Uterine fibroids are benign tumors formed by the proliferation of uterine smooth muscle tissue, and are also the most common benign tumors of the female reproductive system. The disease is common in women between 30 and 50 years old, and is rare under the age of 20. It is currently estimated that the prevalence of women of childbearing age can reach 25%. This is because the occurrence of uterine fibroids is related to sex hormones. The uterus is like a piece of fertile soil that provides abundant blood for uterine fibroids, and women of childbearing age secrete high levels of estrogen and become the cause of uterine fibroids. accomplice”.
The symptoms of uterine fibroids are related to the size, number, location, growth rate and degeneration of fibroids. Some patients with uterine fibroids may be asymptomatic and are only found during physical examination. Clinically, the most common symptoms of uterine fibroids are menstrual changes, increased menstrual flow and prolonged menstrual periods. Uterine fibroids cannot be touched in the abdomen when they are small. When the fibroids gradually grow and make the uterus larger than the size of the uterus in 3 months of pregnancy, the masses in the lower abdomen can be touched. Usually, because the tumor oppresses the pelvic blood vessels, causing congestion, or oppressing the nerves, backache, lower abdomen swelling, and lower abdomen pain are prone to occur. If uterine fibroids are too large, they can cause frequent urination, dysuria and constipation. Long-term bleeding without timely treatment can develop anemia, mostly mild to moderate anemia, but severe anemia can lead to anemic heart disease and myocardial degeneration. In addition, the factor uterine fibroids compressing the fallopian tube can cause it to twist, and intermural fibroids or submucosal fibroids can deform the uterine cavity, hinder the implantation of fertilized eggs, and cause infertility. Even if pregnant, the spontaneous abortion rate is higher than the normal population.
At present, patients with asymptomatic uterine fibroids generally do not need treatment, but surgery is recommended for the following situations: (1) The diameter of the fibroids is ≥4cm, and there is a need for fertility; (2) Menorrhagia, shortened cycles, prolonged menstruation, and abnormal bleeding , Secondary anemia; (3) Fibroids grow faster, have bladder and rectal compression symptoms, etc., as well as failure of conservative treatment, or infertility or recurrent miscarriage to rule out other causes.
Among them, uterine myomectomy is suitable for young patients under the age of 45 who have fertility needs. The fibroids are removed and the uterus is preserved, which also preserves fertility and maintains the integrity of the pelvic floor anatomy. Laparoscopic surgery and open surgery are possible for intramuscular and subserosal fibroids. Laparoscopic surgery has the characteristics of short hospital stay, small incision, beautiful appearance, and quick postoperative recovery, which is more conducive to the physical and mental health of patients. The disadvantage is that after surgery There is a possibility of recurrence.
Hysterectomy is suitable for those who do not need to preserve fertility or suspected of malignant transformation. Cervical intraepithelial lesions, cervical cancer, and endometrial cancer should be excluded before surgery. After the operation, there is no need to worry about the pathological changes of the uterus and cervix, no need to worry about the recurrence of fibroids, let alone the unintended pregnancy. But pay attention to keeping the wound clean and dry. Intercourse and heavy physical activity are forbidden for 3 months after surgery. Usually pay attention to a balanced diet, eat more fresh fruits and vegetables, and eat less spicy and greasy foods.
What needs special reminder is that if you choose a subtotal hysterectomy, that is, the uterus is removed, but the normal cervical tissue is preserved, and the integrity of the pelvic floor organs is also preserved. After the operation, there is a risk of cervical stump cancer and cervical fibroids. Regular cervical screening and pelvic color Doppler ultrasound are required.
In addition, there is focused ultrasound therapy, which raises the internal temperature of the tumor to above 65°C, which causes the tumor to coagulate, degenerate, and die, and is finally absorbed and discharged by the body to reduce clinical symptoms. The therapeutic dose electromagnetic wave has no effect on doctors and patients, does not damage the surrounding tissues, and does not affect the blood supply of the ovaries. It has the characteristics of quick recovery after surgery and no scars.
In short, the surgical treatment of uterine fibroids should be based on a comprehensive consideration of the patient’s age, condition, size, number and location of the fibroids, and choose the best surgical plan.
