Prevalence, clinical presentation and factors associated with Uterine fibroids among women attending the Gynecology Outpatient Department at a large Referral Hospital in Southwestern Uganda

Abstract

Background: Uterine fibroids are the most common benign female gynecologic tumors. There are multiple risk factors, including age and reduced fertility. There is however a paucity of data on disease burden and risk factors among African populations. Objective: We determined the prevalence, clinical presentation and factors associated with uterine fibroids among women at Mbarara hospital gynecology clinic, Uganda. Methods: We conducted a cross sectional study from November 2018 to February 2019 on 319 women attending gynecology clinic. An abdomino-pelvic ultrasound scan was performed on each participant and data analyzed using Stata Version 13. Multivariable logistic regression was used to determine association between selected characteristics and uterine fibroid appearance. P value of less than 0.05 was interpreted as significant. Results: The number of women with fibroids was 90 out of 319, representing a prevalence of uterine fibroids of 28.2%. About 67 (74.4%) of the participants with fibroids were symptomatic having pelvic pain 65 (72.2%), menorrhagia 57 (63.3%), pelvic mass 20 (22.2%) and failure to conceive 9 (10%). Women in age group of 31 – 50 years (adjusted OR 4.2; 95% CI,2.0 to 8.5), those separated from their spouses (adjusted OR 4.4; 95% CI,1.8 to 10.5), overweight (adjusted OR 4.9; 95% CI, 2.6 to 9.6), obesity (adjusted OR 4.1; 95% CI,1.6 to 10.5) were more likely to be diagnosed with uterine fibroids while delayed menarche (adjusted OR 0.4; 95% CI, 0.1 to 0.8) was protective. Conclusion: The study found the prevalence of uterine fibroids to be high. Majority of patients were symptomatic at presentation with pelvic pain, menorrhagia, irregular menses and pelvic mass. Uterine fibroids cause significant morbidity among reproductive age women. The identified risk factors included overweight and age group of 31 to 50 years. We recommend Ultrasound scan in women of reproductive age attending gynecology clinic to detect uterine fibroids early in order to manage them promptly so as to prevent the associated complications.