Postmyomectomy sonographic imaging: Uterus remodeling and scar repair

Purpose: Description and evaluation of the sonographic changes at the site of the myomectomy and follow-up of the healing process. Methods: Twelve patients with intramural fibroids underwent myomectomy. Pre- and postoperative ultrasound examinations included measurements of uterine volume and the largest diameters of the largest fibroid and the myomectomy scar. Results: The mean uterine preoperative volume was 773 cm³ (range 271-1,343) (SD 285). It decreased postoperatively to 318 cm³ (range 98-756) (SD 192) and 185 cm³ (range 78-420) (SD 96) in the immediate and late scans, respectively. The mean size of the largest diameter of the largest fibroid was 10 cm (range 7-15) (SD 2.3). The largest diameter of the immediate postoperative myomectomy site was 4.5 cm (range 2.2-8) (SD 1.8) decreasing later to 2.4 cm (range 0-6) (SD 1.6). Conclusion: The postoperative sonographic findings following myomectomy demonstrates a solid finding that may mistakenly be interpreted as the remaining fibroid that shrinks gradually. The finding is probably the result of changes in hyperplastic myometrial tissue, focal small hematomata and suture material.