A Text-book of Diseases of Women

by Charles B. Penrose

The fatty and calcareous changes are not to be considered dangerous forms of degeneration.

The other changes, however, are often attended with great danger to life. The dangers of suppuration and of sarcomatous degeneration are obvious. The edematous fibroid is often of rapid and unlimited growth, and is usually accompanied by profuse hemorrhages from the uterus. The cystic fibroid may grow as rapidly and as large as an ovarian cyst. The telangiectatic tumors grow to large size and are attended by the dangers of thrombosis and embolism.

Cancer of the fundus with fibroid tumor may only be a coincidence, and we will not assume that predisposition to cancer is caused by the fibroid.

The statistics that have been given, however, show that in at least 38 cases out of 205, or in about 18 per cent. of the cases, changes took place in the fibroid that seriously endangered the life of the woman.

Sterility, abortion, and difficult or impossible labor are caused by uterine fibroids. Conception is impeded on account of the displaced, distorted uterus and the hemorrhage and discharge. Abortion is likely to occur, on account of the endometritis and the unequal expansibility and the irritability of the uterus.

Labor is sometimes rendered impossible by the presence of a uterine fibroid that obstructs the pelvis, and Cesarean section has been performed for this cause.

The cause of fibroid tumor of the uterus is unknown. Some authorities consider the condition, or at least the predisposition to the condition, to be congenital. Uterine fibroids have been observed in girls near the age of puberty, and hysterectomy for fibroid has been performed at the age of eighteen.

Usually the disease begins to cause symptoms, and first comes under the observation of the physician, after the thirtieth year. It is very probable that small interstitial or subperitoneal fibroids exist in many women before this period, but, on account of the small size and the position of the growths, they produce no marked symptoms, and if the woman bears children, the tumors are very likely absorbed during the process of uterine involution.

Fibroid tumors occur in both the white and the black races—with somewhat greater frequency in the latter than in the former. Tait says that fibroid tumors of the uterus are unknown among the black women of Africa. The disease is certainly very common among their descendants in this country.

The frequency of uterine fibroids is difficult to determine, for there are many cases in which the disease is unrecognized on account of the small size of the tumor and the absence of symptoms. It is, however, one of the commonest diseases with which women suffer. In a series of 504 celiotomies performed for diseases of women at the University and Gynecean Hospitals, uterine fibroids were found in 85, or in about 17 per cent. of the cases.