What should be checked before uterine fibroid surgery? Are uterine fibroids multiple?

Uterine fibroids are the most common benign tumors of the female genitalia. Different types of uterine fibroids may present clinical manifestations such as menorrhagia, lower abdominal mass or dysuria. So, what is the preoperative examination for uterine fibroids?

Uterine fibroids are usually multiple and can be divided into four types: myometrium accounts for about 60-70%; serosa accounts for 20%; mucosa accounts for 10%, and cervical fibroids are rare. The following are some items that need to be checked before surgery for uterine fibroids:

1. Ultrasound examination: B-ultrasound examination is a common method for diagnosing uterine fibroids, and the accuracy of fibroid identification can reach 93.1%. Ultrasound examination shows that the uterus is enlarged and irregular in shape; the number, location, size of fibroids, whether the fibroids are uniform or liquefied cysts; and whether there is compression of other organs around.

2. Uterine probe examination: Use a probe to measure the uterine cavity. Intramural fibroids or submucosal fibroids often enlarge and deform the uterine cavity. The uterine probe can be used to detect the size and direction of the uterine cavity. Compared with the double clinic, it helps to determine the nature of the mass and understand whether there is a mass in the cavity and its location.

3. Plain X-ray examination: When the tumor is calcified, it appears as scattered uniform spots, or a shell-like calcified capsule, or a rough, wavy, honeycomb-like edge.

4. Diagnostic curettage: Small submucosal fibroids or dysfunctional uterine bleeding, endometrial polyps are not easy to be found through biphasic diagnosis, and can be assisted by curettage. If it is a submucosal fibroid, the scraper feels the uterine cavity bulge, starts high and then slides, or feels something sliding in the uterine cavity. However, small submucosal fibroids are easy to slide and missed, which is the shortcoming of diagnostic curettage.

5. Hysterosalpingography: Ideal hysterosalpingography can not only show the number and size of submucosal fibroids, but also locate them. Therefore, it is very helpful for the early diagnosis of submucosal fibroids, and the method is simple. Photography of the fibroid site shows that the uterine cavity is incomplete.