When should I consider referring a patient with uterine fibroids for surgical intervention?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with uterine fibroids for surgical intervention if fibroids are large, rapidly growing, or symptoms are not responding to drug treatment(s) .

Referral should also be considered if fibroids are confirmed to be 3 cm or more in diameter or suspected submucosal fibroids, which may benefit from hysteroscopy assessment .

Additionally, if there are suspected fertility or obstetric issues associated with fibroids, referral is advised .

In cases of rapid or unexpected fibroid growth after menopause, referral is recommended as this may indicate a serious alternative diagnosis such as leiomyosarcoma .

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