[Myoma, fortuitous discovery or metrorrhagia: Which is more revealing?].

Introduction: myoma is commonly diagnosed in our hospital. It can be accidentally discovered or discovered due to metrorrhagia. The purpose of this study is to evaluate the association between the size of myomas and the circumstances under which they are detected and between the location of myomas and the occurrence of bleeding.

Methods: we conducted a cross-sectional study including women aged 18 or older undergoing ultrasound at the University Teaching Hospital Bogodogo and who were diagnosed with at least one uterine myoma over a period of 6 years from January 2012 to December 2018. Binary logistic regression was used to assess metrorrhagia while multinomial logistic regression was used to assess circumstances under which they were detected and size.

Results: we assessed 1049 women, among whom 2294 had myomas diagnosed on ultrasound. Each woman had two myomas. The average age of patients was 37 years. Women with myomas larger than 50 mm accounted for 29.7% (n=311). There was a strong association between interstitial, subserosal and submucosal myomas and the occurrence of metrorrhagias (p<0.001). A size less than 50 mm was significantly associated with fortuitous discovery (p=0.016) but not with revealing metrorrhagia (p=0.084). Women who had submucosal myomas (OR=3.13; CI95%= [1.45-6.76]), interstitial and submucosal myomas (OR=2.24; CI95%= [1.05-4.78] as well as interstitial, subserosal and submucosal myomas (OR=3.57; CI95%= [1.88-6.76]) were at higher risk of developing metrorrhagia. Myomas measuring less than 50 mm had twice the odds of revealing fortuitously (RRR=1.80; CI95%= [1.25-2.62]) or by metrorrhagia (RRR=1.75; CI95%= [1.04-2.95].

Conclusion: metrorrhagia is more common in women with myomas in specific locations.