A clinico-pathologicalanalysis of uterine leiomyomata in Maiduguri, Nigeria

Abstract

Uterine leiomyoma (UL) is the commonest benign tumour of the female genital tract in the reproductive age group. There is little or no literature on the histopathological study of the disease in Nigeria. This may be the first study to serve as a baseline data in Maiduguri. Objective: To analyse the frequency of occurrence, age and parity of the patients, clinical presentation, degenerative changes, diseases associated with uterine leiomyomata and the treatment modalities of the tumour in Maiduguri. Methods: A retrospective analysis of all cases of uterine leiomyomata histologically diagnosed in the Histopathology Department of the University of Maiduguri Teaching Hospital, Nigeria between January 1994 and December 2003 inclusive. Results: A total of 501 cases of uterine leiomyomas were examined in this study, representing 4.5% of all disease conditions histopathologically diagnosed within the study period. The mean age of patients was 36.3 (±8.3SD) and the th peak age incidence was in the 4 decade of life. The symptoms are presented in the following order of frequency: lower
abdominal pain, 187 (87.8%); menstrual pain and irregularity, 164 (77.0%); urinary frequency/hesitancy/urgency, 68 (31.9%); infertility/subfertility, 42 (19.7%) and constipation 24 (11.3%). Multiparous women accounted for 64.9% of all cases. There were 121 cases of uterine leiomyoma coexisting with adenomyosis (30), ovarian cysts [Non-neoplastic (41), Neoplastic [benign (12), malignant (8)] and cervical inflammatory diseases (30). The commonest mode of treatment was myomectomy in 367 (73%) and hysterectomy in 134 (27%) cases, with mean age of 33.9 and 46.7 years respectively There were 104 cases of degenerative changes: hyaline (92), cystic (12), calcification (9) and red degeneration(6) Conclusion: Uterine leiomyoma is common, especially in the reproductive age group and is often associated with degenerative changes, and coexistent with ovarian cysts, adenomyosis and chronic cervicitis. There is need to find the
aetiological relationships of the disease in order to reduce its incidence as well as the frequent exposure of women to operations that are necessitated by the disease and its associated complications.