Among gynecological diseases, uterine fibroids (commonly known locally as sarcomas) are by far the most common type of benign tumor in women and one of the most common tumors in the human body. Most patients with uterine fibroids are middle-aged women, commonly between the ages of 35 and 50. About one in five people have fibroids in their uterus. Causes and Symptoms: The cause of fibroids is related to excessive estrogen in the body, as well as long-term stimulation, which occurs with sustained and prolonged estrogen action. Currently, many women are more likely to develop fibroids because they have fewer children or have never had children, i.e., they have never been pregnant; this is due to the fact that women do not menstruate during the first trimester of pregnancy, which stops the cycle of estrogen and reduces stimulation in the body. Women who have not been pregnant are more likely to have high estrogen levels, which can stimulate the uterus and lead to fibroids. It is important to note that most patients with fibroids are asymptomatic and usually do not experience pain, and are usually detected during gynecological exams or ultrasounds. The symptoms of fibroids are related to the location and growth rate of the fibroids. The most common symptoms are shortened menstrual cycles, increased blood flow, or prolonged menstrual periods. Other symptoms include abdominal masses. Some patients may feel some substantial masses in the lower abdomen, especially when they get up early in the morning and their bladder is full. Since fibroids are usually asymptomatic, regular gynecological examinations should be done to prevent and control fibroids in order to detect small fibroids early. Those with small tumors can be followed up regularly, while those with large tumors should be actively treated. Even for those who have undergone myomectomy, regular follow-up is necessary because of the possibility of recurrence of fibroids. What are the conditions for surgery? The chance of fibroids deteriorating is very small, usually around 0.5%, so surgery is not necessary for those who have fibroids, but they must be followed up regularly. 2.Uterine fibroids cause pressure on other organs in the pelvis, such as tumors that are too large and press on the bladder, causing frequent urination or difficulty in urination, which also requires surgery. 3.The fibroids grow too fast, or after menopause, the fibroids not only do not shrink, but also become bigger. 4.When a woman is infertile and all other tests are normal, the cause of infertility may be fibroids, and then she must undergo surgery. Should the uterus be removed? Before undergoing surgery, both the patient and the doctor will consider whether the fibroids should be removed or whether the uterus should be removed. This depends on the location and size of the fibroids, the patient’s age, fertility status, and the severity of the symptoms. If the patient is over 40 years old and is not considering having any more children, hysterectomy may be considered. As for whether the ovaries should be removed, that is even more important to consider. Because the ovaries are the main source of estrogen and must be supplemented with estrogen replacement therapy after removal, women under 40 years of age generally do not have their ovaries removed if possible. Hysterectomy is further divided into total and subtotal hysterectomy. A total hysterectomy removes the body of the uterus along with the cervix; a subtotal hysterectomy allows the patient to keep the cervix. Hysterectomy is quite common nowadays and there are no major technical difficulties and the scope of surgery is not too large.