Surgical indications and methods for uterine fibroids

Uterine fibroids are the most common benign tumors in women. Treatment should be based on the patient's age, fertility requirements, symptoms, location and size of the fibroids, etc. Western medicine treatment methods include follow-up observation, surgical treatment, drug treatment, etc. Among them, the indications and methods of surgical treatment include the following:

1. Indications for surgery

The following patients need surgical treatment: those with uterine fibroids larger than the uterus at 10 weeks of pregnancy; those with menorrhagia, secondary anemia, and ineffective drug treatment; those with bladder and rectal compression symptoms; those with cervical fibroids; those with rapidly growing fibroids and suspected malignant transformation, etc.

2. Surgical method

Patients with uterine fibroids can undergo surgery through the abdomen, vagina, or under hysteroscopy or laparoscopy. The main surgical methods include:

Myomectomy: It is a method of removing uterine myomas and preserving the uterus. It is suitable for patients who wish to retain their fertility. It can be removed through the abdomen or laparoscopy. If it is a submucosal myoma, it can be removed through the vagina or hysteroscopy. It should be noted that about 50% of patients may relapse after myomectomy, and about 1/3 of patients need to undergo surgery again.

Hysterectomy: including total hysterectomy and supravaginal hysterectomy, mainly suitable for patients who do not need to retain fertility or suspected of malignant transformation. Cervical cytology should be performed before surgery to rule out cervical malignant lesions.