Format

Send to

Choose Destination
Arch Gynecol Obstet. 2016 Jun;293(6):1235-41. doi: 10.1007/s00404-015-3937-1. Epub 2015 Nov 2.

The challenge of preoperative identification of uterine myomas: Is ultrasound trustworthy? A prospective cohort study.

Author information

1
Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
2
Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy. s.capriglione@unicampus.it.
3
Department of Gynecology, Universiy Campus Bio-Medico of Rome, via Álvaro del Portillo, 200, 00128, Rome, Italy.

Abstract

PURPOSE:

To correlate preoperative ultrasound examination with intraoperative and anatomo-pathological findings, including estimation of number, localization and size of uterine myomas, uterine diameters and volume.

METHODS:

A prospective study on 126 women undergoing surgery for uterine myomatosis at Campus Bio-medico between May 2013 and April 2014. The patients were divided into two groups: one submitted to hysterectomy and the other submitted to open myomectomy. Ultrasound scans were performed 1 day before surgery by the same expert sonographer. The number of myomas at ultrasound was compared to intraoperative visualization and anatomo-pathological findings. Wilcoxon Test was applied to compare data registered with each technique.

RESULTS:

There was no significant difference between the number of myomas recorded at visualization and at ultrasound, while there was a significant difference between visualization and anatomo-pathology (p = 0.0006). The analysis showed a non-significant difference between myoma number at ultrasound and at anatomo-pathology in the two groups, if the number of myomas was less than or equal to six. Contrarily, we observed a significant difference if the number of myomas was more than six (p = 0.003).

CONCLUSIONS:

Our data show that ultrasound has limits in identifying the exact number of uterine myomas. This mapping is particularly needed in a minority of patients with usually desiring fertility who need a debulking procedure due to the large size and/or number of myomas or myoma location causing symptomatology. In patients with more than six myomas, voluminous uterus, a second-level examination such as Magnetic Resonance may be helpful.

KEYWORDS:

Hysterectomy; Myomectomy; Preoperative ultrasound; Prospective study; Ultrasound; Uterine myomas

PMID:
26525700
DOI:
10.1007/s00404-015-3937-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center