"At what size does a uterine fibroid require surgical removal?"

Surgical Indications for Uterine Fibroids

Uterine fibroids, one of the common benign tumors among women, often do not require surgical removal in most cases. However, surgical intervention becomes necessary when the fibroid diameter exceeds 5 cm, the uterus enlarges beyond the size of a two-and-a-half-month pregnancy, fibroids grow rapidly, symptoms are pronounced, or infertility or recurrent miscarriages occur.

1. Fibroid Diameter Exceeding 5 cm

When the diameter of a single fibroid reaches or exceeds 5 cm, it is considered an indication for surgery. This is because larger fibroids can compress surrounding organs, causing related symptoms and increasing the risk of malignancy.

2. Uterine Size Exceeding Two-and-a-Half-Month Pregnancy

When the overall size of the uterus exceeds that of a two-and-a-half-month pregnancy, it also meets the criteria for surgery. In such cases, fibroids may have significantly impacted the uterus's structure and function.

3. Rapid Growth of Fibroids

If fibroids rapidly increase in size within a short period (e.g., within half a year), especially doubling in size, it may suggest malignancy, necessitating early surgery.

4. Pronounced Symptoms

When uterine fibroids cause significant symptoms, such as excessive menstrual bleeding leading to severe anemia, severe menstrual cramps unresponsive to medication, dyspareunia, or chronic pelvic pain, and these symptoms interfere with patients' daily work and life, surgical treatment should be considered.

5. Infertility or Recurrent Miscarriages

When uterine fibroids lead to infertility, recurrent miscarriages, or premature births, and the patient desires to conceive, surgical removal of the fibroids can be considered to preserve the uterus and increase the patient's chances of fertility.

The criteria for surgical removal of uterine fibroids are multifaceted, taking into account both the size of the fibroids and their growth rate and symptoms. In deciding whether to proceed with surgery, a comprehensive assessment of the specific situation is required.