Uterine fibroid surgery methods

The main surgical methods for uterine fibroids include myomectomy, hysterectomy, uterine artery embolization, focused ultrasound ablation, hysteroscopic resection of uterine fibroids, etc. Uterine fibroids are common benign tumors in the female reproductive system. The surgical method needs to be selected based on factors such as the patient's age, fertility needs, fibroid size and location.

1. Uterine myomectomy

Myomectomy is suitable for young patients who want to have children. Through open or laparoscopic surgery, the fibroids are completely separated from the myometrium and the uterine structure is preserved. This surgery may increase the risk of intraoperative bleeding due to the deep location or excessive number of fibroids, and pelvic adhesions may occur postoperatively. Common indications are single fibroids or subserosal fibroids, which require regular postoperative review to prevent recurrence.

2. Hysterectomy

Hysterectomy is suitable for patients who have no need for childbearing, whose fibroids are too large, or who are suspected of malignant transformation. It is divided into two types: total hysterectomy and subtotal hysterectomy. Surgery can be done open, vaginally or laparoscopically and can completely resolve the problem of fibroid recurrence, but can result in permanent loss of fertility. Complications such as early menopause and pelvic floor dysfunction may occur after surgery.

3. Uterine artery embolization

Uterine artery embolization is an interventional treatment that blocks the blood supply of fibroids to cause ischemic necrosis and shrinkage. This method has less trauma and faster recovery, and is suitable for patients who cannot tolerate surgery. However, it may cause severe abdominal pain, infection and other adverse reactions. After treatment, the volume of fibroids is usually reduced by 40-60%, and the effect on pedunculated submucosal fibroids is poor.

4. Focused ultrasound ablation surgery

Focused ultrasound ablation uses ultrasound waves to precisely heat and ablate fibroid tissue without the need for incision and preserves the integrity of the uterus. The treatment is suitable for intramural fibroids less than 10 cm in diameter. Side effects such as skin burns and sacrococcygeal pain may occur. The volume of fibroids can be reduced by 30-50% 3-6 months after surgery, but there is a risk of incomplete ablation requiring secondary treatment.

5. Hysteroscopic electroresection of uterine fibroids

Hysteroscopic uterine fibroid resection is suitable for submucosal fibroids protruding into the uterine cavity. The fibroids are removed through the natural cavity to avoid uterine damage. The operation time is short and recovery is quick, but it may be complicated by uterine perforation or water intoxication. Postoperative drug treatment is required to prevent intrauterine adhesions. It is not suitable for patients with intramural fibroids whose depth exceeds 50%.

After uterine fibroids surgery, the perineum should be kept clean and heavy physical labor and bathing should be avoided for 1-2 months. The diet needs to increase the intake of high-quality protein and iron, such as lean meat, animal liver, spinach, etc., to promote wound repair. Perform regular pelvic ultrasound review and seek medical attention promptly if abnormal vaginal bleeding or fever is found. Premenopausal patients still need to monitor hormone levels after surgery to prevent the growth of residual small fibroids.