Pre-operative ultrasonographic evaluation of nongravid, enlarged uteri — correlation with bimanual examination

The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy

“…Moreover Flickinger et al found greater errors in estimates of the uterine size when using bimanual examination than by ultrasonography, when compared with the actual uterine volume after hysterectomy [17]. But the study populations were small and not all included patients were diagnosed with uterine fibroids, unlike our study [16,17]. In contrast, a large study by Harb et al found only bimanual estimation to be an accurate method, and questions the use of routine ultrasound to confirm the uterine size before hysterectomy [18].…”

“…Three studies showed that ultrasonographic dimensions significantly correlate with the true dimensions of the removed uteri as described in histopathology reports [16,17,21]. Moreover Flickinger et al found greater errors in estimates of the uterine size when using bimanual examination than by ultrasonography, when compared with the actual uterine volume after hysterectomy [17].…”

“…It is uncertain how reliable and accurate bimanual and ultrasound examinations are in the assessment of uterine volume. Only a few studies have compared the uterine volume estimated through bimanual examination and ultrasound with exact uterine volumes or weights during histopathologic examination [15][16][17][18][19]. To our knowledge, no previous study has compared estimated uterine volumes of the enlarged non gravid fibroid uteri with bimanual examination and transvaginal ultrasound with MRI.…”

Is transvaginal ultrasound a worthwhile investigation for women undergoing vaginal hysterectomy?

“…Dekel et al (1998) have demonstrated the accuracy of preoperative ultrasonographic evaluation of the uterus. In their study, the uterine size of 49 consecutive patients who underwent elective hysterectomy was assessed by bimanual examination, preoperative ultrasound and actual postoperative size.…”

Preoperative Factors That Predict the Need to Morcellate in Total Laparoscopic Hysterectomy

“…Our study found that preoperative uterine measurements that most accurately predict the need to morcellate at the time of TLH are bimanual exam, uterine cross-sectional area, and size of the largest leiomyoma. Prior studies on this subject have used uterine pathologic weight to determine cut-offs as to which specimens will require morcellation and then have relied on conversion equations to translate uterine weight to estimated preoperative uterine volume [23][24][25][26]. This is the first study to our knowledge to evaluate all uterine measurements that may be available preoperatively.…”