A manual of gynæcology and pelvic surgery, for students and practitioners (1916) (14581189157)

Identifier: manualofgyncol00skeeuoft (find matches)

Title: A manual of gynæcology and pelvic surgery, for students and practitioners

Year: 1916 (1910s)

Authors: Skeel, Roland E., 1869-

Subjects: Gynecology Gynecology, Operative

Publisher: Philadelphia : P. Blakiston's Sons

Contributing Library: Gerstein - University of Toronto

Digitizing Sponsor: University of Toronto

Text Appearing Before Image:

ra-tion of the protruding vaginal wall may take place but is notso common as ulceration of the cervix when uterine prolapse ispresent. When the cystocele is of moderate size no protrusion may beapparent with the patient in the dorsal position, and it is broughtto view only by straining efforts during which more and moreof the anterior vaginal wall is everted through the vulvar ring.Digital examination shows partial or entire absence of thestrong sling of levator on either side of the vagina, and if furtherevidence of the character of the protrusion is needed it may besecured by passing a sound through the urethra into the pro-lapsed bladder. The treatment is anterior colporrhaphy and perineorrhaphyas described on pages 132 to 152. RECTOCELE 125 Rectocele, or protrusion of the rectum covered by the pos-terior vaginal wall, is frequently but not necessarily associatedwith cystocele, and is only occasionally found alone. Themechanism of its production is similar except that injury to the

Text Appearing After Image:

Fig. 42.—Secondary results of injury to pelvic diaphragm. Digital exami-nation shows partial or entire absence of the strong sling of levator on either sideof the vagina. anterior segment of the pelvic floor is not a necessary antecedent.Posterior displacement of the anus causes the fecal massto impinge upon the anterior rectal wall during defecation, andthus tends to drive the rectum through the vulvar orifice which 126 INJURIES TO THE PERINEUM AND PELVIC DIAPHRAGM is itself imperfectly closed. The patients attention may bedirected to this by difficulty in evacuating the bowels, and inextreme cases she is forced to hold the rectum back with thefingers in the vagina before it can be emptied. The nature of the protrusion is evident at a glance but may beconfirmed by rectal examination if necessary. 1

a manual of gynecology and pelvic surgery for students and practitioners by roland e skeel 1916 rectocele book illustrations medicine surgery gynecology images from internet archive canada

1916

University of Toronto

http://commons.wikimedia.org/

public domain