I often come across some women who are afraid of talking about “tumor” and find themselves suffering from uterine fibroids, and often ask their doctors nervously: Is this disease very serious? Is it necessary to have surgery? The actual fact is that you can find a lot of people who are not able to get a lot of money from the internet. On the contrary, there are some women with uterine fibroids who need surgery, who are extremely afraid of surgery and need it, but hesitate to do it and put it off again and again until their bodies gradually span down, or even complicate with anemic heart disease, fainting or shock. Of course, patients often ask if there are other treatments besides surgery. In fact, as one of the most common benign tumors, the incidence of uterine fibroids is high, and it is reported that about 20% of women over 35 years old suffer from this disease, with the most common in 40-50 years old and less common under 20 years old. The structure of the uterine wall is like a wall of a house. The inner layer of the uterine wall, which is the inner surface of the uterine cavity, is equivalent to the wall painted in the house, and is the mucosal layer; the outer surface of the uterine wall is covered with a plasma membrane, which is the plasma membrane layer; the part between the mucosal layer and the plasma membrane layer is the myometrium of the uterine wall. Interstitial fibroids (located in the myometrial layer of the uterine wall), subplasma fibroids (located in the plasma layer of the uterine wall) and submucosal fibroids (located in the mucosal layer). I. Why do I get fibroids Many women with fibroids have asked the question, “Why am I so unlucky to have fibroids?” Unfortunately, the specific cause of uterine fibroids, like other tumors, has not been completely clarified, but it is generally believed that fibroids are a hormone-dependent tumor, related to estrogen and progesterone in women’s bodies, so they mostly occur in women of childbearing age and tend to increase rapidly during pregnancy, while most fibroids stop growing or even shrink after menopause. Some patients have family history, that is, there is a certain family gathering phenomenon. The actual diagnosis of uterine fibroids is not difficult for those who have uncomfortable symptoms through gynecological examination, combined with ultrasound. Of course, there are many patients with uterine fibroids who do not have special discomfort symptoms and are only found during physical examination. How to treat fibroids Most fibroids are small and asymptomatic, so they do not need treatment at all and can only be observed on follow-up visits; those with mild symptoms, near menopausal age and systemic conditions that cannot tolerate surgery can be given symptomatic treatment with drugs; and those who need surgical treatment are limited to a small percentage of patients. Treatment is what many patients are eager to know, so here is the focus. 1.Follow-up observation The number of patients with uterine fibroids who need treatment is a minority. Most patients with fibroids do not need treatment or do not need treatment for the time being, including those with no obvious symptoms, small fibroids, especially those who are near menopause or have menopause, and those with low estrogen levels, the fibroids can shrink or disappear naturally. The method of follow-up observation has benefited most patients with fibroids from surgery, even for those who later need surgical treatment again, usually without adverse effects. However, for young women who require fertility, those with fibroids >3cm in diameter (instead of >5-6cm in diameter) or suspected submucosal fibroids found before pregnancy should be surgically removed, regardless of obvious symptoms, to avoid adverse effects due to the increase of fibroids after pregnancy, and those with infertile fibroids should be myomectomized and should not be included in the expectant therapy. 2, drug therapy Drug therapy is mainly used for: women with fibroids near menopause, after drug therapy, they can often transition to natural menopause and can achieve the purpose of treating fibroids; fibroids combined with anemia, in order to avoid intraoperative blood transfusion, drug therapy can be used to achieve amenorrhea, and anemia can be corrected after elective surgery; larger fibroids, the volume of fibroids needs to be reduced before surgery to reduce the difficulty of surgery, or for laparoscopic surgery or For larger fibroids, the size of the fibroids needs to be reduced before surgery to reduce the difficulty of surgery or to provide an opportunity for laparoscopic surgery or cathartic hysterectomy; for fibroids intended for endoscopic surgery, medication can be used before surgery (e.g. hysteroscopic submucosal myomectomy) to reduce the size of the fibroids in order to reduce intraoperative bleeding; for those who are contraindicated for surgery, medication can be used first to relieve symptoms. Commonly used drugs mainly include androgens, gonadotropin-releasing hormone agonists (GnRHα) and mifepristone, etc. 3.Surgical treatment Except for those who need treatment with regular follow-up, surgical treatment is still the main treatment method for uterine fibroids, and the surgical methods are still divided into two types of surgery: uterine fibroid removal surgery and hysterectomy.