title: The challenge of preoperative identification of uterine myomas: Is ultrasound trustworthy? A prospective cohort study.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Cleonice
authors.initials: C
authors.lastname: Battista
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy. s.capriglione@unicampus.it.
authors.forename: Stella
authors.initials: S
authors.lastname: Capriglione
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Guzzo
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Luvero
authors.affiliation: Department of Gynecology, Universiy Campus Bio-Medico of Rome, via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Beniamino
authors.initials: B
authors.lastname: Sadun
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Ester Valentina
authors.initials: EV
authors.lastname: Cafà
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Maria Isabella
authors.initials: MI
authors.lastname: Sereni
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Terranova
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Plotti
authors.affiliation: Department of Obstetrics, Gynecology, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D063186:Uterine Myomectomy / Q000379:methods; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
keywords: Hysterectomy; Myomectomy; Preoperative ultrasound; Prospective study; Ultrasound; Uterine myomas