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Physical Exam

Uterine fibroids are usually discovered during a routine pelvic examination. During the examination, the doctor is able to feel an enlarged uterus or a pelvic mass. If a doctor thinks that fibroids are present and the uterus has grown to at least the size of a 12-week pregnancy, s/he will sometimes immediately recommend a hysterectomy. Without any further tests.

Here's one, very emphatic piece of sisterly advice: INSIST ON FURTHER TESTS! Do not, let me repeat, do NOT go from a simple physical examination directly to the surgical suite for a hysterectomy. In at least one major hospital review of hysterectomies where the uterus was removed purely because of the hospital admitting diagnosis of uterine fibroids, up to 9% of the uteri were completely normal. No fibroids. No disease whatsoever. 9%. Apparently, the diagnosis of uterine fibroids by manual examination of the uterus is not without its problems.

To confirm the diagnosis of uterine fibroids, your doctor should request some form of imaging examination. A transvaginal ultrasound, magnetic resonance imaging (MRI), hysterosonogram, hysteroscopy, or laparoscopy is usually scheduled. Imaging tests can tell your doctor approximately how big your uterus is, how many fibroids you have, their size and their location. In addition, endometrial polyps or hyperplasia (an abnormal development of cells) can be visualized as well as ovarian cysts, masses, and endometriosis. Sometimes imaging can also reveal specific characteristics of fibroids such as whether or not they are degenerating or dying. With an MRI, the presence of adenomyosis (endometrial tissue invasion of the myometrium) can also be determined.

Link
Site Name/Author
What You'll Find
www.ahcpr.gov/consumer
/uterine1.htm#sec2
Agency for Health Care Policy and Research Finding Out About The Problem: Medical History and Physical Exam
www.gyn101.com/indexE.htm Pfizer Inc. The Exam: Simply written yet detailed explanation of full pelvic exam including: external genital exam; speculum exam; bimanual exam; and a rectovaginal exam.
content.health.msn.com/
content/dmk/dmk_article_5963003
M. Sara Rosenthal
The Gynecological Sourcebook
Excerpt: Diagnosing and Treating Fibroids
www.plannedparenthood.org/
WOMENSHEALTH/
gynexam.htm
Planned Parenthood The Gynecological Exam: Your Key to Good Health. Terrific information on what to expect with gynecological exam.
www.onna.org/information
/invasive.html#emb
The ONNA Community WWW.ONNA.ORG is an online community of people who want to have children, and who are finding it more difficult than they originally expected. This link takes you to an explanation of the endometrial biopsy as well as patient stories from undergoing this and other diagnostic tests.
www.ascp.org/general/
pub_resources/papsmear/
American Society of Clinical Pathologists Understanding Your Pap Smear
www.cap.org/html/public/pap.html College of American Pathologists What is a Pap examination?
www.ascp.org/general/
pub_resources/labtest/
American Society of Clinical Pathologists
Joyce McCreary
I Had a Lab Test. Children's story explaining lab testing in simple format. Available in book form but this online version made it easy for me to explain to my 7-year-old some of what lab testing is all about.
www.ascp.org/general/
pub_resources/pathologist.asp
American Society of Clinical Pathologists Explanation of what a pathologist is and does and the role he/she plays in laboratory testing.

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This page last updated Wednesday, April 10, 2002