I have a subserosal fibroid of 5.1 * 4.9 cm in the anterior wall , at least two intra mural fibroids of 3 cm each, 30 yrs no kids, do i need surgery?

Cavity distorted?: Surgery is indicated if the internal uterine cavity is distorted.

Fibroids: You have a very large fibroid and two moderate ones. Any pelvic pain or abnormal uterine bleeding? Surgical excision is definitely a consideration. Consult your ob/gyn. One of the concerns regarding very large fibroids is a malignancy, leiomyosarcoma.

No symptom No treat: 25-50% women develop benign uterine fibroid (muscle) tumors. If you don't have symptoms (heavy periods, pain) then no intervention is needed. Also infertility doctors may recommend removal if you're unable to conceive after one year. Myomectomy is a major operation and studies show that about 1 in 4 women will have fibroid recurrence with symptoms requiring surgery in the future.

Yes: You will find differing opinions on the matter, but i see many pts where the fibroids have grown larger over the years and will only cuase potential hinderance and not the opposite as you get older. These fibroids can be removed laparoscopically under capable hands and i would recommend having them removed. The pelvis is a confined space to begin with; you may have urinary/bladder issues already.