Objective To retrospectively study the factors affecting the outcome of perimenopausal patients with uterine fibroids, and to analyze the differences in the quality of life between the surgical treatment group and the non-surgical treatment group, so as to provide the basis for the selection of treatment options for such patients.

Methods 320 female patients who met the criteria with the largest perimenopausal fibroids diameter of 2-5 cm in the Jing'an District Central Hospital and Fudan University Obstetrics and Gynecology Hospital from 2012 to 2021 were randomly selected. All patients completed the questionnaire and were divided into surgical intervention group (n=107) and non-surgical intervention group (n=213) according to the outcome of the last follow-up. Medical history data were entered in the form of questionnaires, and the perimenopausal Greene scale was used to assess the quality of life.

Results The factors affecting the selection of treatment methods for patients with fibroids included age, current address, household registration, body mass index (BMI), degree of dysmenorrhea, mode of delivery, with or without underlying diseases, years of fibroids, number of fibroids, with or without complications, age at menopause, location of fibroids, and size of fibroids. There was no significant difference in the satisfaction rate of psychological symptoms, somatic symptoms and vasoconstrictive symptoms, and the satisfaction rate of sexual life in the non-surgical group was higher than that in the surgical group (P=0.005).

Conclusions The choice of surgical treatment for perimenopausal patients with uterine leiomyomas is affected by a variety of factors.There is no significant difference in the impact of quality of life between the two treatment modalities except sexual satisfaction.The treatment plan should be individualized according to the characteristics of patients' medical history.