Operative gynecology : . s pulled over by it backward. The unusual size and antero-posterior thickness will be of assistance here in clearing up the diagnosis, espe-cially if a sound is introduced into the uterine cavity when the finger in therectum detects the increased thickness of the intervening body. The uterinesound used so much by Sir James Y. Simpson and his contemporaries as ameans of determining flexions and correcting them, has now passed largely outof vogue. There can, however, be no objection to its occasional gentle use forthe purpose of diagnosis and demonstration, but it should
Operative gynecology : . s pulled over by it backward. The unusual size and antero-posterior thickness will be of assistance here in clearing up the diagnosis, espe-cially if a sound is introduced into the uterine cavity when the finger in therectum detects the increased thickness of the intervening body. The uterinesound used so much by Sir James Y. Simpson and his contemporaries as ameans of determining flexions and correcting them, has now passed largely outof vogue. There can, however, be no objection to its occasional gentle use forthe purpose of diagnosis and demonstration, but it should never be employedto prize the uterus up into an anteposition. A sharp line of distinction must be drawn between retroclisplacements inwomen who have not borne children and those following childbirth. We willfirst consider those affecting women who have never borne children. Many patients in this group make no complaints whatever directly refer-able to the uterus, and these cases may be dismissed as symptomless displace-. V-Jet Fig. 92.—Steps in the Reduction of the Uteres in the Palliative Treatment of Retroflexion. The anterior lip of the cervix is grasped with a tenaculum forceps and drawn in the direction ofthe arrow. (See p. 180.) ments. In these cases the retroposition is often congenital, as shown by theshort vagina which keeps the cervix so low in the pelvis that the fundus mustof necessity fall back; here the retroposition is natural and an antepositionwould be abnormal, so that all efforts to induce such a uterus to remain inanteversion will, fortunately for the patient, prove futile. If the patientcomplains of backache, bearing clown pains in the pelvis, and dysmenorrhea,the practitioner must be on his guard against tracing a causal relationshipbetween the displacement and the symptoms, remembering that women with TREATMENT OF RETROFLEXION. 179 normally placed uteri make the same complaints. Even if he secures a de-cided measure of temporary relief from the use of
Size: 2371px × 1054px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
