| Abstrakt: |
With advancing sexual age, the Fallopian tubes undergo certain changes consisting, first of all and most typically, of a marked hypertrophy and sclerosis involving the connective tissue of the folds. Later, there is also a replacement of ciliated epithelium by nonciliated and flatter cells. This sclerosis was noted in a high proportion (45 per cent) of cases with uterine leiomyofibromas. But the occurrence had little or no relationship to the size of the tumors. Moreover, an investigation of a like number of cases, which corresponded in all particulars except for the absence of even tiny fibroids, showed the condition in approximately the same proportion, the incidence increasing in both series with advancing age. Sclerosis of the Fallopian tubes showed no relationship to the history regarding previous pregnancies. The incidence of the condition was increased with the development of irregularities and anomalies of menstruation, and this was most marked with the onset of the climacteric and afterwards. The same tendency was noted also with the histologic evidences of sex hormone diminution. However, both here and with the menstrual changes there were definite exceptions to the general rules. Examination of a small series of tubes associated with pregnancy showed that sclerosis is occasionally present, and therefore it (or its cause) is not an absolute barrier to pregnancy. Left unanswered, however, were such questions as its possible role as a relativefactor in sterility and also as a cause of tubal pregnancy. An interesting point incidental to the main purpose of this study was the discovery of such a high frequency of leiomyofibromas of the uterus in the material from Harper Hospital as to cast doubt on statistical studies which apparently indicate a relationship between fibroids and certain other conditions, particularly carcinoma of the uterine fundus. |
