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

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.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Battista C,Capriglione S,Guzzo F,Luvero D,Sadun B,Cafà EV,Sereni MI,Terranova C,Plotti F,Angioli R

doi

10.1007/s00404-015-3937-1

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

1235-41

issue

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-015-3937-1

journal_volume

293

pub_type

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