Comparison of the number of uterine myomas detected by in-office transvaginal ultrasonography removed by laparotomic myomectomy: preoperative work-up concerns.
OBJECTIVE
To assess the ability of detecting the number of uterine myomas by transvaginal ultrasonography (TVS) performed supporting the clinical examination of general gynecologists' office practice.


METHODS
A retrospective comparison of the number of myomas revealed by preoperative in-office TVS and documented after laparotomic myomectomy was conducted in 110 consecutive premenopausal patients referred for surgery.


RESULTS
The sensitivity of TVS in revealing the exact number of myomas was 59.4% in the whole series. In the subgroup of 88 patients with a preoperative diagnosis of three or fewer myomas TVS missed at least one myoma in 31 (35.2%) cases, achieving a 64.8% sensitivity. Among the 72 women diagnosed with one myoma at preoperative TVS, 19 (26.4%) resulted to have two or more myomas at the end of surgery, reaching a 73.6% sensitivity of TVS in revealing the exact number of myomas.


CONCLUSIONS
In-office TVS reinforces the clinical diagnosis of uterine myomas but it often fails in the detection of their number, resulting in a poor preoperative characterization of patients. The fact that one myoma may be overlooked in one-third of patients theoretically eligible for laparoscopic conservative surgery may motivate the implementation of US diagnosis when laparoscopic myomectomy is considered.
Fambrini
M
M
Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy. maxfambrini@libero.it
Tondi
F
F
Scarselli
G
G
Penna
C
C
Pieralli
A
A
Andersson
K L
KL
Marchionni
M
M
D000328:Adult; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery