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DIAGNOSIS OF FIBROIDS

Diagnosis of fibroids are made in various ways.



By physical examination.

Physical examination and gynecologic bimanual pelvic examination typically can identify the presence of larger uterine fibroids.

By ultrasound.

Ultrasound – Uses sound waves to produce the picture or images. Majority of the sonographic investigations of the female reproductive organs are done via trans vaginal route and is called Trans Vaginal Sonography ( TVS). It is superior to the abdonimal sonogram and requires you to empty your bladder completely immediately before your procedure. It is a painless procedure. It is done with a high frequency transducer that gives a very clear picture of the female’s uterus and ovaries. It does not show any tubal details except when the tubes are diseased with hydrosalpinx ( fluid collections and swollen).



Ultrasound has evolved as the standard tool to evaluate the uterus for fibroids. Sonography will depict the fibroids as focal masses with a heterogeneous texture, which usually cause shadowing of the ultrasound beam. The location can be determined and dimensions of the lesion measured.



By womb X-ray called Hysterosalpingography (HSG)

Womb X-ray is one of the oldest tools available to the doctor for investigating the females for any pathology involving the womb or the fallopian tubes. The presence of fibroids may cause the womb to show some filling defects or varying degrees of distortions of the uterine cavities as shown below.

UTERUS WITH MULTIPLE FILLING DEFECTS DISTORTED UTERUS

DISTORTED ENDOMETRIAL MASS (SHG) SUBMUCOUS FIBROID (HSG)

HSG WITH SUBMUCOUS FIBROID

By Saline Infusion Sonography (SIS)

  • This procedure is to aid the physician in diagnosis and management of uterine conditions affecting fertility and abnormal uterine bleeding. It is a very simple and benign procedure used to evaluate the endometrial cavity for intra-cavitary lesions such as fibroids and polyps. A sonohysterogram involves injecting water or saline solution into the uterus and making ultrasound pictures.

EXTRACTION OF SUBMUCOUS FIBROID

EXTRACTION OF SUBMUCOUS FIBROID

Clinical examination, ultrasonography, hysterosalpingography and saline infusion sonography are inexpensive and relatively non invasive procedures that will diagnose majority of fibroids in low resource economies.

Other more expensive and not readily available procedures in Africa include:

Magnetic resonance imaging (MRI) – Uses magnets and radio waves to produce the picture Magnetic Resonance Imaging (MRI) can be used to define the depiction of the size and location of the fibroids within the uterus.

  • Cat scan (CT) – Takes many X-ray pictures of the body from different angles for a more complete image


You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:

  • Laparoscopy– The involves anesthesia and inserting of a long, thin scope with bright light and a camera. into a tiny incision made in or near the umbilicus. This allows the doctor to view the uterus and other organs on a monitor during the procedure.
  • Hysteroscopy–this is a long, thin scope with a light source that is passed through the vagina and cervix into the uterus. The doctor can look inside the uterus for fibroids and other problems, such as polyps.