Ms. Lu, 43 years old. She came to our gynecology outpatient clinic with heavy menstruation and stomach pain. The patient used to have relatively regular menstruation with occasional dysmenorrhea. Gynecological examination revealed an enlarged uterus with hard texture and pressure pain. The patient was recommended to be hospitalized and underwent laparoscopic myomectomy. Now the patient has been discharged from the hospital and regularly visits our gynecology clinic for follow-up.
What are fibroids?
Uterine fibroids are the most common benign tumors of the female reproductive system, consisting of smooth muscle and connective tissue, and occur mostly in women between the ages of 30 and 50, the cause of which is still unclear. Uterine fibroids are mostly found in the body of the uterus, while cervical fibroids are less common; according to their relationship with the myometrium, uterine fibroids can be divided into interstitial, submucosal and subplasma fibroids.
What are the conditions in daily life that may be caused by fibroids?
The most common condition in women with uterine fibroids is heavy menstrual flow and prolonged menstrual periods, which may lead to anemia if the condition persists for a long time. Other patients may feel a lump on their stomach, or have difficulty urinating when urinating, frequent urination, or feel anal swelling and constipation when defecating. This condition is usually caused by fibroids compressing the bladder or rectum.
What tests are needed to detect uterine fibroids?
First of all, patients are advised to have a vaginal ultrasound, which can indicate the size, number and location of fibroids. If the ultrasound reveals that the patient’s fibroids are protruding into the uterine cavity, a hysterosalpingogram will also be required.
When do fibroids require surgery?
Surgery is generally recommended if the fibroids are ≥125px in diameter. Without surgery, the fibroids may continue to grow and even have a chance of malignancy. In addition, surgery is also recommended for menopausal women if the fibroids are found to be growing rapidly and malignancy cannot be ruled out. Patients with small fibroids and no obvious symptoms can be reviewed regularly, coming to the clinic for ultrasound every 3 months.
What are the surgical treatments for uterine fibroids?
There are two types of surgical treatment in general, one is myomectomy: mainly used for patients who wish to preserve their reproductive function. There is also hysterectomy: for menopausal women who do not require preservation of reproductive function. Both procedures can be performed by transabdominal, transvaginal, laparoscopic, or hysteroscopic routes. Currently, laparoscopic surgery is more common, less invasive, with a quick and easy post-operative recovery.
How long is the hospital stay for surgical treatment?
Usually 7-10 days.
How do I recuperate after surgery for fibroids?
Pay attention to rest and nutrition, and review in the outpatient clinic 1 month after surgery. If you have stomach pain or vaginal bleeding more than your usual menstrual flow after surgery, you should visit the outpatient clinic or emergency room anytime.
Can I take medicine to treat fibroids if I don’t want to have surgery?
Taking medicine can only relieve some symptoms caused by fibroids in the short term, it does not make them disappear. For patients with symptoms, surgery is the first choice for a complete cure.
Can fibroids affect pregnancy?
For patients with fibroids larger than 125px in diameter and who have a need to have children, surgery is recommended to remove the fibroids before pregnancy. If the fibroids are not large, located in the subplasma or intermuscular wall, do not significantly change the morphology of the uterine cavity, and especially if the patient is older or wants to have a second child, it is recommended to take advantage of the best period of fertility to get pregnant first.
Can I drink Chinese medicine to regulate my fibroids if they are relatively small?
If the fibroids are small and there are no obvious symptoms, you can choose to take some herbal products that regulate qi and blood, dissolve silt and disperse nodules. You also need to come to the hospital for regular outpatient review.