. Atlas and epitome of gynecology . laced uponthe mons veneris. 3 and 4. Infantile anteflexion(Plate 15, Fig. 3) of a small organ isoften associated with stenosis of thecervical canal or its external orifice. Puerile anteflexion consists in asharp bending forward of a normal,large, flexible organ, with a shortenedanterior vaginal wall, in the elongatedaxis of which the hypertrophic supra-vaginal cervix is found. Symptoms.—Dysmenorrhea (8)and sterility. Both may be purelymechanical, from the narrowed lumen,or the angle of flexion, especially whenthe latter has become rigid from longduration and
. Atlas and epitome of gynecology . laced uponthe mons veneris. 3 and 4. Infantile anteflexion(Plate 15, Fig. 3) of a small organ isoften associated with stenosis of thecervical canal or its external orifice. Puerile anteflexion consists in asharp bending forward of a normal,large, flexible organ, with a shortenedanterior vaginal wall, in the elongatedaxis of which the hypertrophic supra-vaginal cervix is found. Symptoms.—Dysmenorrhea (8)and sterility. Both may be purelymechanical, from the narrowed lumen,or the angle of flexion, especially whenthe latter has become rigid from longduration and secondary inflammatorychanges. The more frequent cause of both, however, isthe passive hyperemia and the resulting congestive endo-metritis, while the sterility is still further accounted forby the frequent hypoplasia. Diagnosis.—After emptying the bladder the anteflexionis recognized bimanually, the form and direction of thevagina being noted. (Plate 22.) The sound demon-strates the direction of the cervix and the size of its. Fig. 1 The normal length of the uterus, as measured by the sound, is sixcentimeters. INFANTILE ANTEFLEXION 37 lumen,1 whether it is narrowed throughout or at one of itsorifices only, and whether secondary dilatation of the uter-ine cavity or cervical canal has taken place. (Plate 1 5,Fig. 3.) Treatment.—If no other cause for the symptoms exists(an endometritis, for example), the stenosis should be re-moved by dilatation with metal sounds, laminaria tents, oriodoform-gauze tampons every few weeks. A more per-manent result is obtained by making, immediately afterthe period, bilateral transverse incisions, about one centi-meter deep, in the cervical commissures by means ofCoopers scissors. The mucous membrane of the cervicalcanal is then brought into apposition with that of the in-tra vaginal cervix in such a manner that the two rows ofstitches pass from the anterior to the posterior cervical lipand the uterine orifice gapes.
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