Urology treats urinary tract diseases in all genders and male reproductive issues, covering the kidneys, bladder, prostate, urethra, from infections to complex cancers.
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At Liv Hospital, we diagnose uterine fibroids by taking a detailed medical history, doing a physical exam, and using advanced imaging. We aim to not only find fibroids but also to map out their size, number, location (using the FIGO system), and blood supply. This detailed mapping helps us choose the best treatment, especially if preserving fertility is important.
Physical Examination
Hysteroscopy: This is a diagnostic (and potentially therapeutic) procedure where a thin telescope (hysteroscope) is inserted through the cervix into the uterus. It allows for direct visual inspection of the endometrial cavity. It is the gold standard for diagnosing submucosal fibroids and assessing the feasibility of transcervical resection.
Endometrial Biopsy (Pipelle): In women over age 35, or those with risk factors (obesity, chronic anovulation), an endometrial biopsy is performed to rule out endometrial hyperplasia or carcinoma. Fibroids and endometrial cancer can coexist, and treating the fibroids without checking the lining can lead to a missed cancer diagnosis.
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While ultrasound is excellent for screening, MRI provides a detailed, high-resolution 3D map of the uterus. It is superior at distinguishing fibroids from adenomyosis (a condition in which the lining grows into the muscle), determining the exact number of tumors (which is critical for myomectomy planning), and identifying degeneration or malignant features that ultrasound might miss.
Diagnostic hysteroscopy is a quick office procedure. While it involves passing a camera through the cervix, most women experience only mild to moderate cramping similar to menstrual cramps. It is generally well-tolerated with local anesthesia or oral NSAIDs, and it provides the most accurate assessment of the uterine cavity.
HSG uses X-ray fluoroscopy and an iodine-based dye primarily to check if the fallopian tubes are patent (open) for fertility evaluation. Sonohysterography (SIS) uses ultrasound and saline to evaluate the uterine cavity contour and detect fibroids or polyps. SIS is generally better for visualizing the fibroids themselves.
No. A Pap smear is a screening test for cervical cancer, collecting cells from the surface of the cervix. It does not detect fibroids, which are tumors located deep within the muscular wall of the uterus.
An endometrial biopsy is clinically indicated in women with Abnormal Uterine Bleeding who are over 45, or younger women with risk factors like obesity or PCOS. It ensures that the heavy bleeding is indeed due to the fibroids and not due to pre-cancerous or cancerous changes in the uterine lining.
Robotic hysterectomy is a new way to treat gynecological issues. A big worry for patients is how long it takes to get better. Studies show
Did you know that nearly 600,000 women in the United States undergo hysterectomy every year? This surgery removes the uterus and is a common treatment
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