Gynecological diagnosis . Fig. 149.—Rectocele. 370 DISEASES OF THE VAGINA months and years, and the disease is frequent among the working-classes for the same reason as in the case of cystocele. Symptoms.—The symptoms are a sense of fullness in, or pro-trusion from, the vulva, weight and dragging in the pelvis, anddifficulty in defecation. Sometimes the woman is obliged toreplace the rectocele with her fingers before she can empty thebowel, and in pronounced cases of rectocele there is apt to berectal tenesmus and a feeling as if the rectum had not been emptiedcompletely. Diagnosis.—Bulging of
Gynecological diagnosis . Fig. 149.—Rectocele. 370 DISEASES OF THE VAGINA months and years, and the disease is frequent among the working-classes for the same reason as in the case of cystocele. Symptoms.—The symptoms are a sense of fullness in, or pro-trusion from, the vulva, weight and dragging in the pelvis, anddifficulty in defecation. Sometimes the woman is obliged toreplace the rectocele with her fingers before she can empty thebowel, and in pronounced cases of rectocele there is apt to berectal tenesmus and a feeling as if the rectum had not been emptiedcompletely. Diagnosis.—Bulging of the posterior vaginal wall may be visible. Fig. 149a.—Diagrammatic Representation of Rectocele. on separating the labia when the patient is in the dorsal brings the wall into view and it recedes again when theeffort is over. The physician, passing a forefinger through theanus, hooks it forward into the rectocele. This makes positivethe diagnosis and differentiates separation of the posterior vaginalwall from the rectum, from cases of true rectocele. We mustrule out cysts and other tumors of the posterior vaginal wall andtrue posterior vaginal hernia or enterocele. Both of these arepalpated between a finger in the rectum and another finger in thevagina. A cyst or tumor is fluctuating or hard, and is felt as adistinct mass between the two fingers, whereas in rectocele therectum and vaginal walls alone are between the fingers. INJURIES OF THE VAGINA 371 In the case of enterocele the doughy feel of intestine with gur-gling on pressure is to be made out, and, on placing the patientin the knee-chest position the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
