To investigate the feasibility, safety, and clinical efficacy of transcervical resection of myoma (TCRM) in the management of International Federation of Gynecology and Obstetrics(FIGO) type 3 uterine fibroids.

A retrospective analysis was conducted on the clinical data of 42 patients with solitary FIGO type 3 uterine fibroids treated at XiJing Hospital, Air Force Medical University between Feb. 2021 and Feb. 2024. Perioperative parameters, surgical complications, improvement in menstrual symptoms, and postoperative reproductive outcomes were recorded and analyzed.

The mean age of the 42 patients was 34.3±5.1 years, with a mean fibroid diameter of 4.6±1.8 cm. The primary procedure success rate was 85.7%(36/42). The mean operative time was 43±18 minutes, and the mean intraoperative blood loss was 26±16 ml. The shortest distance from the tumor cavity to the uterine serosa significantly increased from 3.1±1.3 mm preoperatively to 8.4±1.5 mm postoperatively. No severe complications, such as uterine perforation or major hemorrhage, occurred. Among the 35 patients with preoperative menorrhagia, the cure rate was 80.0%(28/35), resulting in a total effective rate of 97.1%(34/35). Among the 28 patients with fertility desires, the average follow-up duration was 16.2±7.3 months. The pregnancy rate within one year postoperatively was 78.5%(22/28). Seventeen patients have delivered (11 vaginal deliveries and 6 cesarean sections), with no cases of uterine rupture reported.

For FIGO type 3 uterine fibroids, hysteroscopic resection performed by experienced surgeons under ultrasonographic guidance is a safe and effective minimally invasive treatment. It significantly ameliorates menstrual symptoms and is associated with favorable reproductive outcomes.