File:Transactions of the Southern Surgical and Gynecological Association (1910) (14768344732).jpg

Identifier: transactionsofso2319sout (find matches)
Title: Transactions of the Southern Surgical and Gynecological Association
Year: 1910 (1910s)
Authors: Southern Surgical and Gynecological Association (U.S.)
Subjects: Surgery Gynecology Surgery Genital Diseases, Female
Publisher: (S.l.) : The Association
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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aped incision, commencing at the level of themeatus, and at a point close to the inner side of the labiumminorum (1) extending downward, following closely along thebase of the labium minorum on the inner side of the perineum(1 to 2), and curving across it just in front of the anus and extend- 166 FORMATION OF A PLASTIC VAGINA ing to the opposite side (2 to 3); from this point it turns upwardfollowing the inner side of the opposite labium minorum to apoint that corresponds exactly to the starting place (3 to 4).This flap is dissected upward, taking the skin from the perineumand the mucous membrane from over the site of the vaginalorifice up to the urethra. When free it is held upward, and thebladder is then separated from the rectum. In making thisdissection the finger should penetrate the fatty tissue on oneside between the rectum and vagina, then extend upward tothe peritoneum, and at this point turn across to the oppositeside, passing between the rectum and bladder in the extraperi-
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toneal fatty tissue. The entire attachment between the rectumand vagina can then be hooked down by the finger and broughtinto the vaginal orifice. The index finger of the other hand thenpenetrates the opposite side between the rectum and vaginaand passes up to the tip of the finger previously introduced.This will enable one to turn out the vesicorectal attachmentsand separate them under the eye. The next step consists inoutlining the two flaps on the labia majora. The incision ismade from the clitoris downward, following the outer side of thelabium minorum close to its base until it joins the raw surfacemade by dissecting the central flap (5 to 6). An incision is madefrom the clitoris upward and outward at an angle of about 40 DISCUSSION 167 to 45 degrees to the mucocutaneous junction (5 to 7), then down-ward along the mucocutaneous line to the perineum (7 to 3).From this point the line should curve gradually outward. Asimilar flap is outlined on the opposite side. They are dissectedo

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