Uterine fibroids and interventional therapy

  1.What is uterine fibroid? How is it classified?  Uterine fibroids are one of the more common tumors in women of childbearing age, mostly seen in 30-50 years old, formed by the proliferation of smooth muscle tissue of the uterus. Most of them are benign. Depending on the location of the fibroids in the uterine wall, they can be classified as interstitial, subplasmic, submucosal and intramural fibroids.  Clinically, there are asymptomatic fibroids and symptomatic fibroids. In the former case, the tumor is mostly small and cannot be felt during physical examination or found unintentionally during gynecological examination without any clinical discomfort and generally no treatment is needed. The latter refers to uterine fibroids accompanied by abnormal menstruation (excessive menstruation, menstrual disorders, etc.) or pressure symptoms such as urinary urgency, frequent urination, increased nocturia, difficult stool, lower abdominal cramps, increased leucorrhea, infertility, etc. They are the main group of clinical treatment targets.  2.Is uterine fibroids single or multiple?  Both single and multiple fibroids are found, but multiple fibroids are the most common.  3.Which fibroids need to be treated?  Treatment should be considered when fibroids are associated with the following conditions: (1) excessive menstrual flow, when other possible causes are excluded, and when medication is ineffective; (2) obvious pressure symptoms, which affect daily work and study; (3) small fibroids, but fast growth rate during follow-up; (4) large fibroids, and the patient is under great psychological pressure and requires timely treatment.  4.What methods can be used to treat fibroids?  Commonly used treatment methods include: surgery, interventional therapy, drug therapy, HIFU, radiofrequency therapy, etc. Surgical treatment and interventional treatment are most commonly used.  5.What are the advantages of surgical treatment compared with interventional treatment?  (1) Surgical treatment includes mainly: hysterectomy or myomectomy, which is suitable for those who have large fibroids or require surgical treatment. Most patients need to have their uterus removed, which seriously affects their long-term quality of life.  (2) Interventional treatment of uterine fibroids mainly involves embolization of uterine arteries with the help of guide wires, catheters and other materials to block the blood supply to the fibroids, promote ischemic necrosis of the tumor and control its growth. It is a well-established technique mostly applied to tumors with a maximum diameter of <12 cm. It is less painful, preserves the patient's uterus after surgery, has fewer side effects and complications; quick recovery, exact efficacy and short hospital stay.  6.Which patients should choose interventional treatment?  (1) symptomatic fibroids who need to improve the symptoms and control the growth of fibroids as soon as possible (2) symptomatic fibroids who need to preserve the uterus 7.How many times does interventional treatment for fibroids need?  Generally, only one intervention is needed.