Fibroid Basics: Diagnosis

Fibroids are usually diagnosed on internal pelvic examination by finding an enlarged or irregularly shaped uterus. Once fibroids are suspected it is advisable to confirm the diagnosis with some type of imaging study. Ultrasonography, either externally through a fluid distended bladder, or internally by a vaginally inserted probe, is usually the first imaging test. MRI is a very useful study to confirm the diagnosis of fibroids, exclude fibroid mimics such as adenomyosis, or ovarian masses.

In women with abnormal uterine bleeding assessment of the uterine cavity is important because a submucous fibroid can be missed on traditional ultrasound. Hysterosonography involves passing a small tube through the cervix and injecting fluid into the uterine cavity to serve as a contrast agent during trans-vaginal ultrasonography. Hysteroscopy is an office-based procedure, performed by a gynecologist, where a small, lighted scope is inserted through the cervix and allows direct visualization of the uterine lining. This can be used to direct biopsy when necessary.

Laparoscopy requires general anesthesia and allows visualization of the outer surface of the uterus and surrounding pelvic structures by passing a lighted scope (laparoscope) into the abdominal cavity. This procedure is more commonly performed in the evaluation of pelvic pain and is very useful in diagnosing endometriosis.

Basics | Symptoms | Diagnosis | Treatment

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