How to treat uterine fibroids? Surgical treatment of uterine fibroids

Uterine fibroids are common benign tumors of the female genitals. It can cause anemia, infertility, uterine bleeding, miscarriage, etc., so the harm of uterine fibroids cannot be ignored. So how to treat uterine fibroids? The size of fibroids varies greatly, from the smallest microscopic fibroids to full-term pregnancy; the symptoms also change, and due to childbirth, the growth site of the tumor is different, so there are many treatment methods. Generally speaking, expected treatment, drug treatment and surgical treatment.

1. Expectant treatment

Expectant treatment has its unique advantages and is increasingly accepted. Expectant treatment is mainly suitable for women with a uterus <12 weeks of gestational size and no symptoms, especially those near menopause. They should be reviewed every 3-6 months, paying attention to uterine enlargement and, if necessary, ultrasound reexamination when symptoms occur. Otherwise, surgery can be used at any time. Literature reports that as long as there is sufficiently high-resolution ultrasound or ultrasound MRI, even fibroids with a follow-up of >12 weeks of gestational size can be treated expectantly.

2. Drug treatment

Drug therapy is an important measure for the treatment of fibroids. Drug therapy can be considered: 1. Uterine fibroids are smaller than 2-2.5 months of gestational uterus, with mild symptoms and close to menopausal age; 2. Large fibroids need to maintain reproductive function, avoid too large uterus and too many incisions; 3. Myomas with excessive menstruation and anemia can be considered for surgery, but patients are unwilling to undergo surgery, 45-50 years old; 4. Larger fibroids are prepared for negative or laparoscopic, hysteroscopic surgical resection; 5. Correct anemia before surgery to avoid intraoperative blood transfusion and complications; 6. Myoma combined with infertility to shrink the fibroids and create conditions for pregnancy; 7. There are medical complications and surgery cannot be performed. Contraindications are: 1. Myomas grow rapidly and malignant changes cannot be ruled out; 2. Myomas are degenerated and malignant changes cannot be ruled out; 3. Submucosal fibroids have obvious symptoms and affect pregnancy; 4. When subserosal fibroids are twisted; 5. Myomas cause obvious compression symptoms, or myomas are incarcerated in the pelvis and cannot be repositioned.

3. Surgical treatment

Surgery is still the main treatment for fibroids, which generally includes abdominal hysterectomy, cervical myomectomy, broad ligament myomectomy, hysteroscopic surgery, vaginal hysterectomy, etc.