Mainly used in surgical treatment of large uterine fibroids, the symptoms can cause significant secondary anemia, with poor results after conservative treatment.
First, myomectomy (treatment of uterine fibroids)
1. Abdominal myomectomy for 40 years of age, unmarried or fertility, although no growth requirements, but do not want a hysterectomy were asked to retain the uterus. The advantage is to retain the uterus does not affect ovarian function; to have the chance of pregnancy as required by birth; to maintain the integrity of the female endocrine axis. Recurrence rate of 25% to 35%, possibly due to a minor surgery when fibroids are missing, after growing up, patients with fibroids Furthermore, risk factors, occurrence of new fibroids, multiple myoma recurrence rate is higher than solitary fibroids.
2. Vaginal myomectomy for pedunculated generally submucosal fibroids, surgery is simple, safe, no need to cut the uterus.
Second, after abdominal hysterectomy
1. Hysterectomy: requirements for non-reproductive, uterine> 3 months of pregnancy uterine size, fibroids, but symptoms were not large, the bladder or rectum compression symptoms, conservative treatment failure or recurrence after myomectomy, fibroids fast-growing malignant can not be excluded. The advantage is a hysterectomy and cervix removal at the same time, can avoid the future occurrence of cervical stump cancer threat.
2. Subtotal hysterectomy: 40 years of age for voluntary retention of the cervix, patients generally need to win time to rescue critical, serious medical complications can not tolerate a long surgery, severe pelvic adhesion removal of the cervix have difficulty. The advantage is the small bladder and sexual function; simple operation, short time, less surgical injury and complications.
3. Fascial hysterectomy: retained subtotal hysterectomy on bladder and sexual function in the small advantages of eliminating the retention of cervical cancer occurring in the future the threat of cervical stump; reduce the hysterectomy surgical injury and concurrent disease.
Third, endoscopic surgery of uterine fibroids
1. Laparoscopic myomectomy can be done it can also be done in the microscope, hysterectomy, abdominal surgery indication and the same, the advantage of trauma and rapid recovery. However, the high cost of its requirements of high technology, hospitals are not yet popular at the grassroots level.
2. Hysteroscopy for submucous myoma, uterine intramural fibroids the uterine cavity, some sudden, cervical fibroids, the advantage is less invasive, it can keep the uterus, and rapid recovery.
In addition, the pregnancy with the incidence of uterine fibroids fibroids account for 0.5% of patients with 1%, accounting for 0.7% of pregnancy 7.2%, during pregnancy, does not require treatment if asymptomatic, regular inspection, if the occurrence of red degeneration of fibroids, subserosal leiomyoma torsion, can be treated conservatively, if conservative treatment fails, or incarcerated in the pelvic fibroids affect pregnancy to continue, or fibroids compress the adjacent organs, severe symptoms, surgical treatment should be.