. Clinical gyncology, medical and surgical. bladder are guarded from injury by a finger in one and a soundin the other. The uterus, when it is readied,is punctured, if necessary, with a largetrocar, and the opening is at once furtherdilated by incisions with a blunt-pointedbistoury on either side of the trocar. Theartificial vagina is kept open with greatdifficulty after such an operation. Thebest means, perhaps, is to transpose a flapof skin from the buttock into the vagina,sewing its ends, if possible, to the and frequent artificial dilatationwith cylindrical dilators must
. Clinical gyncology, medical and surgical. bladder are guarded from injury by a finger in one and a soundin the other. The uterus, when it is readied,is punctured, if necessary, with a largetrocar, and the opening is at once furtherdilated by incisions with a blunt-pointedbistoury on either side of the trocar. Theartificial vagina is kept open with greatdifficulty after such an operation. Thebest means, perhaps, is to transpose a flapof skin from the buttock into the vagina,sewing its ends, if possible, to the and frequent artificial dilatationwith cylindrical dilators must follow. Inspite of all efforts, however, the artificialopening may close again, or may becomeso contracted as to oppose a serious mechanical obstacle to the escape ofthe menstrual fluid. In one case, quoted by Pozzi, temporary successwas attained after making; the artificial vagina bv electrolvsis; but it isdoubtful if the ultimate results of this treatment are any better than thosethat follow frequent and persistent mechanical Occlusion of the ?A B, transverse Fig. 21. Fig. 22.
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