Gynaecology for students and practitioners . on. (2) A pessary rarelycures a displacement, its use cannot be discontinued without recur-rence taking place. (3) An operation, suitably planned, involves butslight surgical risks, and is almost invariably successful in preventingrecurrence. It follows that the field of application of a pessary islimited ; a typical instance in which it may be used is a puerperal back- DISPLACEMENTS 579 ward displacement associated with sub-involution. Here the use of apessary for three months may permanently cure the displacement, for inthat time the uterus m
Gynaecology for students and practitioners . on. (2) A pessary rarelycures a displacement, its use cannot be discontinued without recur-rence taking place. (3) An operation, suitably planned, involves butslight surgical risks, and is almost invariably successful in preventingrecurrence. It follows that the field of application of a pessary islimited ; a typical instance in which it may be used is a puerperal back- DISPLACEMENTS 579 ward displacement associated with sub-involution. Here the use of apessary for three months may permanently cure the displacement, for inthat time the uterus may be restored to its normal size and the cause ofthe displacement thus removed. Other instances are cases of sterility,and cases in which the surgeon is in doubt as to whether the symptomsare due to the malposition or not ; here the pessary affords anexperimental test of the relation of the symptoms to the lesion. Pessary-treatment having been decided upon it must be borne inmind that unless the pessary retains the uterus in a satisfactory. Fig. 304. Method of Digital Replacement of a Retrovertbd step, in which the fundus is drawn forwards away from the sacrum,and the cervix pushed upwards and backwards. position, it has failed in its purpose, and must be discontinued. Failureof the pessary to effect this purpose forms one of the strongest indica-tions for operation. Before attempting to replace the uterus preparatory treatment issometimes necessary. It is essential that the lower bowel should beempty, and in patients habitually constipated a course of aperientsmay be necessary ; if the displaced uterus is very tender, replacementwithout an ansesthetic cannot be carried out, owing to the pain which themanipulation causes. The patient may then be sent to bed for a
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
