Impact of submucous myoma on the severity of anemia

Objective: To analyze the impact of the diameter (myoma-φ) and the uterine cavity protruding proportion (protruding %) of the submucous myoma on serum hemoglobin (Hb) level. Design: Retrospective descriptive study. Setting: Tertiary university hospital. Patient(s): Two hundred fifty-nine women with a single submucous myoma. Intervention(s): Transvaginal ultrasound examination and office hysteroscopy. Main Outcome Measure(s): Myoma-φ and protruding % were determined with transvaginal ultrasound scan and office hysteroscopy. Menorrhagic period (months) and serum Hb were recorded within 2 weeks of these examinations. Result(s): Serum Hb negatively correlated with myoma-φ, protruding %, and menorrhagic period. The negative association between serum Hb and protruding % was even more prominent after adjusting for myoma-φ. Multivariate regression analysis revealed that myoma-φ and protruding %, after adjusting for the confounding effect of menorrhagic period, maintained a strongly negative correlation with serum Hb level. When myoma-φ was <2 cm, however, the serum Hb levels were similar regardless of the protruding %. Conclusion(s): For women with a single submucous myoma, myoma-φ and protruding % can determine the serum Hb level significantly . As myoma-φ and protruding % increased, the serum Hb level decreased accordingly.