”Do I need surgery for my fibroids?” This is one of the most common questions asked by patients. In fact, “symptoms” are more important than “fibroid size” in deciding whether to have surgery. Traditionally, surgery is considered necessary for fibroids ≥ 5 cm, but this concept is now considered outdated and the key factor in deciding whether to operate is the “symptoms”. Symptoms that influence whether to operate include: 1) menstrual changes with anemia: patients with shortened menstrual cycle, increased menstrual flow, prolonged menstrual period, small amount of non-menstrual vaginal bleeding, and blood loss anemia due to appeal symptoms; 2) infertility and miscarriage: since fibroids grow in the uterus, their growth site, size and number may affect conception, and even if conception occurs, it may lead to miscarriage. Therefore, patients who are infertile or have a history of miscarriage need surgery for those who have fertility requirements; 3. Abnormal urination and defecation: If the fibroids are large or in a low position, they may cause pressure on the surrounding organs and make patients have difficulty in urination, urinary urgency, urination and defecation, surgery needs to be considered; 4. Palpable abdominal mass: When the fibroids are large (making the uterus reach the size of 2-3 months of pregnancy) The mass can be felt in the middle of the abdomen with hard texture, especially in the early morning when the bladder is full, and surgery should also be considered at this time; 5. Excessive growth of fibroids: If the diameter of fibroids grows by half of the original volume within one year, or grows by more than 1 cm in diameter within six months, it can be considered as excessive growth of fibroids, and surgery should be considered at this time; 6. Reversal of fibroids and necrosis: If there is sudden and severe pain in the lower abdomen, it may If the fibroid is twisted and necrotic, the fibroid will become infected, so it should be operated urgently; 7.After menopause, the fibroid is not small but large: If the fibroid does not shrink but increases after menopause, it may have the risk of malignant transformation and needs to be operated. Patients with the above symptoms (number of symptoms ≥ 1) may have to consider surgery, but of course, the specific situation needs a comprehensive assessment by the doctor.