Manual of gynecology . heir coincident displacement, and in pregnancythey are drawn up and lie almost vertically. Pathologically, they cicatrizeafter inflammatory attacks causing unilateral deviations of the uterus. 3. The Pelvic Peritoneum on the Side-iualls of the Pelvis.—The Pelvic ANATOMY OF THE FEMALE PELVIC ORGANS. 43 peritoneum clothes the side-walls of the Pelvis. It dips down least at theside of the bladder and most at the utero-sacral ligaments. Although the Pelvic Peritoneum has been described in three sections,it must of course be kept in mind that it is a continuous membrane, with
Manual of gynecology . heir coincident displacement, and in pregnancythey are drawn up and lie almost vertically. Pathologically, they cicatrizeafter inflammatory attacks causing unilateral deviations of the uterus. 3. The Pelvic Peritoneum on the Side-iualls of the Pelvis.—The Pelvic ANATOMY OF THE FEMALE PELVIC ORGANS. 43 peritoneum clothes the side-walls of the Pelvis. It dips down least at theside of the bladder and most at the utero-sacral ligaments. Although the Pelvic Peritoneum has been described in three sections,it must of course be kept in mind that it is a continuous membrane, withno breaks in its continuity. Some special facts about the peritoneum should now be noted. 1. As to the Bladder.—When the bladder is distended, the peritoneumis stripped off the lower part of the anterior abdominal wall to an extentvarying with the distention (Fig. 44). During parturition, the Perito-neum is drawn off the bladder (Fig. 43) (Hart). 2. As to the Rectum.—Its upper part is completely invested by peri-. Relation of peritoneum to bladder during parturition (Braune). a, vagina; d, bladder; c, anus. toneum ; the second part is only partially covered, , the peritoneumgradually leaves the rectum, quitting first the posterior surface, then thesides, and finally passing from the anterior surface on to the posteriorvaginal wall as already described. Over the bladder and anterior abdominal wall the peritoneum is easilyseparable. According to Spiegelberg, above the os internum uteri pos-teriorly it is closely blended with the uterus, below this quite loosely. Practical Points.—In no operative procedure involving the anteriorvaginal wall can the peritoneal cavity be opened into. In the upper thirdor so of the posterior vaginal wall the peritoneum may be opened has indeed been done by the most skilful operators, but the risks at- u MANUAL OF GYNECOLOGY. tending it are not so considerable as usually alleged, especially whendrainage-tubes are employed
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