. Diseases of women. A clinical guide to their diagnosis and treatment. plastic operation. The ?palliative treatment consists in the constant use ofsome appliance to receive the urine. While the patient isabout, the choice lies between a urinal and frequently changedabsorbent pads. The latter is the less disagreeable. Woodwool is the best absorbent material. The pads must be thickerthan is required for the menstrual discharge, and must bechanged often. If the patient is so situated that she must gofor hours without the opportunity of changing the pads, shemust wear a urinal. This appliance con
. Diseases of women. A clinical guide to their diagnosis and treatment. plastic operation. The ?palliative treatment consists in the constant use ofsome appliance to receive the urine. While the patient isabout, the choice lies between a urinal and frequently changedabsorbent pads. The latter is the less disagreeable. Woodwool is the best absorbent material. The pads must be thickerthan is required for the menstrual discharge, and must bechanged often. If the patient is so situated that she must gofor hours without the opportunity of changing the pads, shemust wear a urinal. This appliance consists essentially of atrough to receive the urine, whence it is conducted by anarrow tube to a bag in which it is contained. There are * For a full account of it, see Ckampneys, St. Barths. Hosp. Rep.,vol. xiii. INCONTINENCE OF URINE. 693 practically only two kinds: one in which the trough is maderigid (Fig. 179), so that it keeps its shape, but its pressuremay be irksome; the other (known as the French model)(Fig. 180) in which the trough is made of thin flexible. Fig. 179.—Female urinal. Fig. 180.—Female urinal (French model). indiarubber. The latter is the less uncomfortable. At nightdiscomfort is reduced to a minimum if the patient sleepson what is known as a fracture bed ( one with anopening in the middle for a pan), and is provided withplenty of absorbent material. It is best to postpone operation until at least twomonths after delivery, for two reasons. First, the parts areless vascular and the tissues firmer after involution is com-plete, changes both of them conducive to success in theoperation. Second, a vesical fistula, either cervical or vaginal,may spontaneously close. This is more likely to happen inthe case of a cervical fistula, because such fistuke are small;but I have known a vaginal fistula, big enough to admitseveral fingers, close without operation. 694 DISEASES OF WOMEN. OPERATIONS FOR VESICAL FISTULA. The closure of a vesico-vaginal fistula varies
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