Multiple fibroids do not necessarily require removal of the uterus.
The management of fibroids should be based on the patient’s age, symptoms and fertility requirements, as well as the type, size, number and growth rate of the fibroids in a comprehensive manner.
1. Asymptomatic fibroids generally do not require treatment, especially in near menopausal women. After menopause, most of the leiomyomas may shrink and the symptoms may disappear. Follow-up visits should be made every 3 to 6 months, and further treatment may be considered if symptoms appear.
2. Drug treatment is suitable for those with mild symptoms, near menopausal age or whose general condition is not suitable for surgery.
3. Surgery for uterine fibroids needs to be decided according to the location:
(1) Fibroid in submucosa, because it grows in the uterine cavity, will lead to excessive menstruation and frequency, no matter how big the fibroid is, it should be treated;
(2) Intermural fibroid depends on whether it is projecting into the uterine cavity or into the plasma membrane layer. If it is projecting outward, it can be observed, and the menstrual flow can be observed if it is not heavy. Generally speaking, according to the specific situation, surgery can be considered for most of the fibroids over 5cm, or three fibroids over 3cm can be considered for surgery;
(3) If the patient has abdominal pain, symptoms of bladder and rectal pressure, and excessive menstruation, it is also one of the indications for doing surgery.
After the clinical appearance of multiple fibroids, if the symptoms are not serious and there is no excessive fibroid size or obvious compression, it is usually not necessary to remove the uterus.
If the fibroids are large or numerous and the symptoms are obvious, a hysterectomy may be necessary if possible, but the patient needs to be evaluated in detail by a doctor before the hysterectomy is performed.
If multiple fibroids are already present, don’t be nervous, seek timely medical examination and treatment, and choose the appropriate treatment after comprehensive assessment.