P23.01: Sonographic findings after ulipristal acetate treatment in women with uterine myoma

To describe sonographic modifications brought about by ulipristal acetate for management of uterine myoma. Sonographic evaluation was performed before and after 3 months of treatment by ulipristal acetate in women with symptomatic uterine myoma. Endometrial changes: After a first course of 3 months of UPA, endometrium often appears thicker and hyperechogenous without vascularisation modifications. These modifications can be sonographic report of the PAECS. On the opposite, myometrium right below endometrium present a heavy vascularisation. Modifications in myoma: Myomas are sometimes smaller after a three months treatment by UPA. However, even without size modification, sonographic appearance of myomas after UPA treatment is special. Myomas are surrounded by a hyperechogenous tissu that can be compared to “snow egg”. This aspect is also found during surgery, leading to the conclusion that capsule around myoma is thickened after UPA treatment. However, this capsule describe in surgery is never observed and described in pathological examinations. Myoma sliding: Sometimes, myoma can slide and change their FIGO classification. This sliding was noted from type 2 or 3 to type 0 or 1. Sonographic findings after UPA treatment had to be known to be recognised and not to worry about normal aspects. A sonographic control after UPA treatment and prior to surgery is required to avoid pitfalls about size of myoma but also about type.