Gynecological diagnosis . of prolapse; therefore prolapseis found most frequently among women of the working women are apt to get up and begin work soon after con-finement when the uterus is large and heavy and retroverted. Inversion of the vagina may take place without actual descentof the uterus because of the elasticity of the vagina, and, prolapsemay be simulated by elongation of the lower uterine segment. DESCENT OR PROLAPSE 225 True hypertrophic elongation of the cervix, a lengthening of thecervix and the lower segment of the uterus, is by no means anuncommon condition. In
Gynecological diagnosis . of prolapse; therefore prolapseis found most frequently among women of the working women are apt to get up and begin work soon after con-finement when the uterus is large and heavy and retroverted. Inversion of the vagina may take place without actual descentof the uterus because of the elasticity of the vagina, and, prolapsemay be simulated by elongation of the lower uterine segment. DESCENT OR PROLAPSE 225 True hypertrophic elongation of the cervix, a lengthening of thecervix and the lower segment of the uterus, is by no means anuncommon condition. In such a case, should the utero-sacralligaments, which ordinarily limit the amount of the descent of theuterus, prove to be strong and not susceptible of stretching, thefundus uteri may remain nearly at its normal level while the exter-nal os presents at the introitus vaginae. A typical case of true hyper-tropic elongation of the cervix was reported by Huguier (Memoiresur les Allongements Hypertrophiques du Col de FUterus,. Fig. 88a.—Hypertrophic Elongation of the Cervix in the Virgin. 1860, p. 40) as long ago as 1860. A woman twenty-three years ofage, of poor general health and physique, married two years butnever pregnant, presented herself for treatment because of pain-in the abdomen, dyspareunia, and a tumor in the opening of thevagina. Catamenia began at thirteen and she noticed the pro-jection at the vulva at fourteen and a half years. It came outwhile she was standing or straining and was reduced on lyingdown. Examination showed the vagina only a little shortened andoccupied by the enlarged cervix; fundus uteri only a trifle below its15 226 MALPOSITIONS OF THE UTERUS normal situation; and the uterine cavity measured five inches (13centimeters) in depth. Prolapse is largely a disease of women who have borne is most common after the menopause when the utero-sacralligaments are prone to be fatty degenerated, the other supportsof the uterus have lost their tone,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
