Skip to main content
SpringerLink
Log in

The growth of uterine myomas in untreated women: influence factors and ultrasound monitoring

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Until now there are no systematic studies about the long-term course of myoma growth. Therefore, the aims of the present study were: (1) ultrasound monitoring of the natural course of growth of uterine leiomyomas; (2) assessment of whether the growth of myomas depends on the age of the patients, the location, or the initial size (possible co-factors/predictor criteria for increase of growth); influence of oral contraceptives (OC).

Methods

Patient records (2010–May 2016) were retrospectively and systematically evaluated in regards to their growth and clinical course. The patients received a follow-up questionnaire by mail about the further history. Linear regression analysis and generalized regression analysis were performed to determine the influence of various factors on the growth of myomas.

Results

Overall, 152 met the further inclusion criteria. Most of the myomas increased in size but 10% of the myomas became smaller without therapy. There is a significant dependency between the initial myoma size, and the first and second measurements, but not between those measures and myoma localization. In regression analysis, there was also a significant association between the growth of the myomas and the initial size but no association with age, complaint symptoms, and use of OC. However, the use of OC waas significantly associated with myoma growth in GEE.

Conclusions

The course of growth of myomas has large variance, so this should not be taken as a sign for a malignant event (sarcoma or the so-called STUMP). The growth takes place with considerable individual variability and ultimately is not predictable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Reis M, Bloise M, Ortiga-Carvalho TM (2015) Hormones and pathogenesis of uterine fibroid. Best Pract Res Clin Obstet Gynaecol 34(13–24):25

    Google Scholar 

  2. Sparic R, Mirkovic L, Malvasi A, Tinelli A (2016) Epidemiology of uterine myomas: a review. Int J Fertil Steril 9:424–435

    PubMed  Google Scholar 

  3. Fleischer R, Weston GC, Vollenhoven BJ, Rogers PA (2008) Pathophysiology of fibroid disease: angiogenesis and regulation of smooth muscle proliferation. Best Pract Res Clin Obstet Gynaecol 22(4):603–614

    Article  PubMed  Google Scholar 

  4. Downes E, Sikirica V, Gilabert-Estelles J, Bolge SC, Dodd SL, Maroulis C et al (2010) The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol 152:96–102

    Article  PubMed  Google Scholar 

  5. Segars JH, Akopians AL (2013) The two health disparities of uterine fibroids. Fertil Steril 99:1851–1852

    Article  PubMed  PubMed Central  Google Scholar 

  6. Istre O (2008) Management of symptomatic fibroids: conservative surgical treatment modalities other than abdominal or laparoscopic myomectomy. Best Pract Res Clin Obstet Gynaecol 22:735–747

    Article  PubMed  Google Scholar 

  7. Ichimura T, Kawamura N, Ito F, Shibata S, Minakuchi K, Tsujimura A, Umesaki N, Ogita S (1998) Correlation between the growth of uterine leiomyomata and estrogen and progesterone receptor content in needle biopsy specimens. Fertil Steril 70:967–971

    Article  CAS  PubMed  Google Scholar 

  8. Peddada SD, Laughlin SK, Miner K, Guyon JP, Haneke K, Vahdat HL et al (2008) Growth of uterine leiomyomata among premenopausal black and white women. Proc Natl Acad Sci USA 105:19887–19892

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Davis BJ, Haneke KE, Miner K, Kowalik A, Barrett JC, Peddada S, Baird DD (2009) The fibroid growth study: determinants of therapeutic intervention. J Woments Health 18:725–732

    Article  Google Scholar 

  10. Kasai M, Ichimura T, Kawamura N, Sumikura T, Matsuda M, Asano C, Sumi T, Ishiko O (2012) Prediction of the shrinking rate of uterine leiomyoma nodules using needle biopsy specimens. Fertil Steril 98:440–443

    Article  PubMed  Google Scholar 

  11. Tsuda H, Kawabata M, Nakamoto O, Yamamoto K (1998) Clinical predictors in the natural history of uterine leiomyoma: preliminary study. J Ultrasound Med 17:17–20

