What to do if there are fibroids on the front wall of the uterus

Fibroids on the anterior wall of the uterus can be treated through regular review, drug control, interventional therapy, laparoscopic surgery, laparotomy and other methods. Uterine fibroids are often caused by abnormal hormone levels, genetic factors, stem cell mutations, and other causes.

1. Regular review

When fibroids are less than 3 cm in diameter and asymptomatic, it is recommended to have a follow-up ultrasound every 6-12 months. Monitoring focuses include the growth rate of fibroids, changes in blood flow signals, and whether they compress the bladder and rectum. Avoid taking estrogen-containing health products on a daily basis and reduce your intake of soy products.

2. Drug control

It is suitable for patients with heavy menstrual flow or obvious dysmenorrhea. Gonadotropin-releasing hormone analogs such as leuprolide injections can shrink fibroids, but should not be used for more than 6 months. Tranexamic acid tablets can reduce bleeding, and mifepristone tablets can inhibit the growth of fibroids. Drug treatment needs to be combined with routine blood monitoring to monitor anemia.

3. Interventional treatment

Uterine artery embolization blocks the blood supply to fibroids and causes them to become necrotic. It is suitable for women of childbearing age who want to preserve their uterus. Post-embolization syndrome such as lower abdominal pain and fever may occur after surgery, which usually resolves in 3-7 days. This treatment may lead to reduced ovarian function, so women over 45 years old should choose carefully.

4. Laparoscopic surgery

It is suitable for intramural fibroids with a diameter of 5-10 cm. During the operation, a rotator is used to remove them in pieces. Compared with open surgery, laparoscopic myomectomy has the advantages of less trauma and faster recovery, but there is a possibility of intraoperative bleeding and conversion to open surgery. Contraception is required for 12-18 months after surgery until the myometrium is healed.

5. Laparotomy

For giant fibroids or multiple fibroids, laparotomy can remove the lesions more completely. Traditional surgery can simultaneously treat combined pelvic adhesions or endometriosis. Prophylactic antibiotics need to be used after surgery, and the recovery of intestinal function must be closely observed. Re-pregnancies with scarred uterus are at risk of uterine rupture.

Patients with uterine fibroids should maintain a balanced diet and take appropriate amounts of animal liver and other iron-containing foods to prevent anemia. Regular aerobic exercise such as brisk walking and swimming can help regulate endocrine, but avoid cycling and other exercises that compress the abdomen. Record the changes in menstrual cycle and menstrual volume every month. If you experience compression symptoms such as frequent urination and constipation or the hemoglobin during menstruation is lower than 80g/L, you need to seek medical treatment in time. Postmenopausal fibroids that do not shrink but increase in size should rule out the possibility of malignant transformation.