Typically, symptoms are what drive women to treatment for non-cancerous uterine conditions. Assessment of multiple outcomes require basic methodological work to validate existing measures or develop new measures. Measures need to be validated and standardized so that the findings of different studies can be compared and, possibly, to permit aggregation of results from small studies. Epidemiologic studies, especially large, prospective, community-based cohort studies, are needed to determine the incidence and prevalence of uterine problems, their natural history, and the factors that place some women at high risk. Important variables influencing patients' and providers' perceptions and expectations of different treatments are poorly understood.
Research is needed to explain how physician-patient interaction affects treatment decisions.
Importance of fibroid size. Published criteria generally recommend surgical removal of fibroids if and when they reach the size of the uterus at 12-weeks gestation, and this has become usual practice. Studies are needed to determine how changes in fibroid size influence patients' functional status and quality of life. Formation of leiomyosarcoma. With the possibility of malignant change in fibroids, rapid growth in the size of the uterus or fibroids is often used as justification for hysterectomy.