Are uterine fibroids serious? What should I do?

To ask whether uterine fibroids are serious, the answer is actually yes. Although it is a benign tumor, the symptoms it causes and the possible malignant transformation can pose a great danger to women, and sometimes can even cause infertility or miscarriage.

1. Uterine fibroids must be cured in time, otherwise the consequences will be serious:

1. Cancer. If multiple uterine fibroids undergo sarcoma degeneration, the tumor will develop suddenly. If the tumor grows rapidly, it may become malignant. Clinical investigations show that 0.5~1% of patients may develop malignant transformation.

2. Infertility. Infertility caused by multiple uterine fibroids accounts for 1%-2.4% of female infertility, and the probability of uterine fibroids combined with infertility is as high as 27%. Many patients can resume pregnancy after the uterine fibroids are removed.

3. Miscarriage. Multiple uterine fibroids leading to miscarriage are related to the location of the fibroids. For example, subserosal uterine fibroids have little effect on pregnancy; but intramural fibroids and submucosal fibroids often cause the uterus to enlarge, the uterine cavity to bend and deform, and lead to miscarriage.

2. Treatment of uterine fibroids

1. Medication

It is mainly used for short-term treatment and is mainly suitable for patients with uterine fibroids who have surgical indications. Preoperative medication is used to correct anemia, reduce the size of the uterus, avoid intraoperative bleeding and reduce surgical difficulties; it is also suitable for women who are near menopause, whose uterus is smaller than the size of 10 weeks of pregnancy and whose symptoms are mild; and those who have contraindications to surgery due to other comorbidities. The drugs used have side effects and are not suitable for long-term use.

2. Surgical treatment

Surgery remains the most common treatment for uterine fibroids. It is mainly divided into hysterectomy and myomectomy.

Hysterectomy: Hysterectomy can be performed if there are surgical indications, preservation of fertility is not required, or malignant transformation is suspected. Because the cervix may become cancerous in the future after subtotal hysterectomy, and stump cancer is difficult to treat, total hysterectomy is currently recommended for most patients. A cervical smear cytology examination should be performed before surgery to rule out cervical malignancy. Premenopausal women can retain both adnexa, while postmenopausal women can consider removing both adnexa at the same time.

The operation can be performed abdominally, laparoscopically or vaginally, depending on the size of the patient's uterus, the location of the fibroids, the presence of pelvic and abdominal adhesions, abdominal and vaginal conditions (such as excessive obesity, etc.), and the equipment and technical conditions of the doctor and hospital.