Uterine fibroids are the most common benign tumors in female reproductive organs. They mostly occur in middle-aged women. The common age range is 35 to 45 years old, and they are especially common in infertile women. 25% to 35% of patients with uterine fibroids are infertile. The reason may be that the fibroids prevent the implantation of the fertilized egg, or the deformation of the uterine cavity blocks the entrance of the fallopian tube and prevents sperm from entering the fallopian tube. If the fibroids are close to the serosa layer, they will not have a great impact on pregnancy. In addition, sometimes uterine fibroids are accompanied by ovarian dysfunction and may also be one of the causes of infertility.
If the uterus is irregularly shaped or unusually large, fibroids should be suspected during a pelvic exam. Ultrasound is commonly used to determine the location and size of fibroids. If the fibroids are in the uterus, the fibroids can be removed through the cervix and vagina with the help of a hysteroscope while the patient is anesthetized. A hysteroscope allows doctors to see clearly what is going on inside the uterus, and fibroids can be removed using a metal coil or laser. This does little damage to the uterine muscles or endometrium.
If fibroids grow outside the uterus, they are usually removed through the uterine wall using laparotomy or laparoscopy. This process is called fibroid resection. Sometimes the removal of fibroids requires a complete incision of the patient\’s uterus. If these patients become pregnant after the removal of fibroids, they should choose a cesarean section. A myomectomy is not a hysterectomy, it removes the fibroids but leaves the uterus. Like all surgeries, fibroid removal should be performed by a skilled physician with the goal of maintaining or restoring the patient\’s fertility. If a patient is told that the uterine fibroids are too large and the uterus must be removed, it is wise to listen to other people\’s opinions.
If the fibroids are large and deeply embedded in the uterus, fibroid embolization is a relatively new and promising treatment method. It works by blocking the blood supply, causing the fibroids to shrink. After this treatment, 1% to 2% of patients require immediate hysterectomy due to uterine damage. Because of this potential risk that it may permanently damage the uterus, fibroid embolization is generally not recommended for women who wish to become pregnant.
The principle of treatment of uterine fibroids is to conduct a comprehensive analysis based on the patient\’s age, fertility requirements, the size and location of the fibroids, and the presence or absence of symptoms and comorbidities. Determine treatment. The method is as follows;
(1) Follow-up observation:The fibroids are not large and asymptomatic. alreadyWomen near menopause can be followed up regularly for observation, once every 3 to 6 months. If the fibroids are found to be enlarged or other symptoms occur, surgical treatment is performed.
(2) Dilation and curettage: If the fibroid is not large but there are irregular menstruation, it can be diagnosed Dilation and curettage. On the one hand, it can rule out endometrial lesions, and on the other hand, it can also have a temporary treatment effect.
(3) Surgical treatment: Fibroids are large or have obvious symptoms, and other treatments are ineffective. If so, surgical treatment should be considered. Surgery is divided into: ① Myomectomy, that is, the tumor is removed from the uterus and the uterus is preserved. This kind of surgery is suitable for young women who need to preserve their reproductive function and have a small number of uterine fibroids, which are intramural or subserosal uterine fibroids, and the male\’s reproductive function is normal. ② If the submucosal fibroid has prolapsed outside the cervix, the fibroid can be removed from the vagina. ③ Total or partial hysterectomy, which is the most common treatment method for uterine fibroids.
(4) Radiotherapy: If fibroids require surgery and the patient\’s general condition is not good , or if there are serious complications that are not suitable for surgical treatment, radiation therapy can be used.
(5) Other treatment methods: Such as traditional Chinese medicine, sex hormones, etc., which can have temporary effects .
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao