Gynecological diagnosis . Fig. 148.—Cystocele. 368 DISEASES OF THE VAGINA wall in chronic cystitis, sub-urethral abscess, and true intestinalhernia of the vagina. Tumor of the anterior vaginal wall does notincrease in size or tension on straining and coughing, it does notdisappear on pressure or on putting the patient in the knee-chestposition, filling the bladder has no effect on the size or elasticityof the tumor, and palpation of a sound in the bladder shows thatthere is something besides the walls of the bladder and vaginabetween the tip of the sound and the examiners finger in thevagina.
Gynecological diagnosis . Fig. 148.—Cystocele. 368 DISEASES OF THE VAGINA wall in chronic cystitis, sub-urethral abscess, and true intestinalhernia of the vagina. Tumor of the anterior vaginal wall does notincrease in size or tension on straining and coughing, it does notdisappear on pressure or on putting the patient in the knee-chestposition, filling the bladder has no effect on the size or elasticityof the tumor, and palpation of a sound in the bladder shows thatthere is something besides the walls of the bladder and vaginabetween the tip of the sound and the examiners finger in thevagina. Hypertrophy of the bladder wall in chronic cystitis to the extentof forming a tumor in the vagina is rare. The diagnosis of cystitisby means of the cystoscope and examination of the urine, together. Fig. 148a.—Diagrammatic Representation of Cystocele. with the symptoms of cystitis, point the way toward a differentia-tion. Palpation of the greatly thickened bladder by the fingerin the vagina will settle the diagnosis. Sub-urethral abscess is diagnosed by placing a sound in theurethra and palpating the tumor in the vagina on the this way it will be plain that the urethra is not involved in thetumor. Besides, there are present in the case of the abscess symp-toms and signs of inflammation, and there is apt to be a minuteopening of the abscess into the urethra through which pus maybe forced on pressure. Anterior intestinal vaginal hernia is a rare condition in which DISPLACEMENTS OF THE VAGINA 369 coils of small intestine occupy a sac formed by a pouch of pro-lapsed peritoneum between the front of the uterus and the pouch projects under the anterior vaginal wall in the samesituation as a cystocele. On pressure a true hernia disappearswith a gurgling sound, it
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
