Treatment of uterine fibroids

Uterine fibroids are the most common benign tumors in the female reproductive system, accounting for 20% of women of reproductive age. Although they are benign tumors, a series of clinical symptoms will appear with the growth of fibroids, including excessive menstruation, pelvic pain, frequent urination due to mass compression symptoms, difficulty in urination, and difficulty in drying stools, which bring a lot of pain to patients.  Diagnosis The diagnosis of uterine fibroids is not difficult. If patients show irregular menstruation, excessive menstruation, prolonged menstruation, pelvic pain and discomfort, they can undergo gynecological examination, which will reveal an enlarged uterus, ultrasound examination can clarify the size and location of uterine fibroids, and CT and MRI can confirm the diagnosis.  Treatment 1.Traditional treatment Traditional treatment includes hysterectomy or myomectomy. First of all, the surgery is certainly traumatic, even if the total hysterectomy is performed laparoscopically, it needs to be done under general or lumbar anesthesia. More importantly, surgical removal of the uterus is unacceptable for women who require fertility. It has also been shown that the uterus itself has an endocrine function, so removal of the uterus can also lead to endocrine disorders and early onset of menopausal syndrome or osteoporosis. Also, after total hysterectomy, many women feel like an incomplete woman psychologically, causing psychological damage. Myomectomy does not need to remove the uterus, whether it is performed from the hysteroscope or from the laparoscope there is the problem of higher recurrence rate.  2.Interventional treatment With the development of interventional technology, uterine artery embolization has become a very effective treatment for fibroids in recent years, with the advantages of minimally invasive, low surgical risk, few complications, good efficacy and complete preservation of the uterus.  Interventional treatment principle: Uterine fibroids are benign tumors of smooth muscle origin, and their blood supply comes from the bilateral uterine arteries. The branches of uterine arteries form a rich vascular network in the pseudo-envelope around the fibroids, and there are radial branches into the fibroids, which increase and thicken with the increase of fibroids. The above-mentioned characteristics of blood supply of uterine fibroids make them suitable for interventional embolization treatment. Super-selective embolization of the blood supply artery of uterine fibroids, without causing uterine necrosis, results in ischemia, degeneration, necrosis, and resorption of the fibroids due to the absence of the establishment of collateral circulation.  Interventional treatment method: Interventional treatment is chosen to be performed 2-7 days after menstrual cleansing. Preoperative routine examinations such as liver and kidney function, chest X-ray, blood routine, blood clotting function and electrocardiogram were performed. During the procedure, a small incision of 2mm is made at the root of the thigh and a very thin uterine artery catheter is inserted through the femoral artery to identify the blood supply artery of the fibroid. The entire intervention can be completed in less than an hour. The patient is fully awake and painless, and after removal of the catheter there is no wound, and the patient can get out of bed and move freely the next day.  The common side effects include lower abdominal pain, which is related to ischemia and involvement of normal tissues after uterine artery embolization. Postoperative fever is also common and may be related to ischemia and necrosis of the fibroids after embolization. Postoperative nausea and vomiting may be related to the vagal reflex. All these are tolerable and temporary, and they completely disappear after 2-3 days of symptomatic treatment.  Uterine artery embolization for uterine fibroids is a safe and effective method, which does not require opening the abdomen, does not remove the uterus, is less traumatic, less painful, less side effects, faster recovery and shorter hospital stay, and is especially suitable for young people of childbearing age and women who need to preserve the uterus or patients with severe anemia, hypertension, diabetes and other medical diseases.