. A manual of gynæcology and pelvic surgery, for students and practitioners. uct and may extend deeply into thepara-vaginal structures at the lateral vaginal fornices. Extir-pation may be difficult and bloody, and if it becomes apparentthat complete removal is too formidable the cyst should beincised, as much of its wall removed as possible, and the cavityforced to heal from the bottom by constant gauze packing. Injuries.—Injuries to the vagina may be produced by violenceor the introduction of foreign bodies, and are to be treated on VESICO-VAGINAL AND RECTO-VAGINAL FISTUL^E 167 general surgic
. A manual of gynæcology and pelvic surgery, for students and practitioners. uct and may extend deeply into thepara-vaginal structures at the lateral vaginal fornices. Extir-pation may be difficult and bloody, and if it becomes apparentthat complete removal is too formidable the cyst should beincised, as much of its wall removed as possible, and the cavityforced to heal from the bottom by constant gauze packing. Injuries.—Injuries to the vagina may be produced by violenceor the introduction of foreign bodies, and are to be treated on VESICO-VAGINAL AND RECTO-VAGINAL FISTUL^E 167 general surgical principles by suture, drainage when indicated,etc. Puerperal injuries due to laceration or cutting with forcepsblades need no special comment as they are repaired in con-nection with repair of the injuries to the vaginal outlet withwhich they are associated. VESICO-VAGINAL AND RECTO-VAGINAL FISTULA Puerperal injuries due to sloughing, however, are of quiteanother type, and it was in an effort to cure these that J. MarionSims laid the foundation of modern Fig. 74.—Remote result of sloughing of recto-vaginal septum. Recto-vagina^ fistula. Lacerations through the vaginal wall extending into thebladder usually heal even if unrepaired, and similar injuries ex-tending into the rectum sometimes follow the same course, butsloughing and loss of tissue render healing impossible in theevent that either bladder or rectum are involved. It follows,therefore, that vesico-vaginal and recto-vaginal fistulas occur- 168 DISEASES AND INJURIES OF THE VAGINA ring at the time of labor may heal without intervention, but suchfistulas are likely to remain permanent if they have their incep-tion several days later, when they are due to necrosis andsloughing. The etiology of both vesico-vaginal and recto-vaginal fistulasis the same; sloughing brought about by pressure necrosis dueto great prolongation of the second stage of labor. While thiswas a common accident when the obstetric fo
Size: 1727px × 1446px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
