File:The practice of medicine and surgery, applied to the diseases and accidents incident to women (1881) (14578969360).jpg

Identifier: practiceofme00byfo (find matches)
Title: The practice of medicine and surgery, applied to the diseases and accidents incident to women
Year: 1881 (1880s)
Authors: Byford, William Heath, 1817-1890. (from old catalog)
Subjects: Women
Publisher: Philadelphia, Lindsay & Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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and lateral walls of the vagina, and theremaining portion of the bladder, into which the renal secretions andthe uterine discharges are received and from which they find their wayout through the urethral canal. The vagina may be closed by unit-ing the inner edges of the labia or the anterior and posterior wallsof the vagina quite inside the orifice. The operation for uniting thelabia will be necessitated in some instances. We occasionally meet URINARY FISTULA. 101 with cases where the anterior wall of the vagina is entirely removedfrom the pubis, and nothing is left behind that bone to which theposterior wall of the vagina may be united. So completely is thisremoval of tissue that the posterior face of the pubis is covered withnothino^ but a thin cicatricial substance. The labial closure of thevagina is the only resort in this class of extreme cases. The operation consists in removing a ring of mucous membranefrom the inner margin of the labia, just behind the orifice of the FiCx. 34.
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urethra, three-quarters of an inch deep, and then by means of deepsilver sutures making perfect apposition of the denuded surface.The sutures should be passed deep enough to include the whole ofthe raw portion of the parts, and extend on the outside three-quar-ters of an inch in the substance of the labia beyond their margin.The sutures, to insure union, should be not more than three lines 102 AFFECTIONS OF THE VAGINA. apart. The parts should be carefully adjusted while the wires arebeing twisted, so as to make an even adaptation. When there is sufficient of the vesico-vaginal septum behind thepubis to permit its coaptation to the posterior wall, the operationperformed and proposed about the same time by Simon and Bozemanis preferable to the foregoing. Simons method is simple and efiPec-tual in closing the vagina thoroughly. He denominates the opera-tion Kolpokleisis. The vagina is held open by the instruments andby the method described for operating on fistulse^ and a ring of mu-cous

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