Uterine Myomata: 50 Years of Progress in Gynecology

In 1930, with the creation of the American Board of Obstetrics and Gynecology, our discipline of Obstetrics and Gynecology officially became a medical specialty. Many factors led to the development of gynecology and gynecologic surgery as distinct from general medical care and surgery. Few gynecologic disorders made as substantial an impact on this emerging field as uterine leiomyomata. These tumors were frequently detected and their potential to lead to major clinical problems still continues to play a prominent role in the provision of gynecologic care.

Surgery is the dominant method of treating women with symptomatic uterine leiomyomata. For almost 100 years, at least through the 1970s, treatment for women with markedly symptomatic leiomyomata was limited to major surgery and by 1 of 2 routes (vaginal or abdominal hysterectomy or myomectomy).

The past 50 years have witnessed a significant increase in management options for women with leiomyomata. Newer medical and minor surgical options have reduced the need for major surgery which, when indicated, can often be performed by minimally invasive routes (laparoscopic or transvaginal/transcervical).

Dr. Emad Mikhail (MD) is the director of Minimally Invasive Gynecologic Surgery at the University of South Florida Morsani College of Medicine. There, he has developed a specialized clinical service for women with uterine leiomyomata, which is the subject of the Special Topic in this issue. Dr. Mikhail has recruited an outstanding group of experts on the various management options for these patients, as are described and discussed in their articles.

I hope you find the Special Topic and the other excellent articles in this issue informative and of value to your practice.