Whether or not fibroids affect pregnancy depends on a combination of factors such as the location of the fibroids and the size of the fibroids.
Generally, we encourage patients to try to conceive once with the tumor, if the pregnancy fails once, after the doctor’s examination and exclusion of other factors, it is indeed caused by fibroids. At this time, it is helpful to remove the fibroids so that the patient can get pregnant.
If the fibroids are removed surgically without trying to conceive, the surgery is a double-edged sword and the side effects may cause lifelong infertility due to the side effects of the surgery.
Therefore, patients are generally encouraged to try to conceive, and most of them can go through 1, medication: but the effect of medication for uterine fibroids is almost always not very good, because fibroids is a hormone-dependent disease, and all medications are designed around making the hormone level in the body drop, but many young women will enter menopause early if their hormone level in the body drops too fast. GnRH drugs, for example, can cause a rapid decline in hormones, but can lead to early menopause and other side effects when taken for a long time.
We use GnRH drugs mainly when patients need to do laparoscopic surgery to take out the fibroids, but the surgical operation is difficult, so they can take GnRH for a few months to make the fibroids shrink and facilitate the surgical operation, rather than for therapeutic purposes.
Uterine fibroids are generally not recommended to use medication, it is almost impossible to control the fibroids from growing by medication alone, and the side effects to patients after taking medication for a long time are also great.
2, interventional treatment: interventional treatment has appeared in the last century, mainly by playing embolic agent inside the uterine artery, so that the blood vessels of fibroids are embolized, causing ischemic necrosis inside the fibroids. However, due to the rich blood supply of the uterus, the actual effect is not ideal.
3.Ablation surgery: The principle of ablation surgery is similar to microwave oven, by focusing the ultrasonic energy on a point in the center of fibroids to ablate them. Because of the irregular shape of fibroids, ablation surgery can reduce the size of fibroids slightly, but it is unlikely to ablate all the fibroids, as the fibroid envelope is still there, the fibroids will continue to grow.
The ablation procedure may cause some side effects, such as fever and prolonged vaginal fluid flow. Therefore, this method is usually not used.
4.Surgical treatment: uterine fibroid debridement surgery and hysterectomy
Indications for surgical treatment.
Surgery is recommended when a single fibroid is above 5 C 6 M.
In patients with multiple fibroids, surgery is recommended if the entire uterus is the size of 2.5 months or more of pregnancy.
If the fibroid is solitary and the patient is relatively young, uterine fibroid debulking is usually recommended. If the patient has multiple fibroids, but the patient is young and has not had any children, it is usually recommended to perform myomectomy instead of hysterectomy. So a comprehensive consideration is needed to develop a plan that is in line.
Effects of hysterectomy
After hysterectomy, the first thing for the patient is that it leads to the inability to have children. Secondly, it may affect the sexual life, mainly psychologically. Third, in younger patients, removal of the uterus can lead to premature ovarian failure, since 30% of the blood supply to the ovaries is supplied by the uterus. However, in patients over 45 years of age, this part of the effect is generally less of a consideration. Fourth, a small number of patients will develop pelvic stasis syndrome after hysterectomy and will have long-term, chronic pain.
So for hysterectomy, still need to be very cautious.
Laparoscopic treatment of uterine fibroids
The indications of laparoscopic surgery for uterine fibroids are: 1) subplasmalemma, preferably with a tip, 2) interstitial fibroids: single or multiple fibroids below 2-3.
Submucosal fibroids and fibroids convex to the uterine cavity are generally not recommended for laparoscopic surgery.
Cost of laparoscopic surgery
The cost of laparoscopic surgery is usually about twice the cost of a normal procedure, usually around 12,000.
The fibroids are removed after the child is delivered successfully.