. A manual of gynæcology and pelvic surgery, for students and practitioners. do-mestic status is such that thefunctions of the vagina as a copu-lative organ are not important, amuch simpler operative combina-tion may be selected, and thevagina can be narrowed by theLeFort operation to such an ex-tent and in such a fashion thatprotrusion of the uterus throughit is impossible. If the cervix ishypertrophied it should first beamputated, then the anterior andposterior vaginal walls are de-nuded by removal of a longitu-dinal strip 3 cm. wide, extendingfrom the cervico-vaginal junction to the posteri
. A manual of gynæcology and pelvic surgery, for students and practitioners. do-mestic status is such that thefunctions of the vagina as a copu-lative organ are not important, amuch simpler operative combina-tion may be selected, and thevagina can be narrowed by theLeFort operation to such an ex-tent and in such a fashion thatprotrusion of the uterus throughit is impossible. If the cervix ishypertrophied it should first beamputated, then the anterior andposterior vaginal walls are de-nuded by removal of a longitu-dinal strip 3 cm. wide, extendingfrom the cervico-vaginal junction to the posterior surface of thesymphysis anteriorly, and over a corresponding area these denuded areas are united to each other, a column isformed down the middle of the vagina with a narrow channel oneither side through which the secretions can escape, and inver-sion of the vagina and protrusion of the uterus are effectuallyprevented if there is added to this an efficient perineorrhaphy forthe lowermost support. Before any of these plastic operations are performed the. Fig. 119. -The LeFort sutures. 26o DISPLACEMENTS OF THE UTERUS vaginal walls should be restored to a healthy condition by re-placement of the uterus. Its retention can be secured by rest inbed until such time as any ulcerated excoriated areas upon thevaginal mucosa have been covered by normal epithelium, andthis is effected rapidly when the surfaces are no longer subjectedto contact with the air, decomposing urine, etc. Under favor-able circumstances an operator of moderate dexterity can com-plete all the necessary work at one sitting and avoid the distressof repeated anaesthesia. MAL-POSITIONS Anteversion.—Pathological anteversion may be produced byany cause which increases the weight of the normally anteverted
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Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
