Uterine fibroids: The uterus is an important organ for women. The presence of the uterus allows women to have menstrual cycles and to be able to nurture life, and plays a crucial role in the positioning of women’s roles and physiology and psychology. Uterine fibroids, known as the first gynecological tumor, is the most common gynecological tumor, mostly seen in women of childbearing age between 30 and 50 years old, and its incidence is as high as 20-30%, nearly half of them are women of childbearing age. According to the information of gynecological surgery disease spectrum of Beijing Chaoyang Hospital, uterine fibroids have been the first gynecological surgery disease in the last decade. Symptoms of fibroids: Many studies have shown that fibroids are harmful to women in many ways, including physiological, maternal, psychological, family and social effects. Typical symptoms of fibroids include: altered menstrual cycle, prolonged periods, increased menstrual flow, abnormal uterine bleeding and secondary anemia, lower abdominal mass, frequent urination, constipation, pelvic swelling, back pain, and infertility, which constantly torment patients and cause many adverse effects on health and quality of life. Of course, there are also mostly asymptomatic ones. Psychological performance of patients with uterine fibroids: In reality, there are patients without clinical symptoms, but the presence of fibroids is also a great blow to patients’ physical and mental health, after all, they are tumors. It puts pressure and burden on them physically and emotionally. The negative emotions of fear and worry about the disease can reduce the body’s immunity and tolerance to the disease, which can affect the quality of work and life. Changes in the concept of surgical treatment for uterine fibroids: With the development of social economy and culture, the age of marriage and childbirth of women has been postponed, and the number of patients with uterine fibroids in infertile women is gradually increasing; women are paying more attention to the state of reproductive endocrine health, and more women want to preserve the integrity of the uterus. The concept of surgical treatment of uterine fibroids has changed, as shown by more choices of minimally invasive, individualized, humanized and diversified; even multiple fibroids or huge fibroids can be removed from the theory and the uterus can be preserved. Surgical treatment of fibroids: Surgery is considered to be the only method that can completely treat fibroids at present. It is also the most effective treatment method. It is suitable for those with symptoms or suspected sarcoma changes. Surgical procedures: hysteroscopic, laparoscopic, transvaginal or transabdominal myomectomy, subtotal hysterectomy or total hysterectomy. Realities of surgical treatment of uterine fibroids 1. For patients, talking about surgery, even minimally invasive hysterolaparoscopic surgery, is still a special event that can cause psychological shock, negative emotions and reactions to various treatments that increase patients’ somatic discomfort. 2, Despite the continuous progress in surgical techniques, surgery does involve certain risks and traumas, anesthesia risks and surgical complications, which once they occur will cause irreparable damage to the patient’s body and psyche, and are equally uncomfortable for the practitioner. 3, For women who have not had children, the uterine scar is formed after surgery, and pregnancy must be allowed after six months to two years after surgery, delaying the precious time of childbirth, while the possible pregnancy at the scar and uterine rupture are life-threatening. 4, the risk of fibroid recurrence exists in the surgery to preserve the uterus, and many patients worry that fibroid recurrence after surgery is equal to nothing. 5, Removal of the uterus is the method to eradicate fibroids, but the psychological and spiritual damage of losing the uterus far exceeds the physical, psychological and spiritual and physical damage caused by the uterine disease itself. 6.After hysterectomy, the blood supply to the ovaries will be impaired, causing patients to experience early menopausal symptoms, and the chances of pelvic floor dysfunctional diseases – vaginal prolapse and urinary incontinence – will also increase in the distant future after hysterectomy. 7, using minimally invasive surgery: some are only minimally invasive with skin incision, which cannot avoid uterine incision, and scar healing after incision of the uterus can lead to weak tissue in the area, which has been reported to lead to the risk of uterine rupture in late pregnancy. 8, There are strict indications for surgical treatment, and surgery is not recommended for uterine fibroids whose symptoms and size do not reach the indications. 9. Based on the risk of fibroids to physiological and psychological health and fertility, most patients want to obtain treatment once the fibroids are detected, even if there is only one fibroid of 1-50px in diameter without any clinical symptoms, it is enough to put some patients in extreme anxiety and fear. Should it be treated or not? Should we intervene early? Based on the current status of treatment and its effectiveness, many patients who are unable or unwilling to undergo surgical treatment have to suffer from fibroids for a long time. Analysis of non-surgical treatment for fibroids: Since surgical treatment or minimally invasive treatment are unsatisfactory, is there a safe and effective treatment method that can not only spare the patient pain and fear, but also protect the integrity of the uterus well, so that the uterus is not damaged and its original function is maintained, and also remove the fibroid lesion, reduce its recurrence rate, reduce or eliminate the symptoms, and facilitate fertility? Therefore, non-surgical treatment or non-invasive treatment of uterine fibroids is valued. Although they are effective, they can only temporarily treat the symptoms, control the tumor or shrink the tumor, and then recur after stopping the medication, and cannot be cured, but there are many adverse reactions, and the instructions of some drugs are not written on the indications for the treatment of uterine fibroids, so there are potential risks of medical disputes. It should be used only after full communication and understanding with patients. Uterine artery embolization (UAE): Uterine fibroid embolization is a minimally invasive treatment for uterine fibroids. the principle of UAE treatment is that the fibroid nodules are very sensitive to the acute ischemia caused after UAE, necrosis occurs, and the tumor shrinks or even disappears. At the same time, the integrity of the uterus is not affected by the establishment of collateral circulation; because UAE may cause ovarian failure and postoperative amenorrhea, basal follicle-stimulating hormone (FSH) and estrogen levels should be measured before and after surgery. UAE can cause pelvic pain, postoperative fever, bleeding, thrombosis and myoma recurrence due to acute ischemia of the uterus after surgery. High-intensity focused ultrasound (HIFU): It is a method of focusing acoustic energy on a point in human tissue, causing coagulative necrosis of the tissue in that area, which is then dissolved and absorbed by the body or fibrosis. Due to the massive destruction of microvessels in the lesion, the nutrient supply to the lesion is blocked, which strengthens the biological effect of focused ultrasound to kill the lesion, while the tissue cells outside the focused area are basically undamaged. MRI-guided HIFU is currently the most used non-surgical method for the treatment of uterine fibroids worldwide. Uterine fibroids treatment concept and outlook: Although fibroids have been documented and studied for more than 2,000 years, the cause of the disease is still not fully explained and the diagnosis and treatment of the disease is not satisfactory. With the continuous progress of medical technology, the concept of treating uterine fibroids has been improving and gradually exploring and discovering in the direction of humanization and non-invasiveness. In conclusion, the treatment of uterine fibroids has its pros and cons, regardless of the method used. Choosing a method that causes the least harm to the patient, cures the disease and does not make the patient fearful; comfortable, satisfied and spiritually happy, is the best method not only for the patient but also for the clinic.