Most often, a woman is diagnosed with fibroids after seeking treatment for symptoms such as pelvic pain and heavy bleeding.
There are several types of tests that can be used to diagnose fibroids. These include transvaginal ultrasound, magnetic resonance imaging, and hysteroscopy.
Transvaginal or pelvic ultrasound: Ultrasound is usually the first diagnostic test a woman will undergo for diagnosis, because it's the fastest and least invasive way to diagnose fibroids. However, a transvaginal ultrasound may not always provide enough information for a diagnosis. In these cases MRI or hysteroscopy is another diagnostic option.
Hysteroscopy is the most invasive of the common diagnostic procedures, and is used when ultrasound isn't enough to provide a diagnosis, or when more information is needed about the size and location of fibroids. In this laparoscopic procedure a camera is inserted into the uterus via the vagina and cervix. This allows a gynaecologist to examine the inside of the uterus.
Magnetic resonance imaging (MRI): This diagnostic procedure is usually carried out as a way of “mapping” the location of fibroids in preparation for surgery to remove them.
Treatments for Fibroids
The best treatment for fibroids depends on several factors, including the size and the location of the tumours. And, because some treatments remove a woman's ability to become pregnant and bear children, it's also important that her age and desire for children be taken into account.
Most of these treatments are unable to prevent new fibroids from growing, and in some cases, the fibroids that were removed have a small risk of regrowing. Only hysterectomy can completely eliminate the chance that fibroids will regrow.
Medical Therapy: This term describes fibroid treatments such as hormone therapy and other non-surgical treatments. These treatments are not always effective, however, and some have undesirable side effects, such as menopause-like symptoms.
Myomectomy: This is the surgical removal of tumours. It can be carried out via endoscopy, or via abdominal surgery. This is often the best option for women who want to have children; however, the success of the procedure depends on the number and size of fibroids present, and fibroids can recur after several years.
Uterine artery embolisation: In this procedure, the arteries that provide the fibroids with a blood supply are blocked at the points where they feed the fibroids. This cuts off the supply of blood to the tumours, causing them to shrink. This is a minimally-invasive procedure with a low risk of complications, but requires a hospital stay of up to 36 hours. This procedure can be painful, and doesn't prevent fibroids from regrowing.
Myolysis: Fibroid tumours are destroyed within the uterus, using laser, heat, or cryotherapy, which involves freezing. Myolysis is a relatively simple procedure, minimally invasive, and generally with a fast recovery time. However, this treatment doesn't guarantee that tumours will not regrow.
Hysterectomy: As a hysterectomy involves the complete surgical removal of the uterus, this is the only fibroid treatment that conclusively guarantees that no more fibroids will grow. However, as this treatment also prevents a woman from having children, it's not ideal for everyone. A hysterectomy can be carried out laparoscopically, transvaginally, or via abdominal surgery. The laparoscopic option is less invasive and carries fewer risks than the other options.