Design: A case study with preoperative images, surgical video, and postoperative follow-up is reviewed.

Setting: Ambulatory surgical center in the operating room at an urban, academic institution in the Bronx, NY.

Patients or Participants: A 50 year-old G5P3023 with a history of abnormal uterine bleeding and a known intramural uterine fibroid status post uterine artery embolization four months prior presented with chronic vaginal discharge persistent since the embolization. Imaging was concerning for a submucosal uterine fibroid for which patient desired uterine-sparing management.

Interventions: Hysteroscopy was performed in the operating room where an unexpected 2.5cm intracervical fibroid was appreciated. Bipolar resectoscope was used for resection of the cervical fibroid.

Measurements and Main Results: On hysteroscopy, a normal endometrial cavity and bilateral tubal ostia were appreciated. The likely source of the patient’s symptoms was arising from this mass in the cervical cavity. We proceeded to resect 90% of the cervical fibroid with the bipolar resectoscope until the tissue was flush the cervical canal and normal anatomy was restored. Pathology confirmed leiomyoma.

Conclusion: Hysteroscopic resection for intracervical fibroid removal can be considered in symptomatic patients.