“Professor, my uterus is 100mm. Is it necessary to cut the uterus with such a big uterus? Can I still have a uterine preservation surgery?” “Dr. Deng, I usually have a feeling of swelling, and I went to the hospital to check the ultrasound and said that there is a large fibroid of more than 80, can such a large fibroid be removed surgically? Or do I have to have my uterus cut?” We often encounter such questions in our daily consultations. Patients are worried that their uterus is too big or their fibroids are too large and they have to have their uterus removed, but they are also worried about the damage it will do to their body if the uterus is removed. After determining that the uterus can be preserved without cutting the uterus, they are worried that such a large uterus with fibroids will make the uterus preservation surgery more difficult and will not solve the underlying problem. In fact, no matter how big the uterus is with adenomyosis, fibroids, it is possible to preserve the uterus, and there is no need to worry about the difficulty of surgery, which is the scope that doctors should consider. And patients with large uterus do not increase the difficulty of uterus preservation surgery, but rather small uterus, small fibroids, adhesions (try to avoid surgery, abortion, scraping, can reduce the occurrence of adhesions) … uterus, why would patients with larger fibroids than patients with small uterus, small fibroids easier to do surgery? The reasoning is actually the same as if you pick a shell, stone from the sand and a grain of rice from the sand. Also adhesions are one of the things that make surgery more difficult. Before each surgery, if the patient has adhesions, we need to separate the adhesions before performing the surgery. In adenomyosis patients, there are severe adhesions, even rectal adhesions, which require the experience and skill of the surgeon to separate and perform the uterine preservation surgery. In order to prevent adhesions after adenomyosis conserving surgery, we use an anti-adhesion film to form a protective barrier for the patient after the conserving surgery, that is, after the uterus has been sutured. In fact, as a patient with adenomyosis, there is no need to consider the difficulty of surgery, but only whether adenomyosis itself has affected my life and work. Is it very painful. If it does, it is advisable to consider surgery. The first adenomyosis surgery today is a patient with a large uterus, Ms. Hu, from Cangzhou, Hebei, only 39 years old this year, adenomyosis painful menstruation history has been up to 11 years, or very young adenomyosis patients, the size of the uterus before surgery: 160x145x117mm, her three uterus diameter has reached more than 100mm, into a spherical shape. Ms. Hu had lower abdominal pain during menstruation 11 years ago with no obvious cause, which was tolerable, and went to the local hospital for ultrasound suggesting adenomyosis, which was recommended for hysterectomy, but did not accept the treatment. More than a year ago, her menstrual flow increased 3 times again, accompanied by dizziness, weakness, frequent urination and other discomforts, and she went to a local hospital for ultrasound: the uterus was significantly larger than before. She finally came to me for uterine preservation surgery. This morning, I successfully preserved her uterus, removed the adenomyoma, adenomyosis, myoma, left ovarian cyst and removed the ring. The whole procedure still went very well. So it is not necessary to cut the uterus to solve the problem of large uterus, but it is also possible to preserve the uterus. The uterus can be preserved for such a large uterus, so for what kind of patients, it is necessary to remove the uterus. There are several cases where hysterectomy is recommended: complex hyperplasia of the endometrium after menopause; malignant diseases such as endometrial cancer, ovarian cancer, and cervical cancer require total hysterectomy after careful evaluation by a physician. Other systemic pathologies, such as severe coagulation disorders leading to excessive menstrual bleeding and anemia, and psychiatric disorders preventing self-care, etc., should be evaluated carefully by both doctors and patients. Again, total hysterectomy can be performed after careful evaluation and discussion between the doctor and patient. Other benign diseases, such as adenomyosis, adenomyoma, and myoma, can be preserved or removed depending on the patient’s wishes.