Office gynecology: fibroids-when not to operate

The mere presence of uterine fibroids is not, since qua non, an indication for their surgical removal. Knowing when not to operate is probably more important for the physician than knowing when to operate. It is easy to fall into diagnostic and therapeutic traps when uterine fibroids are known to be present, especially when they occur concomitantly with a condition such as irregular uterine bleeding, infertility, or pregnancy. The contributions of such conditions to problems in diagnosing and managing fibroids must be kept in mind by the prudent physician; a decision in favor of medical rather than surgical management is often best.