the bleeding, this
type of procedure carries a very low chance of hysterectomy for
uncontrollable bleeding. To lessen the likelihood of this you will require 2
injections of ZOLADEX 4 weeks apart before the procedure, as this
medication helps lessen the bleeding at the time of the surgery.
What results can I expect after the procedure?
If you had heavy periods or irregular menstrual bleeding
before your operation you can expect these symptoms to
improve. Your periods will be lighter and more regular
after the operation however this will take place over 2-3
months. If you had an endometrial ablation at the same
time, then evidence shows the reduction in bleeding will
be more pronounced. If you initially had problems in
conceiving, the chance of getting pregnant is improved
after TCRF. However because conceiving depends on
many factors it is difficult to determine which patients will
be successful. If you do not desire pregnancy then you
will need to either start or continue with contraception.
What happens when I get home?
After you have been discharged from hospital you may
still have some abdominal cramps so it will be useful to
have some pain killers like paracetamol (Panadol) or
ibuprofen (Nurofen) available to take as per the
manufacturers instructions. Vaginal bleeding may occur
after the operation for 2-4 weeks and then should settle.
You should rest for a couple of days and then gradually
resume your normal activities
Please read this information in conjunction with the hysteroscopy leaflet.