Hysteroscopic resection ( a guided curette procedure ) removes fibroids with the aid of a camera through the vagina and cervix. The procedure is suitable for small fibroids (up to 4 cm) and the fibroid needs to be protruding into the cavity of the uterus. It is much less invasive than a hysterectomy.
Hysteroscopic resection is a general anaesthetic procedure performed in an operating theatre. First the cervix is dilated. Then the hysteroscope (a mini telescope or endoscope) is inserted into the uterine cavity. A ‘shaving’ device is then used to remove the part of the fibroid protruding into the cavity.
Only small fibroids – less than 4 cm, protruding more than 50% into the cavity – are suitable for hysteroscopic resection. When there are other fibroids and/or adenomyosis present, hysteroscopic resection alone may not be sufficient to successfully control symptoms.
If a woman wishes to avoid a hysterectomy, hysteroscopic resection can be combined with UFE to achieve the goal of keeping her uterus, using two minor procedures to avoid a major operation like hysterectomy and its associated long-term side effects.
After UFE, fibroids adjacent to the uterine cavity might slough off as vaginal discharge and passage of fibroid tissue. Hysterescopic resection ( a curette procedure) might be needed to “clean out ” the dead fibroids attached to the cavity.