Gynecology . eir attachment to the cervical stump, on which aportion of the bladder rests as on a shelf. The results of this operation are excellent, there being little danger ofrecurring prolapse of the cervix or anterior wall of the vagina. Recurrence ofthe rectocele has in a few instances been seen requiring re-operation on the OPERATIONS FOR UTERINE MALPOSITION 599 perineum. The recurrence of rectocele may be avoided by applying severalstitches in Douglas fossa in the manner used in the Moschowitz operationfor rectal prolapse (q. v.). If the patient is desirous of having children, the oper
Gynecology . eir attachment to the cervical stump, on which aportion of the bladder rests as on a shelf. The results of this operation are excellent, there being little danger ofrecurring prolapse of the cervix or anterior wall of the vagina. Recurrence ofthe rectocele has in a few instances been seen requiring re-operation on the OPERATIONS FOR UTERINE MALPOSITION 599 perineum. The recurrence of rectocele may be avoided by applying severalstitches in Douglas fossa in the manner used in the Moschowitz operationfor rectal prolapse (q. v.). If the patient is desirous of having children, the operation for moderate pro-cidentia may be done satisfactorily without removing the uterus. The initialsteps of the operation are the same as in that already described—i. e., highamputation of the cervix, anterior colpoplasty, and perineoplasty. Instead ofperforming a supra-vaginal hysterectomy with abdominal fixation of the cervicalstump, it is possible to secure an excellent result by suspending the uterus by. Fig. 303.—Operation for Procidentia (Authors Method).This is an imaginary view of the completed operation, seen from within the abdominal bladder flap has been drawn over and attached by on& catgut suture behind the cervix. If thereis great relaxation of the bladder the flap may be attached much deeper in the culdesac than is shownin the drawing. The two silk sutures shown in Fig. 301 have been introduced into the abdominalwall through peritoneum, muscle, and fascia and tied on the inside, as in the Olshausen operation(Fig. 278). The abdominal wound has been closed. If by an unusual chance this fixation attach-ment should give way, it may be-seen that the broad ligaments form an efficient secondary defenseto prevent prolapse of the cervix and the vaginal vault. the Olshausen method sufficiently high up on the abdominal wall to reduce theprolapse. The dangers as to childbirth, if the patient becomes pregnant, areno greater than after any of the suspensory roun
Size: 1836px × 1361px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdec, booksubjectgynecology, booksubjectwomen
