For women with heavy menstrual bleeding and fibroids the best diagnostic test is usually a transvaginal ultrasound or ultrasound. This involves instilling fluid into the uterus to look for fibroids that can be removed through the cervix thereby avoiding hysterectomy. The guideline also shows that MRI and CT scanning is usually unnecessary to diagnose fibroids. Each year around 1000 people in New Zealand will have an open leg ulcer. People who have leg ulcers describe them as debilitating.
Compression bandaging for venous leg ulcers is the only proven effective therapy.
A small group of patients with mixed disease can benefit from reduced compression bandages but these patients must be able to feel pain in their leg and who be able to take the bandage off if they feel pain. It is essential that this group of patients is closely monitored for ischaemic legs. If a patient has an arterial leg ulcer there are two options. Either consider referral to a vascular surgeon for surgery or manage the ulcer with a moist wound healing is probably the most effective treatment for an arterial leg. Research shows that moist wounds heal faster than dry wounds.