Understanding Abnormal Uterine Bleeding: Part 2

Summary & Participants

As many as 20 to 50 percent of all women develop fibroids. These benign muscle tumors usually grow in the uterus, and can cause pain, and in some cases, infertility. Join our panel as they discuss abnormal bleeding and fibroid concerns.

Medically Reviewed On: July 09, 2008

Webcast Transcript

PAUL MONIZ: I'm Paul Moniz. Thank you for joining us on this webcast. Today we are discussing abnormal uterine bleeding and it's connection to fibroids. Fibroids are benign muscle tumors that usually grow in the uterus, but they can occur elsewhere, causing in some cases pain and infertility. As many as 20-50 percent of all women actually develop them. If you are suffering from abnormal bleeding, you may have what is known as a submucosal fibroid. Here to talk about that is a gynecologist and one of his patients.

To my left is Dr. Martin Goldstein. He is the Associate Clinical Professor of Obstetrics and Gynecology at Mt. Sinai Hospital. Next to him is Valerie. She is a 50-year-old mother of two who has agreed to join us. We are not showing her face because of the sensitive nature of this topic, but she is willing to share her story. Thank you very much for coming here Valerie. We appreciate it.

Dr. Goldstein, let's begin with you. You have to go through a number of steps to make this diagnosis and determine what, in fact, you're looking at. Take us through that. For instance, Valerie comes into you. What is the workup for a patient?

MARTIN GOLDSTEIN, MD: Valerie presented herself with severe anemia, which had been corrected by transfusion. My feeling was it was imperative to be certain there was not a bowel problem, such as a colon or rectal cancer, or an upper GI bleed from an ulcer, or another cause of blood loss. So, Valerie went through a colonoscopy, an upper GI series and a hematologic evaluation. Based on this, as Valerie had said, we knew that Valerie's blood production was correct, was adequate, and she did not have a cause for bleeding coming from the intestinal tract. Then after that, the most common cause of blood loss in a woman would be menstrual bleeding.

We performed a hysterogram, which is a test where we placed a radiopaque liquid, a liquid that doesn't allow X-rays to penetrate into the uterus.

PAUL MONIZ: We actually have a slide of that. We can show what that is and what that looks like. Walk us through how this tests work. How long is it? What does it show?

MARTIN GOLDSTEIN, MD: A hysterogram is an X-ray test. It is done by placing a small balloon catheter in the bottom of the uterus. The shadow on the bottom of this picture demonstrates the balloon catheter.

Through the balloon catheter, a radiopaque liquid, which shows up white, is injected into the uterus. In Valerie's uterus, which you see here, between the three dark marks there is a footprint shaped irregularity that represents a submucous fibroid. The submucous fibroid, in this case, is fairly large. It's approximately five by seven centimeters, which is about the size of a tennis ball.

PAUL MONIZ: So this is a large growth we're talking about.

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