. Diseases of women. A clinical guide to their diagnosis and treatment. in a handle through the vaginal mucous miem- brane and underlying fibrous and cellular tissue, entering it through the mucous membrane close to the incision, at a point corresponding to the stitch nearest the internal os, and taking up a good bundle of cellular tissue. When the eye of the needle is visible, thread it with the corresponding end of the uterine stitch, and withdraw it. Repeat this on the opposite side. Bring the other two uterine stitches in the same way through the vagina. When this has been done, the three
. Diseases of women. A clinical guide to their diagnosis and treatment. in a handle through the vaginal mucous miem- brane and underlying fibrous and cellular tissue, entering it through the mucous membrane close to the incision, at a point corresponding to the stitch nearest the internal os, and taking up a good bundle of cellular tissue. When the eye of the needle is visible, thread it with the corresponding end of the uterine stitch, and withdraw it. Repeat this on the opposite side. Bring the other two uterine stitches in the same way through the vagina. When this has been done, the three stitches hold the anterior serous covering of the uterus applied to the cut surface of vaginal nbro-cellular and muscular tissue (Fig. 64). Clean the raw surfaces, and then tie the stitches. Leave the ends an inch or two long, so that at the end of a week you can remove them. You may use catgut sutures, cut them short, and leave them to be absorbed; but thick catgut is absorbed slowly, and thin catgut may break. 3. Alexanders operation.—This is shortening the round. Fig. G4.—Vaginal fixation ; stitches inposition before tying. 162 DISEASES OF WOMEN. ligaments, and thus pulling the body of the uterus up-wards and forwards. This operation permanently curesretroflexion of the uterus; but it does not cure cystocele is associated with retroflexion, your patient willnot be cured. But in those rare cases in which withoutappreciable prolapse the body of the uterus is sharply bentback, is painful and tender, and a pessary fails to relieve,I think that Alexanders operation is a means from which, ifsuccessful, we can promise a lasting result. The great objection to Alexanders operation is its risk:the danger to life and the danger of a long illness, withsuppuration of the wounds. The dangers come, in the firstplace, from the difficulty of the operation. You ought notto do it without practising it on the dead subject oftenenough to make you sure of finding the ligaments. In
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