Understanding Uterine Fibroids and the Need for Careful Preoperative Planning
Uterine fibroids are non-cancerous growths in the womb that can cause heavy menstrual bleeding, pain, and fertility issues. For many women, surgery becomes a necessary treatment option when symptoms are severe or fibroids impair quality of life. Across regions with high prevalence, including parts of Africa, the focus on preoperative care is critical to minimize complications and ensure safer procedures.
Why Preoperative Care Matters
Preoperative care prepares the patient physically and emotionally for surgery. For uterine fibroids, this includes medical optimization, anemia management, imaging to map fibroid location, and a clear discussion of risks and expected recovery. Proper preparation helps reduce blood loss, infection risk, and anesthesia-related complications, which are particularly important in settings with limited resources.
Medical Optimization
Health assessments before surgery identify conditions that could raise risk, such as high blood pressure, diabetes, or obesity. Correcting anemia, common in fibroid patients due to heavy bleeding, is a key step. If anemia is present, iron therapy or transfusion planning may be necessary to reduce perioperative complications.
Imaging and Surgical Planning
Accurate imaging—often ultrasound or MRI—helps surgeons plan the approach, size, and number of fibroids. Clear mapping guides decisions about myomectomy versus hysterectomy and informs anesthesia teams about potential airway or bleeding risks. In resource-limited settings, clear imaging protocols and timely reporting are essential for safe operations.
Anaesthesia and Medication Review
A thorough review of current medications, allergies, and prior anesthesia experiences informs anesthesia planning. Some medications affect bleeding risk or interact with anesthetic agents. Patients may be advised to pause certain drugs and adjust dosing under supervision before surgery.
Infection Prevention and Nutrition
Basic infection prevention, including skin cleansing protocols and appropriate antibiotic stewardship, lowers postoperative infection risk. Nutritional status supports healing; a balanced diet, adequate hydration, and, where needed, vitamin supplementation can improve recovery outcomes.
Evidence From High-Prevalence Regions
In areas with high uterine fibroid prevalence, studies emphasize that structured preoperative pathways reduce complication rates and shorten hospital stays. Healthcare systems that integrate patient education, anemia management, imaging, and standardized anesthesia planning tend to report better surgical outcomes and faster return to daily life.
What Women Should Expect During Preoperative Care
Patients should receive clear instructions about laboratory tests, medication management, and fasting requirements before surgery. A preoperative consultation is an opportunity to ask questions about the procedure, recovery timeline, potential risks, and the level of postoperative support at home. Shared decision-making helps patients feel informed and empowered.
Moving Forward: Strengthening Preoperative Protocols
Strengthening preoperative care for uterine fibroids involves training healthcare staff, improving access to imaging, and ensuring supply chains for essential medications. Community health education also plays a role, helping women recognize symptoms early and seek timely medical advice. When implemented well, preoperative care is a simple yet powerful strategy to reduce complications and improve surgical outcomes worldwide, including in Nigeria and other African nations where fibroid burden is high.
