FACT SHEET covering top issues on fibroids
- 1Fibroids are a hormone dependent tumor – both estrogen and progesterone is necessary for the fibroid to grow
- 2Women may begin to develop fibroids as young as the early twenties
- 3Fibroids may cause reproductive problems
- 4Some fibroids grow in multiple numbers they often look like a single fibroid due to their tendency to grow in a cluster
- 5The most common symptom of fibroids is abnormal periods
History of the Myomectomy
Fibroids have been detected in the female uterus for centuries. Using radiographic techniques the Egyptology Department of the English Museum in London detected calcified pelvic masses in mummies, which are suggestive of fibroids.
The ancient Greeks also were aware of the presence of fibroids, with Hippocrates (460-375 B.C.) referring to the tumors as ‘uterine stones’. In the second century of the Christian era, Galen described the fibroids as ‘scleromas’, which medieval texts refer to women who “used to expel bird eggs from their vaginas”. These texts were likely referring to fibroids, however at the time; women suffering from these tumors were accused of being possessed by devil spirits.
The term ‘fibroid’ was introduced by Rokitansky in 1860 and Klob in 1863; however it was a famous German Pathologist, Virchow, demonstrated that these tumors originated from the uterine smooth muscle. Thus, the term “myoma” became current in clinical use.
The first laparotomy, which points to the removal of fibroids, was performed in 1809 in Danville, USA. The surgeon, Ephraim McDowell, performed the surgery on Mrs. Jane Crawford, the cousin of President Abraham Lincoln. It was thought Mrs. Crawford was pregnant with twins, a fact which was not common at the time, as she had an increase of the abdominal volume and respiratory insufficiency. When McDowell operated on her, he removed a large ovarian cyst with a complex content. After the ‘cyst’ was analyzed it was determined it was a fibroid.
The first abdominal myomectomy was done by Dr. Jean Zulema Amussat in France 1840 and just four years later Washington Atley performed a myomectomy in the United States. Atley followed up his success with the first scientific report of a uterus conserving myomectomy, which was published in 1845 in the American Journal of the Medical Science. This article caused widespread excitement among surgeons due to the possibility of preserving the uterus while still removing the fibroids. Eight years later in 1853, Gilman Kimball performed the first deliberate myomectomy after he diagnosed his patient with fibroids. Kimball is also recognized as the first doctor to successfully perform a hysterectomy for the purpose of removing uterine fibroids.
In 1898, Alexander Adams presented 11 cases of myomectomy through an abdominal route. However as the cases he was describing were much more complex than had previously been described his presentation was not received well by the audience who believed the hysterectomy was the safest procedure.
This caused the myomectomy to be abandoned until 1922 when Victor Bonney, a British surgeon, invented the clamp for myomectomy as a way of decreasing intra-operatory bleeding. By 1930, Bonney had performed the myomectomy 403 times with very few fatalities.
Medical treatment has continued to evolve over the years, making treatment for fibroids much more advanced and today is one of the most common surgeries performed on women.