The enlarged uterus. Relation of uterine size to symptoms and histopathologic findings

To determine the association between the weight of an enlarged uterus and it clinical and histopathologic pictures.

Forty-three patients with symptoms related to uterine enlargement of < 280 g who underwent total abdominal hysterectomy were compared to 73 patients with uteri weighing > or = 280 g.

The mean age, parity, duration of disease and incident of past myomectomy were not different. All symptoms except low abdominal pressure were similarly distributed. The incidences of leiomyomata combined with adenomyosis were similar. A leiomyoma alone was more frequent in patients with a uterus of > or = 280 g (P < .001) while adenomyosis alone was more commonly associated with a smaller uterus (P < .001).

Symptoms were not related to uterine weight except for low abdominal pressure, which was absent from smaller uteri. The diagnosis of leiomyomata was confirmed in all uteri > or = 280 g and in 62.8% of smaller uteri. Adenomyosis alone was present in smaller uteri only.