What department should I visit for uterine fibroids?

Written by Sun Shan Shan
Obstetrics and Gynecology
Updated on September 19, 2024
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Uterine fibroids are a common gynecological condition. Once uterine fibroids occur, it is necessary to register for a gynecological examination. Further gynecological ultrasound examinations are required to determine the location of the uterine fibroids. There are several types of uterine fibroids, including subserosal, intramural, and submucosal fibroids. In particular, if submucosal fibroids are present, regardless of their size, timely surgery is needed due to the high risk of severe bleeding and anemia they pose. If the submucosal fibroid is small, hysteroscopic submucosal fibroid electrosurgery can be performed. If the fibroid is large, an open surgery may be necessary. Additionally, in the case of intramural and subserosal uterine fibroids, if the fibroid continues to grow larger than five centimeters, there is also a potential risk of malignancy, thus timely surgical treatment is recommended.

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Does uterine fibroids cause high CRP?

Normal uterine fibroids do not cause an increase in CRP. CRP is an indicator of systemic inflammatory response. Only when a patient experiences infection, rupture, or acute systemic inflammatory reactions will it cause a rise in tumor markers. Uterine fibroids often do not exhibit these symptoms; therefore, most cases will not show an increase in CRP. However, in some patients, infection or rupture, and even malignancy, can lead to an increase in these indicators. Patients should undergo relevant imaging studies to assess the size and location of the uterine fibroids, as well as the presence of uterine bleeding.

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How to treat uterine fibroids?

Uterine fibroids are the most common benign tumors of the female reproductive organs, consisting of smooth muscle and connective tissue, mostly seen in women aged 30-50. Uterine fibroids can be classified into fibroids of the uterine body and cervical fibroids. Depending on their location, the treatments differ. Fibroids of the uterine body are further divided into intramural fibroids, subserosal fibroids, and submucosal fibroids. In cases of submucosal fibroids, prompt symptomatic treatment is necessary once detected, as these fibroids grow towards the uterine cavity and protrude into it, covered only by the endometrium on the surface. Hence, timely surgical intervention and regular physical examinations are crucial for submucosal fibroids.

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What are the symptoms of uterine fibroids?

If the uterine fibroids are relatively small, they generally do not show symptoms. However, submucosal uterine fibroids, regardless of their size, can cause heavy menstrual bleeding and prolonged periods. Intramural uterine fibroids, if protruding into the uterine cavity, can also lead to heavy menstrual bleeding and prolonged periods. If the uterine fibroids are large and press against the bladder in front, symptoms such as frequent urination and urinary urgency can occur. If they press against the rectum in the back, it can lead to difficulty in defecation or a feeling of downward pain. Therefore, if symptoms are present with uterine fibroids, surgical treatment is necessary.

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How can uterine fibroids be reduced?

Uterine fibroids in women are closely related to the levels of estrogen in the body. Some women have relatively small uterine fibroids with no clinical symptoms and can be observed dynamically. Generally, after menopause, when the levels of estrogen decrease, the size of uterine fibroids in these women can naturally shrink. Additionally, certain medications can be used for treatment, such as drugs from the GnRH-a class, which act by causing ovarian ablation. This leads to a decrease in estrogen levels in the body and can also reduce the size of the uterine fibroids. Interventional treatments can also be employed to block the blood supply to the uterine fibroids, reducing their blood supply and consequently decreasing their size.

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How big a uterine fibroid can be without requiring treatment?

The size of uterine fibroids is one of the indicators we consider for whether treatment and surgery are necessary. It is generally believed that surgery is indicated when the diameter of a fibroid exceeds 6cm, or when the entire uterus is larger than the size it would be at ten weeks of pregnancy. However, in reality, the size of a uterine fibroid is not an absolute indicator for surgery. This means that even if the fibroid exceeds 6cm, or the entire uterus reaches around ten weeks in size, it doesn’t necessarily require surgery. At this point, other factors are usually also considered, such as whether there are symptoms, whether the large fibroids cause heavy menstruation and anemia, whether there are compression symptoms, the radiological appearance of the fibroids, whether they resemble malignant conditions, whether the fibroids are rapidly growing, and whether the fibroids are located in special areas like the cervix, the hip ligament, or submucosal. Thus, the size of the uterine fibroids is just one aspect we consider for treatment or surgery; the presence of symptoms and whether the fibroids are malignant, among others, are actually more important.