. Atlas and epitome of gynecology . of the perineum, sometimes involving the anus,the anterior portion of the frsenulum perinsei being leftintact. 6. Lacerations of the perineum of the third degree, orcomplete lacerations : the tear extends into the rectum. While all these tears are brought about, almost withoutexception, by incidents of the sexual life (cohabitation,delivery, and the puerperium—urethral fissures from cathe-terization), the parts of the vulva are also exposed to othertraumatisms. These are followed by serious results, espe-cially if occurring during pregnancy, when the parts a
. Atlas and epitome of gynecology . of the perineum, sometimes involving the anus,the anterior portion of the frsenulum perinsei being leftintact. 6. Lacerations of the perineum of the third degree, orcomplete lacerations : the tear extends into the rectum. While all these tears are brought about, almost withoutexception, by incidents of the sexual life (cohabitation,delivery, and the puerperium—urethral fissures from cathe-terization), the parts of the vulva are also exposed to othertraumatisms. These are followed by serious results, espe-cially if occurring during pregnancy, when the parts arevery vascular. The region of the clitoris is the mostexposed to wounds, which are usually caused by fallingastride of some object. It is also the most dangerousregion, as patients have bled to death in a short time fromhemorrhage from the corpus cavernosum. Hemorrhages and injuries of this character must betreated immediately by suture. Lacerations and perforations of the nymphse are notproductive of further consequences. CO ^v. SY3IPT0MS. —SEQ UELS. 157 Symptoms and Consequences of Perineal Lacera-tions.—If primary union is not obtained by immediatesuture after delivery, these wounds heal by granulation, thelower portions of the labia being drawn apart and dis-torted. / Fissures cause only a burning, and may induce infectious/ulceration ; they may nevertheless be produced in a peri-neal cicatrix as rhagades (after coitus, difficult defecation). In perineal lacerations of the first degree (Plate 54,Fig. 3) the tuberculum vaginae loses the covering and sup-port of the frenulum perinsei. This portion of the anteriorvaginal wall prolapses ; the urethral orifice gapes ; x thereis a predisposition to urethritis and vesical catarrh. In perineal lacerations of the second degree the posteriorvaginal wall prolapses from above the scar (see Plate 27);and if the entire pelvic suspensory apparatus, includingthe pelvic fascia and the levatores ani muscles, has lost its tonus/ all th
Size: 1373px × 1819px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidatlasepi, booksubjectwomen
