Uterine fibroid examination items

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 22, 2024
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When suspecting that a woman has uterine fibroids, the first step is to perform a routine gynecological examination by opening the vagina with a speculum. This is necessary because some women's uterine fibroids are located on the cervix; at this point, it is possible to see an increased size of the cervix and the fibroid may be visible protruding from the cervix. Moreover, during the bimanual gynecological examination, one may find that the uterus is enlarged and irregularly shaped with localized protrusions. Generally, the mobility is quite good. Additionally, some auxiliary examinations can be combined, such as the most common transvaginal ultrasound or pelvic abdominal ultrasound. For suspected submucosal uterine fibroids, a hysteroscopic examination can also be performed for diagnosis.

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What department should I visit for uterine fibroids?

Uterine fibroids are a common gynecological condition. Once uterine fibroids occur, it is necessary to register for a gynecological examination. Further gynecological ultrasound examinations are required to determine the location of the uterine fibroids. There are several types of uterine fibroids, including subserosal, intramural, and submucosal fibroids. In particular, if submucosal fibroids are present, regardless of their size, timely surgery is needed due to the high risk of severe bleeding and anemia they pose. If the submucosal fibroid is small, hysteroscopic submucosal fibroid electrosurgery can be performed. If the fibroid is large, an open surgery may be necessary. Additionally, in the case of intramural and subserosal uterine fibroids, if the fibroid continues to grow larger than five centimeters, there is also a potential risk of malignancy, thus timely surgical treatment is recommended.

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How to check for uterine fibroids?

Uterine fibroids can primarily be diagnosed through ultrasound and gynecological examinations. Uterine fibroids are relatively easy to diagnose; an ultrasound can reveal irregular masses on the uterus or solid echoes, with a fairly intact capsule, which could be either solitary or multiple, confirming the presence of uterine fibroids. During a gynecological examination, an irregular uterine shape with localized protrusions can be felt, which are fairly mobile and typically not associated with significant pain, further confirming the presence of uterine fibroids.

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Can uterine fibroids be inherited?

Uterine fibroids are common benign tumors clinically, with a prevalence rate of 20%-40% among women, approximately 20% of which are hereditary. Most tumors do not show clear clinical symptoms, so patients need not worry too much even after the tumors develop. However, some patients may experience increased menstrual flow, prolonged menstrual cycles, or even symptoms such as anemia, abdominal pain, and bloating. In such cases, surgical removal may be considered, which is a routine procedure in clinical settings, so patients should not be overly concerned.

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What should I do about uterine fibroids?

Uterine fibroids first require examining the location and size of the fibroids. Uterine fibroids can be classified into subserosal fibroids, submucosal fibroids, and intramural fibroids. If it is a submucosal fibroid, no matter the size of the fibroid, it is necessary to promptly perform a hysteroscopic submucosal fibroid surgery. If the submucosal fibroid is large, it may be necessary to perform a hysterectomy through abdominal surgery. For intramural and subserosal fibroids, if the fibroid's diameter exceeds five centimeters or if the fibroid is growing rapidly, surgical treatment is recommended at that time, because there is a chance of malignant transformation in uterine fibroids, which ranges from 0.2% to 0.3%. Therefore, once such a situation occurs, surgical treatment is required.

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Uterine fibroids are classified into several types.

Uterine fibroids are classified by location into two types: myometrial fibroids and cervical fibroids. Based on the relationship between the uterine fibroids and the muscular wall, there are three kinds of uterine fibroids: intramural fibroids, subserosal fibroids, and submucosal fibroids. Intramural fibroids, primarily located within the uterine wall and enclosed by a muscular layer, are recommended for surgical treatment once the fibroid's diameter exceeds four centimeters, as they tend to grow rapidly. Similarly, subserosal fibroids grow towards the peritoneal surface of the uterus and are on the exterior of the uterus. If subserosal fibroids also exceed four centimeters in diameter and are accompanied by menstrual changes, surgical treatment is advised. Furthermore, submucosal fibroids, regardless of their size, require timely surgical intervention due to their association with heavy bleeding and a high risk of anemia.