Uterine Fibroids

Uterine Fibroids are non-cancerous tumors that form on the uterus. They are also know as leiomyomas or fibromyomas. Up to 75% of women can or will develop fibroids, but most will go undetected because more often than not, there are no symptoms.
For those women that do experience symptoms, the most common are heavy menstrual bleeding, back ache, pain in the pelvic area, frequent and/or trouble urinating.
Uterine fibroids acutally form in the smooth muscle layer of the uterus called they myometrium. A cell will reproduce rapidly until it forms a mass, which can be too small to detect with the human eye or very large. The major causes of fibroids are genetics, race, or from an unbalance of the two major hormones in the female body, estrogen and progesterone.
Most fibroids are discovered during routine pelvic examinations. To further investigate, a Md will order a pelvic ultrasound, where the radiologist can get a better look at the fibroid(s) and measure their size. A trasvaginal ultrasound can get a very good look at fibroids since the transducer is closer to the uterus. If an ultrasound doesn't get a good view, there are numerous exams that can be ordered such as MRI, CT, or a hystersalpingography. MRI is very useful as it is very detailed and the use of IV contrast can help enhance the fibroids.
There are many treatment options for uterine fibroids. If there are no symptoms, one could wait and watch the fibroids to see if they get any bigger and/or cause problems. If the patient is past child-bearing years and has problem causing symptoms, a hysterectomy could be performed, where the uterus (containing the fibroids) can be completely removed. Another surgical procedure can be performed called a myomectomy, where the fibroids are removed, but the uterus is left in place. This is a good option for women who still want to bear children, although fibroid can still redevelop. There are also many drugs to help further stop the growth of fibroids and may even shrink the fibroids.

Renal Artery Stenosis

Renal artery stenosis is a narrowing of the right, left, or both renal arteries, which branch off the abdominal aorta and supply blood to the kidneys. It is most common in those over the age of 65, but in rare cases can happen in younger people. The major causes of renal artery stenosis are atherosclerosis, high blood pressure, diabetes, and cigarette smoking.
Patients who have renal artery stenosis may present symptoms of chronic high blood pressure, decreased kidney function, and/or hormone imbalance. Blood tests and routine check-ups can determine if kidneys are properly functioning.
There are numerous tests that can be performed to determine an accurate diagnosis. As for the imaging tests, a patient could have an angiogram, MRI, CT, or doppler ultrasound. An angiogram is the most invasive exam as it is done in an interventional radiology department and entails a catheter being inserted in the patient's groin and contrast injected and watched via live xray as the contrast enters the renal arteries. Although this is more invasive, if there is stenosis, a stent can be placed at the time of the angiogram, thus reducing the need for another procedure. A CT or MR angiogram can also be performed and is much quicker and less invasive. For both exams, intravenous contrast is administered and images are taken in a timed manner to "catch" the contrast as it's entering the renal arteries from the abdominal. Post process procedures can later be done to produced well-defined cut-out images (MIP's) of just the abdominal aorta, renal arteries, and kidneys.
Treatment for renal artery stenosis varies depending on the cause. If high blood pressure is the culprit, the medicines are usually the answer. More invasive/surgical treatments are needed for more serious cases of stenosis. These include an angioplasty and/or placing a stent in the narrowed artery to let blood flow more freely.