. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... kwald, inwhich the cervix is first divided by a transverse incision into an an-terior and posterior lip ; a wedge-shaped piece is then removed fromeach (see Fig. 39), and the flaps of each lip are brought togetherwith sutures, either of silkworm gut, catgut, or silver wire. Stenosis of the Cervix. What is the etiology ? It may be either congenital or acquired. When congenital, it isusually associated with a small uterus, long cervix, and of the externa
. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... kwald, inwhich the cervix is first divided by a transverse incision into an an-terior and posterior lip ; a wedge-shaped piece is then removed fromeach (see Fig. 39), and the flaps of each lip are brought togetherwith sutures, either of silkworm gut, catgut, or silver wire. Stenosis of the Cervix. What is the etiology ? It may be either congenital or acquired. When congenital, it isusually associated with a small uterus, long cervix, and of the external os is more frequent than of the whole canal. LACERATION OF THE CERVIX. 163 Acquired stenosis results from cicatrization following the use oftoo strong caustics, endocervicitis, or a too complete closure of tliecervical canal in a trachelorrhaphy. What are the symptoms ? D^^smenorrhoea and sterility The stenosis results in an insufficientdrainage of the cervical canal. The retained secretion gives rise toan endocervicitis which, rather than the stenosis, is to be consideredthe direct cause of the sterility. Fig. Marckwalds method of splitting the cervix into an anterior and posterior lip andthen uniting cervical to vaginal mucous membrane {Schroeder). What is the treatment ? Dilate the ceiTix with one of the glove-stretcher dilators andmaintain the dilatation by the occasional introduction of graduatedsounds. Iodoform gauze packing may be used for the first fewdays following the dilatation of the canal. Laceration of the Cervix. What is the etiology ? The usual cause is parturition or abortion ; it occasionally occursas a result of mechanical dilatation of the cervix. It occurs in par-turition in about 32 per cent, of women ; especially in tedious, pre- 164 ESSENTIALS OF GYNECOLOGY. cipitate or instrumental deliveries. It is jn-edisposed to by a rigidOS, faulty presentation or condition of the foetus, premature ruptureof the membranes and previous disease of the cervix. W
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