File:The Principles and practice of gynecology - for students and practitioners (1904) (14787961513).jpg

Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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n the line of union and onthe sutures and prevent or destroy union. The benzoic acid mixtureor the acid sodium phosphate, already mentioned, should therefore becontinued. The long retention of the catheter and the continueddorsal position may give rise to great discomfort; hence the necessityin many cases of using more or less morphine, opium, or other ano- GENITAL FISTULJE 595 dyne. A cathartic should Ix; given on the third day, and tlicrcufterthe bowels kept regular by moderate catharsis and eneiuata. Afterthe final removal of the catheter there may be retention of urine, andit may be necessary, therefore, in order to prevent distention of thebladder, to draw the urine every few hours. In old cases the l)ladder,either from disuse or from cystitis, may be much contracted, andtherefore liable to distention from a small quantity of urine. Thefimctional powers of the bladder and urethra progressively improve asthe bladder gradually becomes accustomed to the retention of con- FiGUEE 327.
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Fistula involving loss of entire vesicovaginal septum as seen through the speculum. siderable quantities of urine, so that a bladder for many years con-tracted by vesicovaginal fistula may regain its full capacity in a shorttime after closure of the opening. Atypical Operations.—The ingenuity and skill of the operatorwill enable him to modify the operation according to the requirementsof an atypical case. An operation may be only partially successful,and may have to be repeated again and again until the closure is com-plete, or it may be necessary to close the opening only in part at eachone of several operations. Loss of the Entire Vesicovaginal Septum is associated usually with 596 TRAUMATISMS. more or less destruction of cervical tissue and cicatricial developmentin the posterior vaginal fornix. The usual operation in such a case isto close by a transverse line of union—that is, to stitch the anteriorlip of the cervix uteri to the neck of the bladder. In some cases thecervix is

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