File:Treatise on gynæcology - medical and surgical (1891) (14755257206).jpg

Identifier: treatiseongync00pozz (find matches)
Title: Treatise on gynæcology : medical and surgical
Year: 1891 (1890s)
Authors: Pozzi, S. (Samuel Jean), 1846-1918 Wells, Brooks H. (Brooks Hughes), b. 1859
Subjects: Gynecology Genital Diseases, Female
Publisher: New York : W. Wood
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Fig. 235. —Hodge Pessary with Anterior Depression to Avoid Compressing the Urethra. (It is to be remembered that this method of instrumental repositionis only to be employed after a most careful examination has shown theprobable absence of any recent parametritic trouble or of marked dis-ease of the uterine appendages, and that in its employment the mostscrupulous asepsis is to be maintained. With these precautions, andremembering that to avoid mechanical injury to the uterine tissue the DISPLACEMENTS OF THE UTERUS. 445 sound should be inserted only to within a quarter of an inch of thefundus and the finger tip in the vagina and not the cervix used asa fulcrum, the method is comparatively safe.) Fixation of tlie Reduced Uterus.—For this purpose we may em-ploy either prothetic measures (pessaries) or various operations. Pessaries.—A simple tampon of cotton in the posterior pouch isa means of maintaining the uterus and is easily renewed, but it is bet-
Text Appearing After Image:
Fig. 236.—Introduction of a Hodge Pessary in a Case of Retroflexion (Which Should First be Reduced). ter to employ an indifferent joessary, like D union trjalliers ring, whichhas at times caused the reposition of the organ without the surgeonsefforts by the steady pressure which it exerts (Fig. 234). (Ring pes-saries of either hard or soft rubber, while often effective, are objec-tionable because of the stretching of the vagina which they cause.)A better instrument is the Hodge pessary with a double curve (Figs.235, 236, and 237). The pessary should be chosen to fit each case. If too small it is of novalue, if too large it becomes intolerable. If the perineum is resistant, 446 CLINICAL AND OPERATIVE GYNECOLOGY. the pessary may be a little narrowed below (Albert Smiths); this wouldbe an inconvenience in the contrary condition. It is well to have asmall depression in the anterior portion to avoid injury to the ure-thra (Fig. 235). The most convenient kind of pessary is that formedof o

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