#. Ms. A, who experienced unusually severe menstrual cramps and abdominal pain unrelated to her period, dismissed the discomfort as stress-induced. However, after noticing a sudden increase in her menstrual flow, she visited an obstetrics and gynecology clinic and was diagnosed with uterine fibroids through an ultrasound examination. She subsequently underwent surgery to remove the fibroids, recovered her health, and was discharged.
The number of patients with uterine fibroids in South Korea is increasing rapidly. According to the Health Insurance Review & Assessment Service (HIRA), the number of patients receiving treatment for uterine fibroids rose from 524,133 in 2020 to 631,113 in 2024, a 20.4% increase over four years.
Uterine fibroids are benign tumors that develop in the muscular layer of the uterus and are a common condition, found in 20% to 40% of women of childbearing age. The challenge is that symptoms vary significantly depending on the location of the tumor, making early detection difficult.
Kim So-jung, head of the Department of Obstetrics and Gynecology at Bundang Jeseng Hospital under Daejin Medical Foundation, explained, "Having uterine fibroids does not necessarily mean symptoms will appear." She added, "Even for fibroids of the same size, if they develop in the submucosal area inside the uterus, heavy menstrual bleeding and pain may be prominent, whereas if they develop in the subserosal area on the outside of the uterus, pelvic pressure symptoms may manifest first."
She further noted, "It is important to comprehensively evaluate factors such as location, symptoms, number, and growth pattern of uterine fibroids, rather than determining the need for treatment based solely on size."
Uterine fibroids are classified into intramural fibroids, submucosal fibroids, and subserosal fibroids depending on their location of occurrence. The most common type is intramural fibroids, which develop within the muscular layer of the uterus. Submucosal fibroids, which protrude into the interior of the uterus, can cause increased menstrual flow or abnormal bleeding even if they are small. In contrast, subserosal fibroids, which grow outward from the uterus, may first present with pelvic pressure or urinary discomfort even when quite large, or they may not cause any specific symptoms at all.
Uterine fibroids are identified through obstetric and gynecological examinations and pelvic ultrasounds to determine the size, location, and number of fibroids. If necessary, a hysteroscopy is performed to directly examine the interior of the uterus, and MRI (magnetic resonance imaging) may be additionally conducted when formulating a surgical plan or when it is necessary to accurately assess the location and extent of the fibroids.
Treatment is determined by comprehensively considering the severity of symptoms, the location, number, and growth rate of the fibroids, as well as the patient's age and pregnancy plans. Head Kim added, "For women of childbearing age who need to preserve their uterus, it is important to jointly decide on uterine preservation and the surgical method by taking into account factors such as the location and number of fibroids."
Head Kim stated, "If there are no symptoms and significant changes in fibroid size, the condition can be monitored through regular ultrasound examinations." She continued, "In cases of heavy menstrual bleeding or pain, drug therapy may be administered. Surgical treatments, such as myomectomy or hysterectomy, are considered when symptoms are severe, fibroids grow rapidly, or there is a possibility that they will affect pregnancy."
Among treatments for uterine fibroids, the da Vinci SP single-port robotic surgery is a minimally invasive technique that utilizes a single incision inside the navel. It allows for precise surgery using robotic joints even in a narrow pelvic space and can reduce the burden of visible scars depending on the patient's condition.
Although the exact cause of uterine fibroids has not been clearly identified, it is known that various factors, including female hormones such as estrogen and progesterone and family history, are involved in their development. They are commonly found in women in their 30s and 40s but can occur at any age. While the size of fibroids may decrease as female hormone levels decline upon entering menopause, not all fibroids necessarily shrink.
Uterine fibroids are frequently discovered incidentally during health check-ups or examinations for other conditions. It is recommended to consult with an obstetrician and gynecologist if you experience any of the following: △ increased menstrual flow or prolonged periods; △ vaginal bleeding outside of your period; △ severe menstrual cramps or pelvic pain; △ a heavy feeling of pressure or bloating in the lower abdomen; △ frequent urination or urinary discomfort; △ constipation; △ discomfort during bowel movements; △ pain during sexual intercourse; or △ symptoms of anemia caused by excessive menstruation.
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