Adenomyoma and fibroids are not the same disease, but they are both common and frequent in women of childbearing age, and some patients may have both diseases. Uterine fibroids are made up of a proliferation of smooth muscle cells that contain a small amount of connective tissue. Adenomyoma, which can also be called adenomyosis, is a lesion in which the endometrium grows ectopically from the basal layer into the muscular layer and is confined to the myometrium. Both diseases can affect women’s health, but generally speaking, adenomyosis may cause relatively more distress and be more noticeable to the patient. Uterine fibroids: Uterine fibroids are the most common type of benign tumor in the female reproductive organs and one of the most common tumors in the human body. Uterine fibroids are mainly caused by the proliferation of uterine smooth muscle cells, so they are also known as uterine smooth muscle tumors. The majority of these fibroids are benign and very few are malignant. I have been working in gynecology for more than 30 years and I have rarely encountered cases of fibroids that have become malignant. So women with fibroids in their bodies generally don’t have to worry too much. In fact, 99% of the patients with fibroids have no obvious symptoms and the patients themselves do not feel anything. Usually, fibroids do not cause menstrual pain, and their menstrual flow is not particularly heavy and does not affect pregnancy. The vast majority of patients with fibroids do not require special treatment, surgery, or medication (at present, it is unscientific to say that medication will get rid of fibroids). However, the incidence of fibroids is relatively high, and if they grow very large or are not well positioned, they can still have certain effects on the patient: i. They can affect menstruation, leading to heavy menstruation, irregular vaginal bleeding, anemia, etc. 2. Infertility and miscarriage. Compression symptoms: the large size or special location of the fibroids has led to compression of the bladder, rectum, ureter and even hydronephrosis. Fourth, abdominal pain. Usually fibroids do not cause pain, but if combined with adenomyosis there will be dysmenorrhea, which will be talked about below. Treatment: There are more treatment methods for fibroids, but the mainstream is still surgery (drugs do not work). The old method is to cut the uterus, but it is generally less acceptable. Usually we recommend the use of fibroid excision. Examples are the common laparoscopic surgery and open surgery. Laparoscopy is suitable for single individual distinct fibroids and open surgery for multiple fibroids. Uterine fibroids are hormone-dependent fibroids, and they are more likely to occur more frequently when women have higher estrogen levels. Fibroids rarely grow in women before puberty because the estrogen level in women’s bodies is relatively low at this time; while the estrogen level in women’s bodies gradually decreases around the age of 50 (menopause stage) and afterwards, the smaller fibroids in patients’ bodies will usually shrink and disappear naturally at this time. Therefore, as long as the fibroids are not particularly large and there are no symptoms, women in the menopausal stage do not need surgery. Adenomyosis: This disease is more painful. If you have uterine fibroids, you do not hurt, do not know; then adenomyosis, I’m afraid you will tear your heart and lungs, home without peace. Adenomyosis is a difficult gynecological disease, it is the endometrial glands and interstitial invasion of the myometrium to form a diffuse or limited lesion, mostly in menstruating women aged 30 to 50 years old. Although the cancer rate of this disease is not high, it is called the “undead cancer” and the patient’s pain is not cancer but better than cancer. Common symptoms: 1. Menstrual pain. How painful is it? There are extreme cases of pain to depression and light-heartedness, and some patients reported that they were so confused and faint that they could not get up in the elevator when they went to the resuscitation room. …… In the late stages of the disease, serious patients will have abdominal pain before and after menstruation, not only pain during menstruation. Second, the menstrual volume is large. How big is it? Dozens of sanitary napkins are too lame to use directly on the diaper. Heavy menstrual flow often leads to anemia in adenomyosis patients, and several patients who come in for surgery often cannot be scheduled for surgery immediately because of anemia and must undergo preoperative treatment to correct the anemia. Third, the uterus is enlarged. This is caused by the adenomyosis lesion. Some patients have an enlarged uterus and their belly bulges like a pregnant woman in her third or fourth month of pregnancy. Usually this uterine enlargement is progressive, that is, it grows slowly over time as the disease progresses. Patients with a uterus that is too large, even if other symptoms are not obvious, are recommended for surgery, because this can have the uncertainty of malignant change. Fourth, anal swelling, nausea and vomiting, back pain, and lower limb pain. These are mostly caused by ectopic lesions of adenomyosis or caused by involving pain, all of which are common concomitant symptoms of adenomyosis. Although adenomyosis patients have very many symptoms, the specific performance symptoms may vary for each person with different conditions. In general, it is not very difficult to distinguish uterine fibroids from adenomyosis, and there are differences between the two in terms of ultrasound findings. Common conditions in the sonogram of uterine fibroids: most of the uterus is enlarged, even larger than the child’s head in some cases, or locally elevated, with morphologic derangement, circular isoechoic or hypoechoic masses seen in the cut surface, and endometrial pressure deviation. The masses can be subplasmic, intramyocardial, submucosal, and intracervical. The most common masses are intermural, with clear borders, regular morphology, and diverse heterogeneous internal echogenicity, and attenuated posterior echogenicity. The uterus is uniformly enlarged with a full morphology, diffuse or focal thickening of the myometrial wall is seen in the uterine section, posterior wall thickening is more common, the echogenicity is heterogeneous, the echogenicity is enhanced by rough spots, some of the uterus has limited hypoechoic or hyperechoic areas with unclear and irregular margins, small anechoic areas are seen in the uterine marginal zone, the endometrial line is mostly shifted, and some of them are combined with ovarian chocolate The endometrial line is mostly shifted, and some of them are combined with ovarian chocolate cysts and uterine fibroids. This is a very common condition, and depending on the patient’s condition, I usually recommend open uterine surgery, which can solve the problems of both diseases in one operation, and the patient can avoid a second operation. For small adenomyosis lesions and fibroids, the surgery requires great patience and care, which tests the operating experience and proficiency of the surgeon, and only when every lesion is cleaned can the patient’s pain be eradicated.