Uterine fibroids are mainly formed by the proliferation of smooth muscle cells in the uterus, forming a verrucous body. Fibroids can be solitary or multiple. A small amount of fibrous connective tissue is present as a supporting tissue, so it is more accurately referred to as a smooth muscle tumor of the uterus. They are referred to as uterine fibroids. Uterine fibroids are a type of gynecologic tumor. It is a hormone-dependent tumor with a prevalence of 20% in women over 35 years old, in other words, one out of five women over 35 years old suffer from fibroids at the same time. In addition, according to the location of fibroids, they can be classified as interstitial fibroids, subplasmic fibroids, and submucosal fibroids. After the formation of fibroids, there are different clinical manifestations depending on the location of fibroids, their impact on the uterine cavity, and their impact on the endometrial area. However, in general, fibroids are not like adenomyosis, which can cause severe menstrual cramps and heavy menstrual flow. That means most patients with fibroids do not have any symptoms, and discomfort, and cannot even find out they have fibroids for a long time. It is only discovered by chance during a gynecological ultrasound examination. For these patients who do not have any pain or discomfort and do not have fertility needs, they naturally do not need surgery or treatment, and regular observation is sufficient. Then when is surgery needed? Dr. Deng suggests that the following cases must be operated! 1, resulting in increased menstrual flow and anemia Generally, there is no change in menstruation when you have fibroids, but there is one type of fibroid that has an effect on menstruation, and that is submucosal fibroids, which most easily affects menstruation. Submucosal fibroids, divided into intermural submucosal fibroids, are usually located in the intermural area, but one side grows into the uterine cavity and protrudes into the uterine cavity and comes into direct contact with the mucosal layer, which leads to an increase in the size of the uterine cavity and deformation. There is also a type of submucosal fibroid called a juxtamucosal submucosal fibroid, which has a tip attached to the uterus. These two types of fibroids usually cause increased menstrual flow and slowly lead to anemia. Some patients may also suffer from menstrual pain. Therefore, surgery is recommended for these patients with increased menstrual flow, anemia, and dysmenorrhea. 2, fibroids are too large and compression symptoms occur. In other patients, fibroids are too large and can lead to compression symptoms, such as large fibroids in the anterior wall of the uterus close to the bladder can produce bladder irritation symptoms, manifested as frequent and urgent urination. When cervical fibroids grow forward to a particularly large size, they can also cause bladder pressure and lead to discomfort in the upper part of the pubic bone, urinary frequency, urinary retention or overflow incontinence. There are also fibroids growing in the back wall of the uterus, and its enlargement can also cause constipation by pressing on the rectum. 3. Rapid growth in a short period of time, consider the risk of cancer There is another situation, which also needs your high attention, that is, the uterus, or uterine fibroids grow rapidly in a short period of time. There are glassy changes, which are considered to have malignant tendency. This time, you must go to the hospital first and treat the surgery as early as possible. 4, fibroids lead to infertility or miscarriage In addition, if fibroids lead to infertility or miscarriage, these patients, too, must be operated as soon as possible to solve the problem of fibroids first, and then consider the fertility problem. Fibroid infertility is most often caused by the size of the fibroids or the location of the fibroids. For example, they are close to the fallopian tubes and protrude into the uterine cavity. What kind of surgery is usually appropriate for patients with fibroids? It depends on the specific location of the fibroid. If it is a subplasmalemma with a tipped fibroid, it is usually solved by minimally invasive laparoscopy, and if it is a submucosal fibroid, hysteroscopy can be considered. However, if the fibroids are in the interstitial space, especially in the case of multiple fibroids, open hysteroplasty is recommended. All fibroids will be removed together during the surgery to solve the worries.