Operative gynecology : . Fig. 97.—The final step is the production of an extreme ante-position of the fundus, and the insertion of a pack into theupper part of the vagina to hold the cervix up. They 182 UTERINE DISPLACEMENTS AND THEIR Fig. 98. -Hodge or Closed LeverPessary. The posterior bar to the left lies behindthe cervix while the anterior bar lies incontact with the anterior vaginal wall be-hind the symphysis. anism of labor, were wont to imagine. A properly fitted pessary simply splintsthe loose vaginal walls and keeps the cervix well back in the pelvis. If thecervix is held
Operative gynecology : . Fig. 97.—The final step is the production of an extreme ante-position of the fundus, and the insertion of a pack into theupper part of the vagina to hold the cervix up. They 182 UTERINE DISPLACEMENTS AND THEIR Fig. 98. -Hodge or Closed LeverPessary. The posterior bar to the left lies behindthe cervix while the anterior bar lies incontact with the anterior vaginal wall be-hind the symphysis. anism of labor, were wont to imagine. A properly fitted pessary simply splintsthe loose vaginal walls and keeps the cervix well back in the pelvis. If thecervix is held far enough back, the fundus can not get behind it, and prac-titioners, acting on this fact, are apt to err by inserting a large, long pessary,which makes strong posterior pressure. Such an instrument is often painful in introduction and uncomfortable whileworn; moreover, it may ulcerate the pos-terior vaginal wall even to the extent ofcutting through it, and, if tolerated, iteventually stretches the vagina. The rules for the choice and the appli-cation of a pessary are: (1) It must be asnug, easy fit in the vagina, not looseenough to wobble about and not tightenough to make pressure at any point;(2) it must stay in place, and there mustbe
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