What size uterine fibroids should be removed?

This is an automatically translated article.

The article was professionally consulted with Doctor Nguyen Thi Man - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Danang International General Hospital.
How is uterine cancer treated? Should uterine fibroids be operated on? These are questions of many people, especially women of childbearing age who unfortunately have the disease. To answer these questions, first of all, you need to know the basic knowledge about the disease as well as how to treat this disease.

1. What are uterine fibroids?

Uterine fibroids are a common gynecological disease of all ages, especially women in the period of childbearing, pregnancy or menopause. This is an abnormal growth of milia growths from the muscle of the uterus. Depending on the location of fibroids can be divided into:
Subserosal. In the uterus. Under the mucosa. It may be in the cervix or in the broad ligament.

2. Manifestations of uterine fibroids

Fibroids are often asymptomatic or can be severe. Patients often come to the doctor because of menstrual disorders, infertility, delayed pregnancy or abnormal vaginal bleeding: Menorrhagia, long-term hypermenorrhoea causing anemia. The patient has a feeling of heaviness in the abdomen, abdominal pain, pain in the lower abdomen or pelvis. If the tumor is large, it can press on nearby organs, on the bladder causing frequent urination, sometimes causing urinary retention, on the rectum causing constipation or pain during defecation. Up the intestines, the stomach can lead to digestive disorders.

3. How to treat uterine fibroids?

3.1. Treatment goals

Alleviate symptoms: abnormal bleeding, pain, symptoms caused by tumor pressing on adjacent organs,... Reduce the size of fibroids. Treatment of uterine fibroids can be by means of monitoring, medical treatment or surgery, the choice of intervention method depends on the individual patient's condition based on the following factors:
Size, location Tumor location: If the tumor is small, it has not caused symptoms such as menorrhagia, heavy bleeding, then follow up with periodic examination or medical treatment. If the tumor is large and accompanied by the above symptoms, it is necessary to conduct surgery, depending on the patient's condition, to decide whether to preserve or remove the uterus. Accompanying symptoms (menorrhagia, bleeding, compression, pain, infertility). Menopause status. Expectations and capabilities of the patient (cost, convenience, desire to preserve the uterus, side effects).

3.2. What size uterine fibroids should be removed?

Case 1: The tumor is less than 50mm in size and has no typical symptoms of uterine fibroids. Women can have a normal pregnancy. However, pregnant women need to be closely monitored during pregnancy. After childbirth, the following tumor can be treated.
In some cases, due to hormonal changes, the body also changes from the inside a lot after going through pregnancy and childbirth. The tumor may shrink after birth for a while, making it easier to remove.
Case 2: The tumor is over 50mm or less than 50mm but there are symptoms and complications of uterine fibroids At this time, it is necessary to remove the tumor before pregnancy.
Patients can have a normal pregnancy after 1 year from the date of cesarean section. You should not get pregnant too early to avoid post-surgery, the uterus will not recover, which will increase the risk of miscarriage.
The purpose of hysterectomy or total hysterectomy depends on the condition of the tumor and patient's wishes.
Removal of fibroids in young women who have not had children, this case is still may recur and may require reoperation. Partial hysterectomy (depending on the case).
Total hysterectomy is usually in older women, the patient has been thoroughly consulted and agreed before surgery.
With the development of modern medicine, there are many methods applied in uterine fibroid surgery such as: open surgery, conventional laparoscopic surgery and robotic laparoscopic surgery. In which, Robotic surgery is considered as the superior method in surgery for uterine fibroids.
Vinmec International General Hospital is the first hospital to deploy ROBOT SURGERY in gynecological treatment. The robot equipped at Vinmec Times City Robotic Surgery Center is Da Vinci made in the US. This is an advanced robot, sophisticated and modern structure, with 4 arms that almost perfectly simulate human hand movements, meeting the needs of surgery with the highest requirements. Robotic fibroid surgery has many outstanding advantages compared to conventional laparoscopic and open surgery:
No vision restriction, optimal image quality with high accuracy. Can penetrate narrow, deep, difficult-to-reach places compared to conventional surgery. Safe, minimize complications due to infection. Less pain for the patient, less blood loss, shorter recovery time. Ensure aesthetics due to very small surgical scars.

Not only have modern machinery systems, a team of highly qualified and experienced doctors, when choosing to treat uterine fibroids at Vinmec, patients also receive post-operative care with many outstanding advantages:
Doctors care 24/24, continuously monitor at least 3 days after surgery. A team of anesthesiologists, physiotherapists, and nutritionists are always there to ensure that patients can recover as soon as possible. Modern monitoring equipment (heart rate monitor, blood pressure monitor, pulse measurement) in 24/24. Dedicated nursing care and professionally trained to serve postoperative cases.

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