. Atlas and epitome of gynecology . in lichen. DIAGNOSIS. 75 Diagnosis.—The presence or absence of a flexion isfirst determined bimanually, and then the cause of the dis-placement is ascertained. The changed position of theuterus is quite frequently combined with retroversion(Plate 17, 2), elevation (Plate 14, 4), or both (Plate 16,1). Extra-uterine pregnancy must be excluded if tumorsof the adnexa or of Douglas pouch are present. Thesound is to be employed only after the position of thebody of the uterus has been accurately determined. It isclear from the foregoing that an exact differential
. Atlas and epitome of gynecology . in lichen. DIAGNOSIS. 75 Diagnosis.—The presence or absence of a flexion isfirst determined bimanually, and then the cause of the dis-placement is ascertained. The changed position of theuterus is quite frequently combined with retroversion(Plate 17, 2), elevation (Plate 14, 4), or both (Plate 16,1). Extra-uterine pregnancy must be excluded if tumorsof the adnexa or of Douglas pouch are present. Thesound is to be employed only after the position of thebody of the uterus has been accurately determined. It isclear from the foregoing that an exact differential diag-nosis, especially of the tumors of Douglas pouch (see ), must be made. In uncomplicated changes of posi-tion both vaginal vaults retain their normal form andrelations ; the position of the vagina, on the contrary, ischanged, its curve being lessened and its walls beingplaced under greater tension (anteriorly in antepositio). The treatment consists in the removal of tumors andthe extension of cicatricial bands by massage.
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