Gynaecology for students and practitioners . ealt with by first partly dividing them with scissors, and thenforcibly twisting through the remainder. Fibroid polypi of considerable size may remain ?within the iiterinecavity, and their removal is then more difficult, as the cervix cannotbe sufficiently dilated to allow of their being withdrawn through difficulty may be surmounted in either of two ways : (1) byreducing the size of the polypus before attempting its withdrawal;or (2) by enlarging the cervix, by incising it up to the level of theinternal os ; in the case of large polypi these
Gynaecology for students and practitioners . ealt with by first partly dividing them with scissors, and thenforcibly twisting through the remainder. Fibroid polypi of considerable size may remain ?within the iiterinecavity, and their removal is then more difficult, as the cervix cannotbe sufficiently dilated to allow of their being withdrawn through difficulty may be surmounted in either of two ways : (1) byreducing the size of the polypus before attempting its withdrawal;or (2) by enlarging the cervix, by incising it up to the level of theinternal os ; in the case of large polypi these two methods may be 788 GYNECOLOGY combined, as the cervix cannot be enlarged sufficiently to allow thepolypus to pass. In either case the cervix should be first dilated tothe fullest extent, and the preliminary use of a tent is helpful {see , p. 796). Then the index finger is passed into the uterus andthe size and relations of the polypus are determined. Next, thepolypus is detached by division and twisting of its stalk. A sessile. Fig. 457. Vaginal Myomectomy. -The bladder has been dissected off the cervix and is being held up and protected by a flat rectangular spatula {see Fig. 459). The anterior lip of the cervix, steadied by long ligatures, is about to be divided in the mid-line with scissors. submucous fibroid, such as that shown in Fig. 214, p. 434, may bedealt with by the method next to be described. Vaginal Myomectomy by Morcellement. The foregoing descriptionof how to deal with intra-uterine polypi embraces the main principleswhich underlie the operation of vaginal myomectomy. A fullerdescription is necessary of the method of dealing with large submucous VAGINAL MYOMECTOMY 789 myomata by the vaginal route. These tumours frequently slough,and are then accompanied by a putrescent discharge, which rendersany attempt to remove the uterus per abdomen particularly , the cervix is frequently found to be opened up by suchtumours, and their most depen
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
