Diagnosis of Uterine Fibroids
Moderate and large-sized uterine fibroids are often felt by a doctor during a manual pelvic examination. Imaging tests are often done to confirm the presence of uterine fibroids.
An ultrasound probe is inserted into the vagina or over the pelvis on the abdomen, and high-frequency sound waves reflect off the uterus and pelvic structures. The uterus and any uterine fibroids are displayed on a video screen.
Magnetic resonance imaging (pelvic MRI)
An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the uterus and other pelvic structures. Pelvic MRI can confirm the presence of uterine fibroids, if the diagnosis is unclear.
Occasionally, a doctor may be concerned that a mass in the uterus is cancer, not a uterine fibroid. A small piece of tissue (biopsy) taken from the uterus can usually tell a fibroid from cancer. A uterine biopsy may be done through the vagina, or may require surgery.
Dye is injected into the uterus through the vagina and cervix, and X-ray films show an outline of the uterus and fallopian tubes. Hysterosalpingogram is usually done in women with uterine fibroids who are trying to become pregnant.
A water solution is injected into the uterus through the vagina and cervix, and an ultrasound is then done. Sonohysterogram may show uterine fibroids or other growths not visible on a traditional ultrasound.
A tube with a lighted viewer on its tip (endoscope) is advanced into the uterus, and a video screen shows the uterus interior. Hysteroscopy can detect uterine fibroids projecting into the uterus, but cannot see any part of a fibroid in the uterus wall or outside the uterus.
Not all women will need extensive testing for uterine fibroids. In most women, a pelvic exam and ultrasound are sufficient to make the diagnosis of uterine fibroids.
Treatment of Uterine Fibroids
Most uterine fibroids don’t need any treatment, because they don’t cause symptoms or problems. Uterine fibroids causing problems may be treated with non-surgical or surgical options.