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Treatment of benign uterine hemorrhages in women over forty with special consideration of symptoms of abolished function
GRUNDFAST AND SCHENCK :
O~ARIAS
I’REGSAIUCT
715
Postopeuuti~ue C:ocllsc.-The patient’s condition improved immediately after operation, and she made an uneventful recovery. She was ~lischarged on Nov. 5, 1938, on the fourteenth day after operation. T’nthokryic A’eport.-Gross : The specimen consistetl of the right Fallopian tube measuring S 1)~ 0.4 cm. with the attached right ovary. The tube was normal am1 tlw fimhriatecl em1 patent. The ovary measuretl 4 by 3 liy 2 cm. The external srdare was yellow am1 gyrate am1 hat1 a cystic l~emorrhagic protrusion at one pole, measuring 1.3 cm. in (liameter am1 filled with clottell blood. The cut surfacer of the OVilI'y were gray streaked with brown am1 containetl cystic areas up to 3 em. in Ilianieter fIllr11 with light 1)rovv-n ma~rrial and snrroundell lly a thick yellow XLLVY rim. ,IIi~~o,sr~pic~.--At one entl of the specimen there was a broad lumen, containing oltl ant1 more recently rxtravasatell 1110011 ant1 strands of young fibroblasts. Scattrretl in the 1~100~1 clots were well-formed chorionic rilli with preserved Langhans am1 syncytial cells. .4ttached to some of the chorionic villi were sheets of decidnxl cells. Scattered within them were numerous syncytial giant cells. Part of the lumen was lineil by a single row of fat cells resting on a normal baml of hyalinizetl fibrous r~onnective tissue am1 part of it linetl Ily many rows of vvell-preserved, larger irregular lutein cells. Beyontl this was a broa~l band of normal ovarian stroma with old and more recent corpora albicantes and small follieular cysts. In lmxes synrytial giant, cells were seen extruding into the corpus luteum that formetl part of the wall X preparation from another corpus luteum that was seen grossly of the lumen. \vithin the ovary showed a* irregular lumen, containing old ant1 more recently rxtravasatetl hloo~l, and was lined by many rows of well-preservell lutein ~11s. These were irregular with abumlant granular cytoplasm ant1 large vesicular nuclei, am1 reseml~lrtl in appearawe cells noted in previous sections of corpus luteum. Bordering this was a band of ovarian stroma and old ant1 more recent corpora alhicantes The microscopic sections of the right tube were an11 small am1 large follicular cysts. normal am1 showe11 no trophoblastie elements. I)iclg)rosi,s.-Intrafollicular pregnancy of the right ovary witlr two corpora lutea of Iwgnancy.
Pinkert, With Gynak.
M. : Treatment of Benign Uterine Hemorrhages in Women Over Forty Special Consideration of Symptoms of Abolished Function, Arch. f. 168:
309,
1939.
The author discusses the nature of uterine hemorrhages and the irregularity so frequently found in women past forty. He discusses also the symptoms of abolished function of the uterus and ovaries, emphasizing the severity of the symptoms which He emphasizes the absence of arise from roentgen castration or radium therapy. surgically with preservation such symptoms when such a tliseasetl uteru. il is removed He believes that vaginal hysterectomy is superior to irradiation of the ovaries. The castration because of the ability to maintain and continue ovarian function. Irradiation entails less same is true for abdominal hysterectomy for larger tumors. risk and definitely? lowers mortality and morbidity. In spite of this and in spite of the fact that the author was one of the first, to use roentgen treatment for fibroids and metropathia, he now resorts to this form of treatment only occasionally He has definitely arrived at the conclusion and only for the specially selected case. higher morbidity that surgery is the metholl of choice in spite of the somewhat and mortality.
RALPII A. Rsrs.
O~ARIAS
I’REGSAIUCT
715
Postopeuuti~ue C:ocllsc.-The patient’s condition improved immediately after operation, and she made an uneventful recovery. She was ~lischarged on Nov. 5, 1938, on the fourteenth day after operation. T’nthokryic A’eport.-Gross : The specimen consistetl of the right Fallopian tube measuring S 1)~ 0.4 cm. with the attached right ovary. The tube was normal am1 tlw fimhriatecl em1 patent. The ovary measuretl 4 by 3 liy 2 cm. The external srdare was yellow am1 gyrate am1 hat1 a cystic l~emorrhagic protrusion at one pole, measuring 1.3 cm. in (liameter am1 filled with clottell blood. The cut surfacer of the OVilI'y were gray streaked with brown am1 containetl cystic areas up to 3 em. in Ilianieter fIllr11 with light 1)rovv-n ma~rrial and snrroundell lly a thick yellow XLLVY rim. ,IIi~~o,sr~pic~.--At one entl of the specimen there was a broad lumen, containing oltl ant1 more recently rxtravasatell 1110011 ant1 strands of young fibroblasts. Scattrretl in the 1~100~1 clots were well-formed chorionic rilli with preserved Langhans am1 syncytial cells. .4ttached to some of the chorionic villi were sheets of decidnxl cells. Scattered within them were numerous syncytial giant cells. Part of the lumen was lineil by a single row of fat cells resting on a normal baml of hyalinizetl fibrous r~onnective tissue am1 part of it linetl Ily many rows of vvell-preserved, larger irregular lutein cells. Beyontl this was a broa~l band of normal ovarian stroma with old and more recent corpora albicantes and small follieular cysts. In lmxes synrytial giant, cells were seen extruding into the corpus luteum that formetl part of the wall X preparation from another corpus luteum that was seen grossly of the lumen. \vithin the ovary showed a* irregular lumen, containing old ant1 more recently rxtravasatetl hloo~l, and was lined by many rows of well-preservell lutein ~11s. These were irregular with abumlant granular cytoplasm ant1 large vesicular nuclei, am1 reseml~lrtl in appearawe cells noted in previous sections of corpus luteum. Bordering this was a band of ovarian stroma and old ant1 more recent corpora alhicantes The microscopic sections of the right tube were an11 small am1 large follicular cysts. normal am1 showe11 no trophoblastie elements. I)iclg)rosi,s.-Intrafollicular pregnancy of the right ovary witlr two corpora lutea of Iwgnancy.
Pinkert, With Gynak.
M. : Treatment of Benign Uterine Hemorrhages in Women Over Forty Special Consideration of Symptoms of Abolished Function, Arch. f. 168:
309,
1939.
The author discusses the nature of uterine hemorrhages and the irregularity so frequently found in women past forty. He discusses also the symptoms of abolished function of the uterus and ovaries, emphasizing the severity of the symptoms which He emphasizes the absence of arise from roentgen castration or radium therapy. surgically with preservation such symptoms when such a tliseasetl uteru. il is removed He believes that vaginal hysterectomy is superior to irradiation of the ovaries. The castration because of the ability to maintain and continue ovarian function. Irradiation entails less same is true for abdominal hysterectomy for larger tumors. risk and definitely? lowers mortality and morbidity. In spite of this and in spite of the fact that the author was one of the first, to use roentgen treatment for fibroids and metropathia, he now resorts to this form of treatment only occasionally He has definitely arrived at the conclusion and only for the specially selected case. higher morbidity that surgery is the metholl of choice in spite of the somewhat and mortality.
RALPII A. Rsrs.