. American journal of obstetrics and gynecology. many gynecologists have noticed dilated ureters in casesof procidentia. There has, hitherto, been no general recognition of thefact that the uterine prolapse may bear an etiologic relationship tothe ureter dilatation. The only reference to this fact that has come • at the Forty-eighth Annual Meeting of the American Gynecological Society,Hot Springs. \ May 21-23, 1923. BRETTAUEK AND RUBIN: HYDROURETER AND HYDRONEPHROSIS 697 to our notice is to be found in the anatomic study of genital prolapseby Tandler and Halban. T
. American journal of obstetrics and gynecology. many gynecologists have noticed dilated ureters in casesof procidentia. There has, hitherto, been no general recognition of thefact that the uterine prolapse may bear an etiologic relationship tothe ureter dilatation. The only reference to this fact that has come • at the Forty-eighth Annual Meeting of the American Gynecological Society,Hot Springs. \ May 21-23, 1923. BRETTAUEK AND RUBIN: HYDROURETER AND HYDRONEPHROSIS 697 to our notice is to be found in the anatomic study of genital prolapseby Tandler and Halban. These authors report the incidental findingof 15 instances of dilated ureters out of the 23 autopsies describedby them. Fi-oriep, quoted by Tandler and Halban, mentions a finger-wide dilatation of the ureteis in a case of hypertrophy, elongation ofthe cervix and prolapsus uteri and ani without eystocele. He sup-posed that the dilated ureters resulted from stasis in the bladder andkinking of the urethra. Tandler and Halban observe that, whereas. Pig. 1.—Hydroureter associated with uterine prolapse. Dilatation of almost en-tire length of ureter. Vesical end of ureter remains unchanged. (From Tandlerand Halban, Genital Prolapse, Vienna. 1907.) Froriep regarded this pathologic association between uterus andureters as exceptional, their own investigation proved that ureteraldilatation and hypertrophy so frequently accompanied the prolapseas to constitute it a typical finding. Hirokawa in 1911 described twocases of genital prolapse in which ureter dilatation was noted atautopsy and discussed the relation between these two conditions. The ureter dilatation was as wide as a finger (Fig. 1) in five of thecases described by Tandler and Halban, but, as a rule, varied withthe size of the eystocele. According to these authors the dilatation 008 THE AMERICAN JOIRXAL OF OBSTETRICS AND GYNECOLOGY ot the ureters is, generally, proportionate to the size of the the latter is sli
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