A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
This comparatively favorable course condemns the woman to a life of
invalidism, more or less marked, during the years that should be the
most useful and active of her existence. The menopause may be delayed
for five, ten, or fifteen years, or it may be indefinitely postponed;
and even after the menopause has occurred, in a certain number of cases
the fibroid, contrary to the usual rule, continues to grow, and may
ultimately cause death.
=Treatment of Fibroid Tumors of the Uterus.=--Operative treatment
is usually demanded in the case of fibroid tumors. A few years ago
the treatment usually advised was palliative and expectant. The
imperfect technique rendered operations for this disease so fatal
that it was considered safest for the woman to allow the tumor to
pursue its natural course, hoping that, if small and single, it would
be discharged as a polyp, or that it would grow slowly and would
atrophy at the menopause, the physician meanwhile relieving as much as
possible, by palliative treatment, the symptoms that presented before
this favorable termination.
Many women, following this advice, have suffered through the years of
active life, and have finally found relief and cure when the menopause
was reached; others have started upon this dreary course, and have
died from some of the accidents incident to these tumors; still others
have passed through these years of suffering, and then have found the
hoped-for goal vanished, the menopause indefinitely postponed, or the
tumor continuing to grow after this period had been reached.
Many of these women are driven to the operating-table to-day, after
lives that have been wasted by this expectant plan of treatment.
The great majority of fibroid tumors of the uterus demand immediate
operation. The operative technique has been so perfected that the
mortality after operation is very small. The danger of operation is
much less than the dangers to which the woman is exposed from the
various accidents that are liable in this disease.
There are some cases, however, in which immediate operation is not
demanded. In a young woman with a fibroid tumor of small size that is
not causing serious symptoms operation may be deferred and the case may
be watched. This plan is especially desirable if the woman is anxious
to have children. She should be told, however, that conception is less
likely to occur than in the well woman, that she is liable to abort,
and that the tumor will grow more rapidly during her pregnancy. On the
other hand, there is the possibility of its disappearance after labor.
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