Is surgery necessary to treat uterine fibroids? What are the general methods?

Uterine fibroids are one of the killers of modern women's health. This disease is very harmful to female friends. If it is not discovered and treated early, it may be life-threatening. So what are the general treatments for uterine fibroids?

1. Drug treatment

1. Young people who want to preserve their fertility. For women of childbearing age who suffer from infertility or miscarriage due to fibroids, drug treatment can shrink the fibroids and promote conception and fetal survival.

2. For premenopausal women, the fibroids are not very large and the symptoms are mild. After taking the medicine, the uterus will shrink and menopause will occur, and the fibroids will shrink accordingly, thus avoiding surgery.

3. Those who have surgical indications but currently have contraindications and need to be treated before surgery.

4. Patients with concurrent medical or surgical diseases who are unable to undergo surgery or are unwilling to undergo surgery.

5. Before choosing drug treatment, a diagnostic curettage and endometrial biopsy should be performed to rule out malignant changes, especially for those with menstrual disorders or increased menstrual flow. Curettage has both diagnostic and hemostatic functions.

2. Surgical treatment

Under normal circumstances, the intersection of the uterine artery and the ureter is located 2 cm away from the internal cervical os. However, in patients with multiple myomas, especially those in the lower uterine segment and cervical myomas, when they grow into the broad ligament, their anatomical position may change, and the ureter may even run in front of the tumor or along the side wall. Therefore, when encountering the above situation, the ureter should be searched for from the posterior leaf of the broad ligament first, and its direction should be confirmed along its running direction, and it should be avoided during surgery to avoid accidental injury.

Hysterectomy: Pull the uterus outward from the pelvis, use your fingers to press against the cervix and push the bladder down again to a level 1 to 2 cm below the external os of the cervix, and push it sideways 1 cm away from the cervix to avoid damaging the bladder and ureter when cutting the anterior wall of the vagina; use your index finger to push the loose connective tissue under the peritoneum between the broken ends of the uterosacral ligaments on both sides away from the rectum to 2 cm below the external os of the cervix. Expose the posterior vaginal fornix to prevent injury to the rectum when cutting the posterior vaginal wall. Use two fingers to touch the external os of the cervix to check whether it is fully free. Fill the area around the cervix with dry gauze to prevent vaginal secretions from contaminating the abdominal cavity. Cut the anterior or posterior vaginal fornix close to the cervix until purple-blue or brown mucus flows out. Use two curved vascular forceps to clamp the tissues on both sides of the vagina, including the vaginal artery. Use curved tissue scissors to cut the vaginal wall along the vaginal fornix around the anterior and posterior lips of the cervix until the uterus is completely free and removed.