Release date: 2010-01-15
Help: Should uterine fibroids be done?
Ms. Zhang, 36, called and said that she had done a pre-pregnancy check in a hospital before she was pregnant. She found a 3cm fibroid in the uterus. The doctor suggested that she should have surgery, otherwise it would affect fertility. She was not willing to be eager, so she went to another hospital for an examination, which was diagnosed as the most common interstitial fibroids, and only 3cm. The doctor suggested that you can get pregnant without treatment.
Ms. Zhang is confused. She has uterine fibroids. Can she be pregnant? Should I have surgery?
She is struggling in pain. After seeing a series of reports on gynecological diseases in this newspaper, she can't wait to call the newspaper's duty call for help.
Confusion: Most fibroids will not affect fertility Experts say that Ms. Zhang does not have to worry, she can be pregnant normally. Normal women, especially women of reproductive age, mostly have different degrees of uterine fibroids. The fibroids are located in the muscle wall, surrounded by muscle layers. Most of the initial onset is interstitial fibroids, accounting for 60%-70%.
For women in the reproductive period, there are no more than 5cm inter-wall fibroids before pregnancy, and there is no discomfort. They can be pregnant without treatment. On the contrary, surgical removal of fibroids, the greater trauma to the uterus, may lead to infertility. During pregnancy, women's estrogen levels increase, fibroids will grow rapidly, and after pregnancy, as the estrogen level decreases, the fibroids will naturally shrink. Therefore, most fibroids do not affect fertility.
Diagnosis: Color Doppler is the only way to confirm the diagnosis Experts say that uterine fibroids are common benign tumors in women of reproductive age, and most of them have no symptoms. Usually, all of them have a fibroid in the gynecological examination.
In the interview, the expert told the reporter that she had met the 29-year-old Ms. Zhao to come to the clinic. The B-ultrasound was diagnosed with a 2.5cm uterine fibroid, and she did not need treatment at all, but she did not know the medicine but did a vagina in a hospital. Mirror, cervical cell shedding, and mycoplasma chlamydia are a series of examinations and treatments such as physiotherapy and enema.
Experts say that color Doppler ultrasound is the only way to diagnose uterine fibroids.
Colposcopy, cervical cell detachment examination is used to check cervical cancer. When there is inflammation, abdominal pain, genital itching, infertility and other symptoms, it is necessary to do the original chlamydia examination. In fact, Ms. Zhao’s examinations and treatments are unnecessary.
Identification: Some life without treatment. Experts say that after uterine fibroids are found, don't be afraid. Some women who are healthy and have not been examined may not know that their uterus has fibroids throughout their lives. These fibroids are also life-free.
However, both uterine fibroids and sarcomas grow between the muscle walls, and care should be taken to distinguish between the two. If the fibroids grow rapidly, resulting in insufficient blood supply, some tissue edema becomes soft, the spiral structure disappears, and replaced with a uniform transparent substance, which is easily confused with sarcoma degeneration.
About 0.4%-0.6% of uterine fibroids can turn into sarcoma, which is common in older patients with larger fibroids and faster growth, especially in elderly women with postmenopausal fibroids that grow rapidly or relapse after menopause. If the fibroids appear malignant, they need to be operated early.
Symptoms: Menstruation is a clear sign of judgment Most patients with uterine fibroids have no symptoms. If symptoms appear, it is related to the location of fibroids, growth rate and the presence or absence of fibroids.
Experts say that the number of menstruation and whether it is a clear sign of female uterine fibroids. Women in the reproductive period, when appearing: 1 month menstrual changes, manifested as increased menstrual flow, prolonged menstruation, irregular vaginal bleeding; 2 increased vaginal discharge, sometimes a large amount of pus and bloody discharge and carrion-like tissue discharge accompanied by odor; 3 bloating, Self-touching felt a mass in the abdomen; 4 pressure sense, frequent urination, difficulty urinating; 5 infertility, multiple abortions, etc. When these five conditions occur, it is necessary to check the treatment promptly.
Under normal circumstances, uterine fibroids in elderly women after menopause will shrink, without any symptoms. All, elderly friends should go to the hospital for a B-ultrasound every three months or six months.
Treatment: Surgery is not the only means Experts say that surgery is not the only means of treating fibroids, 5cm is a watershed that does not require surgery. After the discovery of uterine fibroids, regular review, common wall fibroids less than 5cm in diameter, no need to deal with. If the fibroids are larger than 5cm and have fertility requirements, the gonadotropin-releasing hormone analogue can be used first to make the fibroids smaller, and then to be treated surgically, which will reduce the trauma to the uterus.
Experts say that submucosal fibroids are the smallest and most terrible. It is most prone to infection and often coexists with acute endometritis after abortion or puerperium. Because the tumor is prominent or the surgical trauma often causes the tumor capsule to rupture, it is easy to be infected and rots after rupture, and severe irregular bleeding and fever occur. No matter how small this type of fibroid is, it should be treated as soon as possible.
Experts pointed out that women who are entering the menopause regularly review the malignant transformation of the fibroids and determine that the condition is no longer developed. They can be treated with drugs first, so that they can enter the menopause in advance. If the postmenopausal fibroids not only do not shrink, but grow up and bleed, they must be treated surgically. Meditech Medical Network
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