Authors investigated 75 patients with uterine
myomas, appraising whether
fibroid pseudocapsule (FP) thickness varies depending on
fibroid location, by a prospective cohort trial (level of evidence II-2) settled in University-affiliated Hospitals. Uteri were scanned via bidimensional and power Doppler ultrasound (US) to map the
fibroids and record the FP thickness, prior to
hysterectomy for symptomatic
uterine fibroids. After
hysterectomy, FP specimens were sampled and analyzed by pathologists. Ultrasound and histology data were matched. Pseudocapsule thickness of 108
fibroids was measured: subserosal
fibroids (SSFs), intramural
fibroids (IMFs), and
fibroids near the endometrial cavity (FEC). The FEC's pseudocapsules were considerably thicker than those of IMF and SSF measured by US and histology (P = .001). A clear cutoff existed between FEC pseudocapsule thickness and all other pseudocapsules, with significant differences observed at 2 mm (P = .001). Similarity between histological and US measurements was observed only with IMF pseudocapsules, whereas FEC or SSF showed significant differences. The pseudocapsule of
fibroids is considerably thicker near the endometrial cavity when compared to those of both IMFs and SSFs. Since
fibroids closest to the endometrial cavity are the most involved in fertility and
infertility and FP is considerably thicker near the endometrial cavity, it is possible to hypothesize an involvement of FP of
fibroid near the endometrium since FP contains many
neuropeptides and
neurotransmitters that are physiologically active, even if these data may take on a broader meaning in a study on a larger number of patients.