Gynecology . nks. In minor gynecologic affections, however, such as dis-placements, small tumors, etc., the relationship between the disease and thepain in the legs is less obvious. Often it may be traced to some orthopediccondition of muscle strain in which the pelvic trouble plays only a contributorypart in lessening the general tonal resistance of the patient. During the con-valescence from gynecologic operations pain in the calf of the leg or along theinner side of the thigh or in the groin should give warning at once of the pos-sible presence of phlebitis, one of the most troublesome of s
Gynecology . nks. In minor gynecologic affections, however, such as dis-placements, small tumors, etc., the relationship between the disease and thepain in the legs is less obvious. Often it may be traced to some orthopediccondition of muscle strain in which the pelvic trouble plays only a contributorypart in lessening the general tonal resistance of the patient. During the con-valescence from gynecologic operations pain in the calf of the leg or along theinner side of the thigh or in the groin should give warning at once of the pos-sible presence of phlebitis, one of the most troublesome of surgical complica-tions. The subject of pain in its relation to gynecology is almost limitless, and theexamples here given must be considered not as having exhausted the theme, butas being those of chief clinical importance. PART III OPERATIVE GYNECOLOGY OPERATIONS ON THE VULVA VULVECTOMY The indications for removal of the vulva are most commonly cancer, krau-rosis, tuberculosis, elephantiasis, and Fig. 197.— double lines show the position of the initial incisions. The area included between these lines is to be completely dissected away. 510 OPERATIONS ON THE VULVA 511 The operation is not a difficult one, but requires special attention to coap-tation of the wound edges in order to safeguard against the predisposition whichlarge wounds of the vulva have to sepsis. An oval incision is made about the entire vulva external to the diseased tissue,extending from above the clitoris to a point between the fourchette and theanus.
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