The History of Uterine Fibroids
Uterine fibroids, also called fibroid tumors, fibromyomas, myoma or leiomyomas, are non-cancerous tumors that develop in a woman’s uterus. This condition affects approximately 1 in 4 women. However, many women with uterine fibroids do not experience any symptoms.
When were uterine fibroids discovered?
In the period of Hippocrates in 460-375 B.C., this lesion was known as the “uterine stone”1. Galen called this finding “scleromas” during the second century of the Christian
period1. The term fibroid was coined and introduced in 1860 by Rokitansky and in the 1863 by Klob1.
In 1854, a German pathologist named Virchow demonstrated that these neoplasms (fibroids) were composed from smooth muscle cells2. It was Virchow who introduced the word “myoma”2.
Historical treatments for uterine fibroids
In 1809, Danville, USA, the first laparotomy was performed consequent to an indication of myoma3. Mrs. Jane Todd Crawford, President Abraham Lincoln’s cousin, was 56 years old when she had an abdominal distention and appeared as if she was pregnant with twins. Laxatives, enemas and phytotherapy were first given as treatments to relieve the distention and volume in the abdomen1. A surgeon named Ephraim Mcdowell performed a laparotomy to remove the ovarian cyst containing complex content and when it was analyzed. It was known to be a pediculate leimyoma4.
The first successful operation of uterine fibroids through myomectomy was performed in 1840 by Jean Zuléma Amussat of Paris5. In 1842, Amussat reported two submucous fibromyoma cases in which vaginal myomectomies were performed5. Later, Dr. Washington Atlee from Pennsylvania was recognized as the first who performed a successful abdominal myomectomy operation that appeared in the American Journal of Medical Science in 18456.
In 1853 Gilman Kimball of Massachusetts conducted the first deliberate myomectomy after diagnosing his patient with uterine fibroids5. He is also the first doctor to successfully perform a hysterectomy for the purpose of removing uterine fibroids 7.
Myomectomy was abandoned until 1922 when British surgeon Victor Bonney, invented the Clamp for myomectomy in an attempt to decrease intra-operatory bleeding1. By 1930, Victor reported 403 myomectomy cases with minimal fatalities1.
As medical knowledge evolved so did the treatment methods for uterine fibroids.
What treatment methods are in place now?
Today, technology has advanced and there is a commercial treatment available for uterine fibroids with a very quick recovery time as there is no cutting, no general anesthesia and no hospital stay. This outpatient procedure uses Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) which ablates the fibroids by using high intensity focused ultrasound waves (HIFU).
This non-invasive procedure destroys fibroids in the uterus without damaging the surrounding tissues. With this procedure, the woman’s uterus remains intact.
Hysterectomy remains to be the most common treatment for large fibroids. This procedure requires the patient to stay admitted in the hospital with a recovery period of up to six weeks. Hysterectomy involves the surgical removal of the uterus (womb) and may also involve the removal of the fallopian tubes, ovaries and cervix. Following this operation women no longer have periods, are no longer fertile and cannot bear children.
Uterine Artery Embolization is a newer approach for managing uterine fibroids. A radiologist makes a small incision on the skin of the groin area to insert a catheter into the artery. Then very tiny particles are injected in the catheter to block the supply of blood feeding the fibroid tumor. This causes the fibroid to shrink. The recovery time for this procedure is one week.
Read about the different treatment options for uterine fibroids.
1. Nilo Bozini; Edmund C Baracat, Division of Ginecology - Medical School of University of São Paulo. The history of Myomectomy at the Medical School of University of São Paulo
Clinics vol.62 no.3 São Paulo 2007
2. Siskin, G. (2009, NY) Thieme Medical Publishers Inc.
Interventional Radiology in Women's Health. pp 27
3. Hysterectomy: A historical perspective (1997) Bailliere's Clinical Obstetrics and Gynaecology, 11 (1), pp. 1-22. http://www.sciencedirect.com/science?_ob...
4. Drife, J., Magowan, B.(2004) Clinical obstetrics and gynaecology. pp10
5. Leda J. Stacy, M.D. (1933) The Treatment of Uterine Fibromyomas. Radiological Society of North America: February 1934 Radiology, 22, 212-218.
6. American Journal of the Medical Sciences: April 1845 - Volume 18 - Issue - ppg 309-335 ART. III.-Case of successful Extirpation of a Fibrous Tumour of the peritoneal surface of the Uterus by the large peritoneal section.
7. Rutkow, I. (1992) The History of Surgery in the United States, 1775-1900, Vol II
pp 102 http://books.google.com/books?id=pGQ0YB7yLy4C&lpg=PP1&pg=PA102#v=onepage&q&f=false