Transcervical Resection of Fibroid (TCRF) is a minimally invasive surgery to remove fibroids (non-cancerous growths) from inside the uterus. A thin, lighted tube (hysteroscope) is passed through the vagina and cervix into the uterus, allowing the surgeon to cut away fibroids. This procedure preserves the uterus and is ideal for submucosal fibroids (those bulging into the uterine cavity).
Why is TCRF Performed?
Your gynaecologist may recommend TCRF if you have:
- Heavy or prolonged periods caused by fibroids.
- Infertility or recurrent miscarriages linked to fibroids.
- Pelvic pain or pressure from fibroids.
- Fibroids located in the uterine cavity (submucosal).
TCRF is not suitable for:
- Fibroids outside the uterine cavity (e.g., intramural or subserosal).
- Very large fibroids or cancer suspicion.
Before the Procedure
- Pre-operative tests
- Pelvic ultrasound or MRI to confirm fibroid location/size.
- Blood tests (check for anaemia or infections).
- Preparation:
- Fasting: No food/drink for 6–8 hours before surgery.
- Medications: Adjust blood thinners (e.g., aspirin) as advised.
- Avoid vaginal products, tampons, or sex for 24 hours before.
- Arrange support: Plan for someone to drive you home post-procedure.
During the Procedure
- Anaesthesia: General anaesthesia (you’ll be asleep).
- Procedure:
- A hysteroscope is inserted through the cervix into the uterus. Fluid expands the uterus for better visibility. Surgical tools attached to the hysteroscope shave or cut away fibroids.
- Removed tissue of fibroid chippings is sent for testing.
- Duration: 30–60 minutes.
What you might feel:
- Mild cramping (if awake) or no discomfort (under general anaesthesia).
Risks and Complications
- Common (temporary):
- Mild cramping, light bleeding, or watery discharge (1–2 weeks).
- Abdominal pain (fluid used during surgery).
- Rare but serious:
- Infection, heavy bleeding, or uterine perforation (small hole in the uterus).
- Fluid overload (from absorption of uterine distension fluid).
- Scarring (Asherman’s syndrome) affecting future fertility.
Recovery
Immediately after:
- Rest in recovery for 1–2 hours; most go home the same day.
- Mild cramping is normal – use prescribed painkillers or paracetamol.
At home:
- Activity:
- Avoid heavy lifting, exercise, or sex for 1–2 weeks.
- Return to work within 1–3 days (if comfortable).
- Vaginal care:
- Use sanitary pads (no tampons) for light bleeding/discharge.
- Avoid swimming or baths until bleeding stops.
- Follow-up:
- Discuss biopsy results at a 2–4 week appointment.
- Ultrasound may be done to confirm fibroid removal.
Long-term Effects
- Menstrual changes: Lighter periods for most women.
- Fertility: Improves chances of conception if fibroids caused infertility.
- Fibroid recurrence: New fibroids may develop (15–30% of cases).
eGynaecologist Advice
- TCRF procedure should be avoided in post-menopausal women where prior histological information of endometrium is not known. You should consult your gynaecologist if you are considering this treatment.
- Fibroids may recur over time and you should consult gynaecologist if you suspect any new symptoms may be because of fibroids.
- You should seek gynaecological consultation if you develop raised temperature>38°C, severe pain, heavy bleeding (>1 pad/hour), or foul-smelling discharge after TCRF procedure.
Frequently Asked Questions
Will it hurt afterward?
Mild cramping is common, but severe pain is rare – contact your gynaecologist if this occurs.
How successful is TCRF?
70–90% of women report reduced bleeding; fertility improves in ~60% of cases.
When can I try to conceive?
Usually after 1–2 menstrual cycles (discuss timing with your gynaecologist).
Can fibroids grow back?
Yes, but regular follow-up fibroid monitoring helps detect recurrence early.
