Urogenital disorders

II./4.4.: Diagnostics beside imaging

The first step in diagnostics is physical examination, which consist of a bimanual examination and exploration. This way the larger lesions are easily recognizable. If myoma is suspected, ultrasonography should be performed. In case of infertility, hysteroscopy is recommended.

In myoma cases, endometrial carcinoma occurs more often than on average, therefore a diagnostic abrasion is recommended to be considered before a planned hysterectomy because of a myoma.

II./4.5.: Differential diagnosis

Pregnancy should be excluded before diagnosis. The most common benign lesions to be considered when setting up a differential diagnosis are: adenomyosis/endometriosis; developmental abnormalities of the uterus and space-occupying processes of the adnexes (dermoid hose, fibroma, tuboovarial abscess). Of the malignant lesions uterine and ovarian malignant tumors must be distinguished. Setting up the final diagnosis is only possible with the help of imaging studies (ultrasound, MRI, CT). Positron emission tomography (PET-CT) has an important role in distinguishing leiomyosarcoma. The suspicion of malignancy should be raised clinically by the unusually rapid growth.