[Uterine myoma in geriatric surgical cases (author's transl)]

The following is a report on 189 cases involving surgical treatment of uterine myoma in women who were at least 60 years old. The cases were collected from 18 gynecological departments in West-Berlin over a 10-year period (1960-1969). 66 of these patients (38,1%) have never been pregnant, 17 (9,8%) had only abortions, while 90 (52,1%) had given birth to one or more children. In only 89 women (47,0%) the pre-operative diagnosis had been uterine myoma. The number of correct diagnosis prior to surgery decreased with increasing age of the patients. 47 patients had been completely asymptomatic; an additional 20 had shown no gynecological symptoms. Total hysterectomy including removal of the tubes and ovaries, which we consider the preferential method of treatment, was done in 105 cases (55,5%). Other surgical procedures were performed in 84 instances (44,5%). 8 registered deaths equal a post-operative mortality rate of 4,2%. Analysis of our cases contradicts the hypothesis regarding postmenopausal involution of uterine myoma. Removal of the uterus for myoma should not be considered a typical geriatric gynecological operation. In many instances it could have been performed at an earlier date; in some cases it even could have been avoided if all diagnostic procedures presently available had been utilized.