    Article  CAS  PubMed  Google Scholar 

  12. DeWaay DJ, Syrop CH, Nygaard IE, Davis WA, Van Voorhis BJ (2002) Natural history of uterine polyps and leiomyomata. Obstet Gynecol 100:3–7

    PubMed  Google Scholar 

  13. Mavrelos D, Ben-Nagi J, Holland T, Hoo W, Naftalin J, Jurkovic D (2010) The natural history of fibroids. Ultrasound Obstet Gynecol 35:238–242

    Article  CAS  PubMed  Google Scholar 

  14. Brölmann H, Tanos V, Grimbizis G, Ind T, Philips K, van den Bosch T, on behalf of the European Society of Gynaecological Endoscopy (ESGE) steering committee on fibroid morcellation et al (2015) Options on fibroid morcellation: a literature review. Gynecol Surg 12:3–15

    Article  PubMed  PubMed Central  Google Scholar 

  15. Exacoustos C, Romanini ME, Amadio A, Amoroso C, Szabolcs B, Zupi E, Arduini D (2007) Can gray-scale and color Doppler sonography differentiate between uterine and leiomyoma? J Clin Ultrasound 35:449–457

    Article  PubMed  Google Scholar 

  16. Baird DD, Garrett TA, Laughlin SK, Davis B, Semelka RC, Peddada SD (2011) Short-term change in growth of uterine leiomyoma: tumor growth spurts. Fertil Steril 95:242–246

    Article  PubMed  Google Scholar 

  17. Malartic C, Morel O, Rivain AL, Placé V, Le Dref O, Dohan A, Gayat E, Barranger E, Soyer P (2013) Evaluation of symptomatic uterine fibroids in candidates for uterine artery embolization: comparison between ultrasonographic and MR imaging findings in 68 consecutive patients. Clin Imaging 37:83–90

    Article  PubMed  Google Scholar 

  18. Ciarmela P, Islam MS, Reis FM, Gray PC, Bloise E, Petraglia F, Vale W, Castellucci M (2011) Growth factors and myometrium: biological effects in uterine fibroid and possible clinical implications. Hum Reprod Update 17:772–790

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Commandeur AE, Styer AK, Teixeira JM (2015) Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth. Hum Reprod Update 21:593–615

    Article  PubMed  PubMed Central  Google Scholar 

  20. Markowski DN, Holzmann C, Bullerdiek J (2015) Genetic alterations in uterine fibroids—a new direction for pharmacological intervention? Expert Opin Ther Targets 19(11):1485–1489

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank Michael Hanna, PhD, (Mercury Medical Research & Writing) for translating the manuscript from German into English.

Author information

Authors and Affiliations

  1. Center for Oncological Surgery, European Competence Center for Ovarian Cancer, Charité University Medicine of Berlin, Campus Virchow-Klinikum, Berlin, Germany

    Robert Armbrust, Jalid Sehouli & Matthias David

  2. SOSTANA GmbH, Berlin, Germany

    Klaus-Dieter Wernecke

  3. Klinik für Gynäkologie, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Robert Armbrust

Authors
  1. Robert Armbrust
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Klaus-Dieter Wernecke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jalid Sehouli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthias David
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RA: Project development, data collection, and manuscript writing. KDW: Data analysis and statistics. JS: Manuscript writing/editing. MD: Project development, data collection, and manuscript writing.

Corresponding author

Correspondence to Robert Armbrust.

Ethics declarations

Conflict of interest

All authors declare that there is no conflict of interests.

Ethical standards

All procedures in this study were in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki Declaration and its later amendments. All patients gave written informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Armbrust, R., Wernecke, KD., Sehouli, J. et al. The growth of uterine myomas in untreated women: influence factors and ultrasound monitoring. Arch Gynecol Obstet 297, 131–137 (2018). https://doi.org/10.1007/s00404-017-4568-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-017-4568-5

Keywords

Search

Navigation