What tests should be done before uterine fibroid surgery?

Before uterine fibroid surgery, it is usually necessary to complete blood routine examination, ultrasound examination, electrocardiogram, coagulation function test, cervical cancer screening and other examination items. These tests can help assess surgical risks, identify the location of fibroids, and rule out other gynecological diseases.

1. Blood routine

Routine blood tests analyze the number of red blood cells, white blood cells, and platelets to determine whether there is anemia or risk of infection. Patients with uterine fibroids may have iron deficiency anemia due to long-term heavy menstruation, and the hemoglobin level needs to be corrected before surgery. Abnormal platelet count may affect intraoperative hemostasis, requiring early intervention.

2. Ultrasound examination

Transvaginal or abdominal ultrasound can clarify the number, size, location and relationship of fibroids to the endometrium, and distinguish submucosal, intramural or subserosal fibroids. Three-dimensional ultrasound can more accurately evaluate the blood supply of fibroids and provide a basis for selecting surgical methods. Under special circumstances, it is necessary to combine magnetic resonance examination to further clarify the nature of the fibroids.

3. Electrocardiogram

Electrocardiogram is used to evaluate cardiac rhythm and myocardial blood supply, and to rule out surgical contraindications such as severe arrhythmia or myocardial ischemia. Patients over 40 years old or with high blood pressure or diabetes may need additional cardiac ultrasound examination. Abnormal electrocardiogram results require consultation with a cardiology department to evaluate surgical tolerance.

4. Coagulation function

Indicators such as prothrombin time and activated partial thromboplastin time can reflect whether the coagulation mechanism is normal. The uterus has a rich blood supply and abnormal coagulation function may increase the risk of intraoperative bleeding. Patients taking anticoagulants for a long time need to adjust their medication regimen in advance and use vitamin K antagonists before surgery if necessary.

5. Cervical cancer screening

TCT combined with HPV testing can rule out cervical intraepithelial neoplasia or malignant tumors. Uterine fibroid surgery may involve cervical manipulation, and if cervical lesions are found before surgery, the scope of surgery needs to be adjusted. This test is even more necessary for postmenopausal patients if they have never had cervical cancer screening.

Antiplatelet drugs such as aspirin need to be stopped 1 week before surgery to avoid menstrual surgery. It is recommended to practice abdominal breathing in advance to relieve postoperative abdominal distension, and prepare loose clothing for easy post-operative wear. During the postoperative recovery period, heavy lifting and strenuous exercise should be avoided, and the perineum should be kept clean. If fever or abnormal bleeding occurs, timely follow-up is required. Eat more high-quality protein and iron-containing foods to promote wound healing, and conduct regular follow-up ultrasounds to observe the recovery.