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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In women who presents with symptoms suggestive of fibroids:

  • evaluate gynaecological history including any cervical screening
  • carry out a pelvic examination to detect any masses
  • check haemoglobin
  • mid stream urine test – in the presence of urinary symptoms to exclude urinary infection (1)

Imaging techniques available for confirming the diagnosis include:

  • ultrasound scanning - carried out initially after an abdominal and pelvic examination.
    • transvaginal ultrasound scan (TVS) is more reliable than abdominal ultrasound
    • helps in
      • identifying size and location of fibroids and whether single or multiple
      • excluding hydronephrosis
      • distortion of the uterine cavity due to a submucous firoid
      • monitor the size of a single fibroid
    • saline infusion sonohysterography based imaging is useful in identifying submucous fibroids
  • MRI
    • although more costly, is the most sensitive investigation to evaluate fibroids
    • useful in identifying the exact location, characteristics, number of fibroids and associated relationship with the nearby viscera
  • hysteroscopy
    • carried out in a dedicated outpatient setting (1,2)

Reference:

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