The diseases of women : a handbook for students and practitioners . ttachment is very lax, thelower portion of the vaginal walls may take part in the pro-trusion, in the form of a cystocele and rectocele; whilst inexceptional cases the tubes and ovaries, the bladder, and aconsiderable portion of the intestines may come to lie inthe hernial mass. There is another mode of production of prolapse in whichdescent of the whole uterus is not the principal feature ; butthe first stage is hypertrophy of the supravaginal portionof the cervix—i. e. the part situated between the internal os 138 DISEASES O
The diseases of women : a handbook for students and practitioners . ttachment is very lax, thelower portion of the vaginal walls may take part in the pro-trusion, in the form of a cystocele and rectocele; whilst inexceptional cases the tubes and ovaries, the bladder, and aconsiderable portion of the intestines may come to lie inthe hernial mass. There is another mode of production of prolapse in whichdescent of the whole uterus is not the principal feature ; butthe first stage is hypertrophy of the supravaginal portionof the cervix—i. e. the part situated between the internal os 138 DISEASES OE WOMEN. and the vaginal portion. In the course of the hypertrophicelongation, either the fundus must be pushed upward orthe vaginal portion downward. The latter is the course ofleast resistance, and is consequently followed. In thesecases the cervix may be low down, while the fundus isnearly in its normal position and the uterine cavity is foundto be greatly lengthened (Fig. 37). Later the whole uterusmay assume a lower position as the result of the increasing. Fig. 36.—Prolapse of uterus due to the pressure of two ovarian dermoids. weight of the cervix. Authors differ in the relative influ-ence which they ascribe to these two conditions, primarydescent and hypertrophy, in the production of prolapse;the difference is no doubt partly due to the fact that incases of primary descent a certain degree of secondaryhypertrophy generally occurs. We believe that primarydescent is the more frequent condition. Results of Prolapse and Procidentia.—The continued re- DISEASES OF THE UTERUS. 139 troversion leads to chronic congestion and hyperplasia ofthe whole uterus; but the effect is most marked in thecervix, which is less supported by surrounding structuresand more exposed to the influences leading to chronic in-flammation. We find, therefore, chronic cervical catarrhand cervical hypertrophy in the majority of cases, whilstadenomatous disease is frequent. In cases of procidentia th
Size: 1538px × 1624px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectgen, booksubjectwomen
