Treatise on gynaecology - medical and surgical (1894) (14593956700)

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

Text Appearing Before Image:

Fia. 71.—Neugebauers Speculum for the Operation of Vesico-vaginal Fistula. prefer rapid dilatation. He first incises the fibrous bands and masseswith the bistoury, and then dilates by introducing one after anotherspecula of gradually increasing size. Local cocaine ansesthesia maybe used. It is also desirable to overcome erythema, excoriations,and cystitis before proceeding to the plastic operation. This ise^ffected by means of lotions, injections, and baths.

Text Appearing After Image:

Fig. 72.—Neugebauers Speculum in Place. Patient in Position upon the Operating-Table. Where we have contraction or obliteration of the urethra weshould first treat these conditions. For the first we may resort todivulsion or the long-continued use of the sound. In case of obliter-ation of the urethra we may do an operation analogous to that ofexternal urethrotomy in the male; the cicatricial tissue is first to beexcised, after which the vaginal mucous membrane, liberated by means CICATEICIAL FISTULJE OF THE VAGHSTA. 309 of incisions and dissections, may be sutured about a permanent ca-theter so as to form a new canal. Operatwe Technique.—1st. Examination for Fistula.—The posi-tion to be given to the patient will vary with the height of the orifice.The dorso-sacral position is available where the fistula is very low orwhere there is at the same time prolapse of the vaginal wall. As arule, however, Sims position or that of semi-pronation will be re-quired. Where the fistula is loc

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1894

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