1. Forty women were in the child-bearing period of life and married; many of them were multiparæ.
2. Twenty were single women and probably capable of bearing children in a favouring environment.
3. The remainder were spinsters or barren wives.
A significant feature in the after-history of ten of these women is the fact that some years later other fibroids grew in the uterus, and hysterectomy became a necessity on account of menorrhagia in seven of them; of these, two died from the operation, which was difficult and tedious. One patient was operated upon two years after the myomectomy, and had borne a child in the interval, and the other seven years.
The last fact to mention is that one patient, from whom a submucous fibroid had been enucleated from the cavity of the uterus (hysterotomy), died four years later from cancer arising in the body of the uterus (see [p. 51]).
Olshausen has recently considered this question, and indicates that the chief objection to the abdominal enucleation of uterine fibroids is its high mortality.
He furnishes a table of 563 cases, collected from twelve operators, including himself; of these 59 patients died, representing a mortality of 10.5 per cent. Olshausen, in the years 1900–5, performed enucleation on 124 patients with 14 deaths. Eight of the patients subsequently came under notice with recrudescence of fibroids. Christopher Martin has performed abdominal myomectomy 73 times with 1 death.
The question of myomectomy, when fibroids complicate pregnancy and labour, or give trouble after labour, is considered in detail on [p. 78].
References to Reports of Hysterectomy performed for Fibroids in Malformed Uteri
Bland-Sutton, J. Fibroids in a Unicorn Uterus. Clin. Journ., Lond., 1901–2, xix. 1.