Razia Iftikhar.
Modes of presentation of Leiomyoma of uterus.
J Surg Pak Jan ;13(3):117-20.

Objective: To find out the frequency, symptomatology and modes of diagnosis of leiomyoma of uterus. Study design: Descriptive study. Place and duration of study: Department of Obstetrics & Gynaecology Baqai Medical University Karachi, from June 2006 to May 2008. Patients and Methods: All patients with fibroid uterus managed during the study period were enrolled. Detailed personal and family history was taken and clinical examination done. Data collection included age, parity and symptoms. Menstrual pattern, previous and current was also noted. All routine investigations were carried out. Abdominal and pelvic examination was done to assess size, consistency and mobility of mass. Ultrasound was also done. Nulliparous patients were put on medical treatment and subsequently for induction of ovulation while myomectomy was performed on the patient where the fibroid was the cause of infertility and in those patients who had menstrual symptoms refractory to medical treatment. Patients who had multiple fibroids and completed their family, were offered hysterectomy. Results: A total 100 cases were enrolled into the study. Greater frequency was found in late reproductive and peri-menopausal years (70%) while 30% were seen in reproductive years. Menstrual symptoms were observed in 82% of cases while mass in abdomen was observed in 60%. Multiple fibroids were found in 46%. Ten percent cases were familial . Infertility was noted in 5% of the cases and 12% of the cases reported recurrent abortions. Diagnosis was mostly clinical and transvaginal sonography was required in 5% of the cases. Conclusions: Fibroids manifest in late productive years. They may remain asymptomatic however, menstrual symptoms are the commonly seen depending upon size, location and number of fibroids. Diagnosis is simple by clinical examination and ultrasonography.

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