File:Treatise on gynaecology - medical and surgical (1894) (14777561831).jpg

Identifier: treatiseongynaec02pozz (find matches)
Title: Treatise on gynaecology : medical and surgical
Year: 1894 (1890s)
Authors: Pozzi, Samuel, 1846-1918 Wells, B. H., tr
Subjects: Gynecology Generative organs, Female Women Gynecology Genital Diseases, Female Gynecologic Surgical Procedures
Publisher: New York : William Wood & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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he objection to that is that it is difficult to obtain complete anteriorunion. In operating, remove a ring of mucous membrane about seven-tenths of an inch broad, carrying the dissection from above down-ward, i:)utting the parts on the stretch with the aid of the forceps.The dissection of the j^osterior wall will be facilitated by having anassistant x^lace a finger in the rectum, while that of the anterior wall CICATEICIAL FISTULA OF THE YAGIjSTA. o2i will be aided by j)lacing a sound in the bladder. The surface of the wound should be carefully evened with the scissors. Fritsch ^^ has proposed to accomplish this denudation by division after a sim^Dle circular incision. Second Stage.—Suture.—Large Hagedorn needles threaded with silk should be passed under the whole of the wounded surface from below uxoward, then fromabove downward. Caremust be used that neitherthe bladder, rectum, norperitoneum are j)erfor-ated. The first suture facil-itates the remainder ofthe operation by assist-
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FiG. 88.—Occlusion of the Vagina, or Colpocleisis : ViVIFICATION AND SUTURE. Fig. 89.—Colpocleisis. CSchematicallydrawn.) ing comparison of the jDarts to be united. Care should be usedin placing the sutures, to avoid overlai^ping. Several superficialsutures will be required (Figs. 88 and 89). In order to appreciate the importance of this operation, we shouldnot lose sight of the miserable condition to which the woman isotherwise abandoned, Colpocleisis is often a valuable resource, al-though attended by inconveniences of its own; impregnation is im-possible, and coitus cannot be practised as a rule, unless in the excep- VOL. II. —21 CLIlSnCAL AISTD OPERATIYE GYJST^COLOGY. tional case wliere the obliteration is very liigli in the vagina. Themenstrual blood may excite vesical catarrh and the contact of thecervix with the nrine produce a metritis. Sometimes we have a^pyelonephritis, and very frequently vesical calculi.^^ When the neck of the bladder is injured so as to cause incont

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