. Operative gynecology. ina with cotton or wooltampons, or by the use of a pessary, which may even be inserted without replac-ing the uterus and still do good. When the tumor is large enough to chokethe pelvis and does not rise into the abdomen, but is held beneath the sacralpromontory, sometimes great relief follows its elevation into the abdomen under 352 MYOMECTOMY—HYSTERO-MYOMECTOMY. an anesthetic. Care must be taken not to force the displacement imless the massseems free from adhesions. There is a decided risk in doing this, because thelarge vessels at the point of attachment of the tumor
. Operative gynecology. ina with cotton or wooltampons, or by the use of a pessary, which may even be inserted without replac-ing the uterus and still do good. When the tumor is large enough to chokethe pelvis and does not rise into the abdomen, but is held beneath the sacralpromontory, sometimes great relief follows its elevation into the abdomen under 352 MYOMECTOMY—HYSTERO-MYOMECTOMY. an anesthetic. Care must be taken not to force the displacement imless the massseems free from adhesions. There is a decided risk in doing this, because thelarge vessels at the point of attachment of the tumor to the uterus are liable torupture when the pedicle is friable. Hemorrhage.—Profuse menstrual hemorrhages with prolonged periods,lasting one, two, or three weeks, often accompany submucous myomata andlarge myomatous uteri in association with a hypertrophy of the uterine mucosa ;this may often be relieved for a long period, or even permanently, by dilata-tion of the cervix and a thorough curettage (see Chapter XIV).. Fig. 4S7.—Large Globular Myoma choking the Pelvis, cumpkessing Kectum and Bladder, andFORCING the Bladder up into the Abdomen. Note the retroflexion of the uterus. About half size. Autopsy, Jan. 15,1897. There should be no relaxation in the preparatory details, as described inChapter XIV, as curettage may be followed by a fatal termination, if greatcare is not observed in rendering the vagina and cervix as sterile as posterior vaginal wall is retracted with a Sims or Simon speculum, theanterior lip of the cervix is caught by a pair of bullet forceps, and the uter-ine sound passed in to determine the length, the direction, and the size of the PALLIATIVE TREATMENT. 353 uterine cavity. Guided by this information, the smallest uterine dilator is in-troduced, and the cervix equably stretched in all directions as described. Theevidence of the thoroughness of the operation will be shown by the large
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
