Gynecology - (1918) (14793398553)

Identifier: gynecologygrav (find matches)

Title: Gynecology :

Year: 1918 (1910s)

Authors: Graves, William Phillips, 1870-1933

Subjects: Gynecology Genital Diseases, Female Women Gynecology

Publisher: Philadelphia : Saunders

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ent at the end and introduced into the bladder. The neck of the bladder can easily be perceived asthe end of the sound passes it. course (Pawlik, Duret). Gersuny advocated dissecting out the urethra andtwisting it so as to narrow the canal. In still another form of operation theurethra is transplanted so that the meatus is brought near the clitoris (Albarran, OPERATIONS ON THE VAGINA 615 Dudley). In this way the urethra is made to describe a sharp bend around thesymphysis. The author has tried all of these methods, and finds that, thoughtemporarily successful, they usually result in recurrence after a few months.The operation devised by Kelly, however, produces a high percentage of per-manent cures. This operation depends for its success on suturing together thelacerated or relaxed tissues of the sphincter at the neck of the bladder. Inasmuch as a considerable proportion of women with functional incontinencealso have a cystocele, we have successfully combined Kellys operation with the

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Fig. 253.—Operation for Functional Incontinence of Urine. Kellys Method Combinedwith the Authors Operation of Anterior Colpoplasty.Sutures have been placed and tied, narrowing the internal orifice of the urethra. Two linensutures are shown placed in the unyielding tissue at the sides of the urethra. When these suturesare tied a firm supporting bridge is created, guarding the first line of sutures. authors anterior colpoplasty. The operation is as follows: The anterior vaginalwall is denuded in exactly the same way as in the operation for cystocele de-scribed on page 609. When the denudation has been completed, the urethrais then dissected out with blunt curved dissecting scissors. This leaves the flapsat the upper part of the operative field free. Tenacula are then inserted in thethree converging angles and the flaps drawn sharply outward. In this way the 616 GYNECOLOGY urethra at its entrance into the bladder and the surrounding tissue are widelyexposed to view (Fig. 253). A uterin

гинекология Уильяма Филлипса Грейвса 1918 урологическая хирургия книжные иллюстрации лекарство медицинские иллюстрации история болезни гинекология болезни изображения из интернет-архива

1918

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