Treatment of fibroids includes surgery, medications and other new methods. Surgery is the primary treatment with immediate results! There are two types of surgical treatment: either complete removal of the uterus, or just removal of the fibroids and preservation of the uterus. So, when is the uterus removed and when is it preserved? In the early days, it was thought that the uterus was growing “tumors”, so of course it should be removed to save lives, not to mention reproduction! It was later discovered that fibroids are benign, and for young women who have not had children, removal of the uterus is cruel! Bonnie, a British gynecological surgery master, suggested that “to remove a woman’s uterus for a dozen purely benign fibroids would undoubtedly be a complete failure of surgery”, and thus began myomectomy (i.e., removing only the fibroids while preserving the uterus). The general textbook suggests that myomectomy can be performed for patients under 35 years of age who wish to preserve their reproductive function. However, there is an increasing number of older childbearers, and the 35-year-old cut-off seems too low; we tend to use 40 years of age as the cut-off in clinical practice. Moreover, many women are reluctant to remove their uterus even if they are no longer considering childbearing, thinking that they will not be women after removal of the uterus (this view is incorrect, please refer to my short article on related science), and there are often requests for myomectomy at the age of about 45. Therefore, our current recommendation: for women under 40 years of age, if fibroids cannot be treated conservatively and surgery is needed, myomectomy is feasible; for women over 40 years of age, hysterectomy is preferable. Of course, myomectomy can be performed if there is a strong desire to preserve the uterus. For women who undergo myomectomy, there are some “ugly words” that need to be said: ① After myomectomy, it may recur and may be operated again after several years; ② If there are too many fibroids or in a special location, there is a lot of bleeding during surgery, and sometimes hysterectomy is performed as a last resort in order to save lives; ③ For fibroids with malignant potential, if the pathological examination after myomectomy confirms that they are malignant, a second operation is needed. ③ For myoma with malignant potential, if the pathological examination after exclusion is confirmed as malignant, a second operation is needed to perform hysterectomy or a wider range of exclusion; ④ The issue of myoma exclusion and pregnancy is more complicated and needs to be discussed in a special article, so I will post it when I have time to sort it out.