A 4cm fibroid is not considered a large fibroid. It is considered a large fibroid only if the diameter of the fibroid is more than 5cm. Whether a fibroid needs surgery or not depends firstly on the size of the fibroid, and fibroids over 5cm are indicated for surgery. Regardless of the size of the fibroid, if the fibroid causes a change in the patient’s menstruation, resulting in prolonged or increased menstrual flow, or if infection or degeneration has occurred, surgery is indicated. Therefore, patients with uterine fibroids should be considered in these two aspects when they are followed up. Many patients with fibroids do not require special treatment, but if the fibroids are significantly enlarged, it is important to consider that degeneration may have occurred and prompt treatment is needed.