Patient's question:
Expert: Hello!Currently, I have undergone both abdominal ultrasound and transvaginal ultrasound. The ultrasound findings are as follows:
The uterus is approximately 56MM62MM78MM in size, anteriorly positioned, with an enlarged uterus volume and abnormal shape. The left lateral wall of the uterus is convex. The anterior and posterior walls of the lower segment show round, solid, low-echo masses, approximately 46MM46MM42MM and 31MM32MM28MM, respectively. The boundaries are relatively clear, with visible pseudocapsular echoes. The internal echo distribution is uneven. The endometrial line is shifted posteriorly, and the endometrium is thickened, measuring about 11MM, and is clear.
The transvaginal ultrasound findings are as follows: The uterine body measures 605865MM, and the endometrium
Doctor's answer:
(1) Myomectomy: A surgical procedure to remove uterine fibroids while preserving the uterus. It is primarily used for young women under 40 who wish to retain their fertility. It is suitable for cases where fibroids are large; cause heavy menstrual bleeding; present with pressure symptoms; lead to infertility due to fibroids; involve submucosal fibroids; or grow rapidly but show no signs of malignancy.(2) Hysterectomy: For patients with significant symptoms, fibroids with a potential for malignancy, or those who do not desire future fertility, a hysterectomy is recommended. The procedure can be either a total or subtotal hysterectomy. For older patients, a total hysterectomy is generally preferred. Preoperative evaluation must exclude the possibility of cervical malignancy.
(3) Uterine Artery Embolization (UAE): A radiologic interventional technique where catheters are inserted directly into the uterine arteries, and permanent embolic particles are injected to block blood supply to the fibroids, causing them to shrink or even disappear. Currently, UAE is mainly used for symptomatic fibroids that cause abnormal bleeding, leading to anemia. When selecting interventional treatment for uterine fibroids, caution is advised. Patients with uncontrolled pelvic inflammation, those who wish to preserve fertility, atherosclerosis patients, or those with contraindications to angiography should be considered ineligible for this treatment. Postoperative risks include a 5% chance of premature ovarian failure and rare reports of pelvic infection.