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| Version | User | Scope of changes |
|---|---|---|
| May 25 2007, 1:59 PM EDT (current) | maboulette | 3 words deleted |
| May 25 2007, 1:54 PM EDT | maboulette | 3 words added |
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Diagnosis of FibroidsDiagnosis of Fibroids
Fibroids may be felt during a pelvic exam, but many times myomas that are causing symptoms may be missed if the examiner relies just on the examination. Also, other conditions such as adenomyosis or ovarian cysts may be mistaken for fibroids. For this reason, I routinely do an ultrasound examination at the time of the first visit when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination. Vaginal probe ultrasound only takes a few minutes to do, is not uncomfortable, and rapidly provides invaluable information if the examiner is experienced in looking at uterine abnormalities. It is possible to fill the uterus with a liquid during the ultrasound (saline enhanced sonography or sonohysterogrami). While this will often provide additional information to the regular ultrasound, I usually learn much more by looking inside the uterus with a little telescope. This exam, called hysteroscopy, is usually a quick office procedure, that allows directly looking inside the uterus.
One of the most common conditions confused with fibroids is adenomyosis. In adenomyosis the lining of the uterus infiltrates the wall of the uterus, causing the wall to thicken and the uterus to enlarge. On ultrasound examination this will often appear as diffuse thickening of the wall, while fibroids are seen as round areas with a discrete border. Adenomyosis is usually a diffuse process, and rarely can be removed without taking out the uterus. Since fibroids can be removed or treated by uterine artery embolization, it is important to differentiate between the two conditions before planning treatment. It is also common to have some adenomyosis in addition to fibroids.
MRI scans also provide an excellent picture of the uterus. An MRI provides detailed pictures of the uterus and fibroids, and can off tell the difference between adenomyosis and fibroids.
Please see the large collection of articles from Dr. Paul Indman, "The Basics of Gynecology - What Every Woman Should Know". Dr. Indman has generously included many informative articles about fibroids and treatment options.
Fibroids may be felt during a pelvic exam, but many times myomas that are causing symptoms may be missed if the examiner relies just on the examination. Also, other conditions such as adenomyosis or ovarian cysts may be mistaken for fibroids. For this reason, I routinely do an ultrasound examination at the time of the first visit when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination. Vaginal probe ultrasound only takes a few minutes to do, is not uncomfortable, and rapidly provides invaluable information if the examiner is experienced in looking at uterine abnormalities. It is possible to fill the uterus with a liquid during the ultrasound (saline enhanced sonography or sonohysterogrami). While this will often provide additional information to the regular ultrasound, I usually learn much more by looking inside the uterus with a little telescope. This exam, called hysteroscopy, is usually a quick office procedure, that allows directly looking inside the uterus.
One of the most common conditions confused with fibroids is adenomyosis. In adenomyosis the lining of the uterus infiltrates the wall of the uterus, causing the wall to thicken and the uterus to enlarge. On ultrasound examination this will often appear as diffuse thickening of the wall, while fibroids are seen as round areas with a discrete border. Adenomyosis is usually a diffuse process, and rarely can be removed without taking out the uterus. Since fibroids can be removed or treated by uterine artery embolization, it is important to differentiate between the two conditions before planning treatment. It is also common to have some adenomyosis in addition to fibroids.
MRI scans also provide an excellent picture of the uterus. An MRI provides detailed pictures of the uterus and fibroids, and can off tell the difference between adenomyosis and fibroids.
Please see the large collection of articles from Dr. Paul Indman, "The Basics of Gynecology - What Every Woman Should Know". Dr. Indman has generously included many informative articles about fibroids and treatment options.
