Does uterine fibroids require the removal of the uterus?

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 11, 2024
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Whether a hysterectomy is needed for uterine fibroids depends on the specific circumstances of the patient. If the fibroids are large and numerous, making the preservation of the uterus unnecessary, then a hysterectomy can be considered. Additionally, the decision should take into account the patient's age, reproductive desires, and personal preference. If the patient is older, has no desire for children, and wishes to have a hysterectomy, then it is feasible to remove the uterus under these circumstances. However, if the patient's condition does not mandate the removal of the uterus, the decision should be made in conjunction with the patient's wishes.

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Written by Hou Jie
Obstetrics and Gynecology
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How to recuperate from uterine fibroids?

Uterine fibroids are the most common benign tumors of the female reproductive organs, composed of smooth muscle and connective tissue. Treatment varies depending on the patient's age, childbearing requirements, presence of symptoms, location and size of the fibroids, and their number. For asymptomatic fibroids, treatment is generally not necessary, especially for women nearing menopause. After menopause, fibroids often shrink or gradually disappear. In such cases, it is recommended to follow up every three to six months, or consider pharmaceutical treatment. Medication is suitable for those with mild symptoms, near menopausal age, or those who are not suitable for surgery. If there are complications such as heavy menstrual bleeding, resulting anemia, ineffective drug treatment, severe abdominal pain, or conditions like fibroid torsion or acute abdomen, surgical treatment is recommended.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How is uterine fibroid surgery performed?

When a woman has uterine fibroids, the surgical method should be decided based on the specific location, size, number of fibroids, age, and fertility requirements. If the uterine fibroid is relatively large, pretreatment can typically be carried out before the surgery. For example, using GNRHA-type drugs can reduce the size of uterine fibroids and lower the risk of surgery. Submucosal fibroids can be treated with hysteroscopic electroresection. Intramural or subserosal fibroids can be removed via laparoscopic surgery.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Early symptoms of uterine fibroid malignancy

Uterine fibroids are a type of benign lesion and generally grow slowly. Sometimes, even after several years of continuous re-examinations, the size of the uterine fibroids may not show significant changes. However, when uterine fibroids become malignant, their growth rate can accelerate, causing women to experience hidden pain in the lower abdomen. After the malignancy of uterine fibroids and an increase in size, they can also compress the pelvic floor nerves, leading to an intensification of abdominal pain; they can press forward against the bladder, causing frequent urination and urgency; and press backward against the rectum, resulting in changes in the characteristics of stools. Additionally, when some women's uterine fibroids turn malignant, they can also affect the surface area of the endometrium, impacting the menstrual cycle, such as causing irregular vaginal bleeding.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Uterine fibroid examination items

When suspecting that a woman has uterine fibroids, the first step is to perform a routine gynecological examination by opening the vagina with a speculum. This is necessary because some women's uterine fibroids are located on the cervix; at this point, it is possible to see an increased size of the cervix and the fibroid may be visible protruding from the cervix. Moreover, during the bimanual gynecological examination, one may find that the uterus is enlarged and irregularly shaped with localized protrusions. Generally, the mobility is quite good. Additionally, some auxiliary examinations can be combined, such as the most common transvaginal ultrasound or pelvic abdominal ultrasound. For suspected submucosal uterine fibroids, a hysteroscopic examination can also be performed for diagnosis.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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How to manage uterine fibroids

The occurrence and development of uterine fibroids are mainly related to congenital factors and have little to do with postnatal lifestyle conditions. Therefore, when uterine fibroids are detected, there is no need for any specific conditioning. Various traditional Chinese medicines, herbal treatments, or hormonal drugs do not have a definite curative effect on uterine fibroids, and so far, there is no specific medication for the treatment of uterine fibroids. When uterine fibroids are detected, the main considerations are whether they cause symptoms such as excessive bleeding, anemia, or whether they are increasing in size and causing compression symptoms on the surrounding tissues. Uterine fibroids without any symptoms generally only require regular physical examinations and may shrink and disappear after menopause.