Gynaecology for students and practitioners . of the mucous membrane and cervical skin prevents adhesionof the cervical lips, by covering in the raw surfaces. The operationis usually begun by curetting the uterus, and concluded by lightlypacking the upper part of the vaginal canal with bismuth gauze,which should be removed after twenty-four hours. The Radical Cure of Cystocele. This operation is designed forthe radical cure of prolapse of the anterior vaginal wall and is therefore performed in cases of simple cystocele, and also incases of marked uterine prolapse, when it is usually
Gynaecology for students and practitioners . of the mucous membrane and cervical skin prevents adhesionof the cervical lips, by covering in the raw surfaces. The operationis usually begun by curetting the uterus, and concluded by lightlypacking the upper part of the vaginal canal with bismuth gauze,which should be removed after twenty-four hours. The Radical Cure of Cystocele. This operation is designed forthe radical cure of prolapse of the anterior vaginal wall and is therefore performed in cases of simple cystocele, and also incases of marked uterine prolapse, when it is usually combined withother procedures, such as perineorrhaphy. The aim of the operation PLASTIC OPERATIONS 807 is to restore the structures which normally form the floor of thebladder, the structures upon which the base of the bladder involves a deep dissection as will be seen immediately, and theoperation differs so much in character from the procedure generallydescribed as anterior colporrhapJiy, that it is advisable to applj^ to. Fig. 481. Radical Cure of Cystocele. Step I: The cervix is pulleddown with a volsella, which, to simplify the illustration, has not been shown. it a different name. It may therefore be spoken of as the radicalcure of cystocele, which brings it into line with the operations, similarin principle, performed for abdominal hernia. The most careful aseptic technique is required to ensure primaryunion of the wound. Urinary infection, and the presence of a purulentvaginal discharge, are absolute contra-indications ; the operationmust be postponed until these conditions have been cured. The full 808 GYNECOLOGY preparation of the patient and of the field of operation must be carriedout in the manner described on p. 728. Stout chromicized or iodine-formalin catgut is the best suture-material. Steps of the Operation. In cases accompanied by prolapse of theuterus, good exposure of the whole length of the anterior vaginal wallcan be obtained by traction o
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
