Treatise on gynæcology : medical and surgical . it in retroversion, declared that therewas here some danger to the adjacent peritoneum. With the same object a transverse fold of the vagina has beensutured in such a way as to shorten one or the other wall of the canal;Sims performed this three times for anteversion. Richelot, Sr.,4s has proposed to consolidate the cervix with theposterior wall of the vagina, and Byford49has performed an analo- DISPLACEMENTS OF THE UTERUS. 457 gous metro-elytrorrhaphy in patients who had passed the ,uniting the anterior vaginal wall on the anterior sur
Treatise on gynæcology : medical and surgical . it in retroversion, declared that therewas here some danger to the adjacent peritoneum. With the same object a transverse fold of the vagina has beensutured in such a way as to shorten one or the other wall of the canal;Sims performed this three times for anteversion. Richelot, Sr.,4s has proposed to consolidate the cervix with theposterior wall of the vagina, and Byford49has performed an analo- DISPLACEMENTS OF THE UTERUS. 457 gous metro-elytrorrhaphy in patients who had passed the ,uniting the anterior vaginal wall on the anterior surface of the cervixwith the posterior wall of the vagina. Doleris50 practised pre- orretro-cervical colporrhaphy in similar cases, after having reduced thedisplacement. When the anterior vaginal wall appears too short, Skutsch51 pro-poses to lengthen it by a transverse incision, which is then suturedlongitudinally. Schiicking32 fixes the fundus of the uterus to the vesico-uterinecul-de-sac by means of a double-threaded, strongly-curved needle. Fig. 248.—Vaginal Hysteropexy. Schuckings Operation. cachee, introduced into the replaced and dilated uterus, with which hepierces the vaginal fundus and vaginal pouch below the bladder, tyingthe suture so as to have the uterus in an exaggerated position of an-teflexion. The suture is removed from the tenth to the fourteenth day,when the exaggerated anteflexion disappears. In spite of reportedsuccesses, this adventurous procedure does not seem to me worthy ofrecommendation. Yon Eabenau53 has proposed to incise the cervix, then to open theanterior vaginal pouch and separate the bladder from the uterus bya dull instrument; the anterior wall of the uterus is then excisedfor a distance of four centimetres and the wound sutured. This opera-tion has been imitated by Schmidt,54 of Cologne. Fraenkel55 hasjustly observed that the cervix is so strongly drawn forward by thecicatricial process that the body of the uterus tends to fall backward. 458
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