AbstractIntroduction: Uterine leiomyomas (fibroids) are the commonest benign tumors in women. Leiomyomas are the most common tumors in women of reproductive age. They are symptomatic in 50% of cases, with the peak incidence of symptoms occurring among women in their 30s and 40s. The presentation of uterine fibroids is quite variable. The majorities of women with uterine fibroids are generally asymptomatic at the early stage and consequently get less clinical attention due to undiagnosed disease, while symptomatic women typically complain of abdominopelvic mass with or without abnormal uterine bleedingmainly menorrhagia. Objectives: To study clinical manifestations of fibroid uterus presenting as abdominopelvic lump. Materials and Method: In the present study total 100 cases of abdominopelvic lump attending the Obstetrics & Gynaecology OPD during the period of June 2013 to October 2014 were enrolled. A detailed history of presenting complaints & associated symptoms were noted along with menstrual history. A thorough general & systemic examination was performed. Examination assessed the presence or absence of mass (upon P/A, P/Sp or P/V). During bimanual examination the position, size, shape, mobility & tenderness of uterus & uterine appendages was noted. A clinical diagnosis was put forth based on the symptomatology, per abdomen, per speculum & per vaginum findings for the presenting condition. Results: Fibroid was the most common abdominopelvic mass (53%). Majority of the women were in the age group of 36 to 45 years. Majority of the women were parous (98%). The most common presenting symptom among the fibroid cases was menstrual irregularity (81.13%) followed by lump in abdomen (60.38%). Pain was reported by 33.96% patients. Among the patients of menstrual disturbances Menorrhagia, dysmenorrhea and polymenorrhea were the most common type observed. 32 cases of fibroid had palpable mass. Most of the fibroid masses were firm in consistency (52.83%). Maximum fibroid masses had smooth contour (52.83%). All the palpable masses were mobile. The findings of clinical diagnosis were compared with the gold standard histopathological examination and it was observed that clinical examination had sensitivity of 73.58% with specificity of 80.85%. Conclusion: Thus we conclude that fibroid uterus was the most common (53%) presenting as abdominopelvic lump. Menstrual irregularity was the most common presenting symptom followed by lump in abdomen and pain was observed. Menorrhagia, dysmenorrhea and polymenorrhea were the most common type of menstrual abnormality. Clinical examination had sensitivity of 73.58% with specificity of 80.85%.
Keywords: Fibroid Uterus; Abdominopelvic Lump; Menstrual Disturbances; Pain.