Uterine fibroids are often discovered by accident during a routine pelvic exam. Your doctor may feel irregularities in your uterus and suspect the presence of fibroids. If you have symptoms of fibroids, your doctor may suggest these steps:
Ultrasound. There are two common probes used for this exam:
Transvaginal: A gel containing condom is placed over the thin probe. Gel is placed on the end of the condom and scanning is performed inside the patient’s vagina.
Transabdominal: A small amount of gel is placed on the end of the probe and scanning occurs across the skin of her lower abdomen and pelvic regions.
MRI. Some patients wonder why they need to undergo a pelvic MRI when they have had a pelvic ultrasound showing fibroids. While ultrasound can diagnose fibroids, it significantly underestimates the number of fibroids due to a much lower resolution than MRI. Occasionally, patients with adenomyosis will be misdiagnosed on ultrasound as having fibroids.
Lab tests. If you have heavy menstrual bleeding, your doctor may recommend other tests to fully understand your condition. Lab tests might include a complete blood count (CBC) to determine if you have anemia because of blood loss and other blood tests to rule out other conditions.
Hysterosonography. Also called a saline infusion sonogram, this test uses sterile saline to expand the uterine cavity, making it easier to get images of submucosal fibroids and the endometrium.
Hysterosalpingography. This test uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. Your doctor may suggest it when infertility is a concern. It can help your doctor determine if your fallopian tubes are open.
Hysteroscopy. For this test, your doctor inserts a small telescope called a hysteroscope through your cervix into your uterus. Then, saline is injected into your uterus to allow your doctor to examine the walls of your uterus and the openings of fallopian tubes.
If you suspect that you may have uterine fibroids or are not satisfied with diagnostic options offered by your doctor, you should ask an experienced interventional radiologist like Dr. John Lipman for a second opinion.