The relationship between uterine leiomyomata and pelvic floor symptoms

Introduction and hypothesis: To compare pelvic floor symptoms in women with a leiomyomatous uterus ≤12 weeks and those >12 weeks in size and to evaluate the resolution of these symptoms after surgical intervention. Methods: The PFDI-20, PFIQ-7 and 3-day voiding diaries were administered prospectively to all subjects. Demographics and questionnaire responses were compared using a t test, Chi-squared test or Mann-Whitney U test as indicated. Results One hundred and forty-five women completed the questionnaires and were included for analysis. There were 58 women with uterine size ≤12 weeks (group I) and 87 women with size >12 weeks (group II). Participants in group I reported more straining to defecate (p =0.042), while group II reported increased feeling of incomplete bladder emptying (p =0.007) and difficulty emptying their bladder (p =0.008). Review of ultrasound images revealed no difference in pelvic floor symptoms when stratified by leiomyoma location. At 1-year follow-up, 69 women (48%) responded, and 40 (58%) had undergone surgical intervention. Surgery was shown to improve symptoms for all questions reviewed at 1-year follow-up. Conclusions: A leiomyomatous uterus >12 weeks is associated with the symptom of incomplete bladder emptying, but does not appear to have an effect on other pelvic floor symptoms compared with women with a smaller leiomyomatous uterus. Surgical intervention for leiomyomata improves pelvic floor symptoms.