The Effect of Uterine Leiomyomas Size on Presenting Symptoms and Accurate Sonography Assessment

Abstract

Background: Uterine leiomyomas are the most common uterine neoplasm; their symptoms could be related to the size and position. They could affect patients' capability to conceive and/or to continue the pregnancy. Ultrasound is the main diagnostic tool. However, accurate assessment might be affected by fibroid characteristics. Objective: To evaluate the relationship between fibroid size, presenting symptoms, previous obstetric history and accurate ultrasound fibroid assessment preoperatively in patients who had abdominal myomectomy. Design: A retrospective data analysis. Setting: University of Dammam Teaching Hospital. Method: All patients who had abdominal myomectomy between 1 December 2007 and 30 November 2012 were reviewed. Personal characteristics, obstetric history, indication for the myomectomy and myoma preoperative and intraoperative features were reviewed. Result: One hundred thirty-seven procedures were performed during the study period. The mean age of the patients was 36 years, 81 (59.1%) were married and 112 (82%) were Saudi nationals. Menorrhagia was the leading presentation in 66 (48.2%) patients, followed by pain in 26 (19%), mass in 16 (12%), sub-fertility in 14 (10.2%) and pressure symptoms in 9 (7%) patients. However, 6 (4.4%) had combined presentations. The median of the two largest diameter myoma was 7 cm and the weight was 320 gm. However, fibroid size had a significant effect on the presenting symptoms. Previous parity was not affected by the size of the fibroid. The size of the fibroid on ultrasound had no effect on the accuracy of the assessment.