Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): Hello Dr. Lu, today I read your article on the internet: uterine artery embolization therapy – micro-innovation therapy for uterine fibroids, and I was very excited because I knew from your article that I might not have to undergo surgery. I am a patient in Tianjin, I was found to have multiple fibroids in 2006, the largest one was 3 cm, until 2010 the largest one grew to 5.5 cm, during this period the period time was unstable, sometimes 7 days clean, sometimes 10 days clean, the blood volume during the period was not large, the first 3 or 4 days was almost nothing, on the 5th or 6th day the blood volume increased. Each period was early, up to 6 days and at least 2 days. And in 2010, two new symptoms appeared: firstly, sometimes there was a downward sensation in the anus, and secondly, occasionally it was difficult to urinate. I have been seeing a doctor at the Tianjin Central Maternity Hospital, and since I had these two symptoms, the doctor told me to have open heart surgery, but because of fear, I have been putting it off until the last few days when I read about the intervention method on the internet, and most importantly, your article. I had taken “Gui Zhi Fu Ling Capsules”, but it did not work. Is it possible to determine by ultrasound whether the fibroids are “subplasmic fibroids with thin tissues, broad ligament fibroids and free fibroids”, and if not, what methods are available to determine this? Thank you for reading my question in your busy schedule, I appreciate your trouble, thank you again. Lu Wei: Hello. Your case has been understood and is a good candidate for uterine artery embolization. In general, ultrasound can show it, after all, subplasmic fibroids with tissues are rare and can usually be seen, but if the fibroid is very large (>10cm), it is not easy to judge, and MRI is needed to determine if it is a subplasmic fibroid with tissues. Patient: Hello Dr. Lu: I would like to wish you good health and success in the New Year. Since I consulted you last time, I haven’t done it yet because the doctor who did the intervention was away for six months, but I still go to the ultrasound examination on time. I’d like to tell you about my recent condition: Whenever I bleed during the last 3 periods (my period lasts 7-10 days, only a little bit on the first two days, none on the third, fourth and fifth days, and the bleeding starts on the sixth and seventh days, the blood volume is not too big), I feel a downward feeling in my stomach and some pain on the fifth and sixth days; I also have some pain at the roots of my thighs; and I always want to have a bowel movement, but I can’t do it. The situation became more and more severe each time, and the last period was the most severe and painful as mentioned above. The last ultrasound result (January 24, 2011) was as follows: uterine body 93×74×82mm, a hypoechoic protrusion on the posterior wall of the uterine fundus 50×57×43mm, uneven echogenic fenestrated echogenicity, peripheral stellar blood flow, a hypoechoic protrusion on the posterior wall of the uterus 63×56×54mm, peripheral stellar blood flow, and the examination suggested: multiple uterine fibroids; the combination of adenomyosis is not excluded; one is an adenomyoma. The examination suggests: multiple fibroids; combined adenomyosis is not excluded; one is an adenoma. After I showed the ultrasound to the doctor, he said that my fibroids are growing outward and not suitable for intervention. I would like to ask you how intervention will work in my case. Thank you! Lu Wei: Intervention can be done for simple subplasmic fibroids, as long as the majority of the fibroid is still attached to the uterus. I hope you can do MRI or CT and send me the film to see if it can be done. Patient: Hello, Dr. Lu! I’m sorry to say that the MRI film was taken, but I didn’t take a very good picture with the camera, so it might be hard for you to see the picture. I was worried that the pictures were not good, so I took a few more pictures, so please take a look at them. Thank you, I wish you good health and all the best! There is another MRI report. Do you think I am suitable for intervention? If so, which embolic agent should I use? Lu Wei: After looking at your pictures in detail, it is a posterior wall leiomyosarcoma, leaning on the subplasma membrane, but not growing outward with the ground, compressing on the rectum, it should be a good indication, we suggest you do intervention as soon as possible. Patient: Thank you, Dr. Lu, for replying to me! I’ll grab the hospital to do the interventional treatment. Thank you so much! Lu Wei: You’re welcome!!!