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Some experiences in the diagnosis and treatment of congenital anomalies of the female genital tract
BROOKLYN
BROOKLYN
GYNECOLOGICAL
GYNECOLOGICAL MEETING
OF
APRIL
DR. GEORC+E G. COCHRAN, JR., presented
in Obstetrics.
(For original
article
947
SOCIETY
SOCIETY 1, 1938’
a paper on Avertin see page 849.)
Analgesia
DISCUSSION DR. JOHN CASAGRANDE.-I have followed a number of cases under avertin analgesia, and have used it in five cesarean sections. I have used 80 mg. instead of 60, supplemented by gas and oxygen. In cesarean section the .patients come out of the anesthetic in two or three hours after the operation, free from nausea or vomiting, and they certainly seem to recover a little better than they do with ether or other general anesthetics. DR. COCHRAN.-The greatest number of doses I have three, and that was in a forty-eight-hour labor. We have observed no excessive bleeding after eesarean has been used.
given section
any in
one patient which
is
avertin
C. HIRST read a paper entit,led Some Experiences in the Diagnosis and Treatment of Congenital Anomalies of the Female
DR. BARTON
Genital
Tract.
(For original
article see page 843.) DISCUSSION
DR. ISIDOR C. RUBIN.-I believe the question of the formation of an artificial vagina resolves itself into a decision between two technics. One consists in utilizing the labia minora. I have had one experience with this which was most gratifying. The patient remained at the hospital seventeen days. I had an opportunity to examine the patient several years after operation and subsequent to marriage, and she had Another procedure is the one devised by been having perfectly satisfactory coitus. Frank and Geist. The end-result after their operation is most satisfactory and permanent. It requires considerable patience in planning the plastic and in carrying However, it requires a minimum of six weeks of hospitalization out the technic later. and longer in some cases. Urethral coitus, which is occasionally encountered, appears to be satisfactory to such couples. The combination of anomalous conditions in the genital or urogenital sphere and remote organic anomalies is also well known. DR. G. W. EOSMAK-The field of genital deformities in the female is one of intense technical interest, and yet, it may be advisable in many cases to let well enough alone, because even the successful technical accomplishment of the restoration of the vaginal canal, so-called, may lead to a considerable degree of trouble later on. I doubt whether the restoration of an anatomic result is sufficient in most cases to make up for the lack of physiologic background, and I believe that is one point which many of our expert plastic operators have missed. While they may be able to restore anatomic details, they are not able to develop the physiologic background which is neeessary in a case of that kind. DR. ERNEST D. RESNIK-I would like to report a case of a patient twentytwo years old, who gave a history of amenorrhea of ten weeks’ duration. She was admitted to the hospital with a diagnosis of incomplete abortion. Examination rectally showed an apparently normal uterus on the right side, and on further examination a large mass was found on the left side, the size of a four and a half months’ pregnancy. Further inspection revealed a complete duplication of the uterus cervix and vagina. On speculum examination the right small uterus had a small piece of placenta protruding through the cervix indicating a pregnancy and abortion on the right side, an& the uterus on the left side was still carrying the pregnancy at about four and a half months.
BROOKLYN
GYNECOLOGICAL
GYNECOLOGICAL MEETING
OF
APRIL
DR. GEORC+E G. COCHRAN, JR., presented
in Obstetrics.
(For original
article
947
SOCIETY
SOCIETY 1, 1938’
a paper on Avertin see page 849.)
Analgesia
DISCUSSION DR. JOHN CASAGRANDE.-I have followed a number of cases under avertin analgesia, and have used it in five cesarean sections. I have used 80 mg. instead of 60, supplemented by gas and oxygen. In cesarean section the .patients come out of the anesthetic in two or three hours after the operation, free from nausea or vomiting, and they certainly seem to recover a little better than they do with ether or other general anesthetics. DR. COCHRAN.-The greatest number of doses I have three, and that was in a forty-eight-hour labor. We have observed no excessive bleeding after eesarean has been used.
given section
any in
one patient which
is
avertin
C. HIRST read a paper entit,led Some Experiences in the Diagnosis and Treatment of Congenital Anomalies of the Female
DR. BARTON
Genital
Tract.
(For original
article see page 843.) DISCUSSION
DR. ISIDOR C. RUBIN.-I believe the question of the formation of an artificial vagina resolves itself into a decision between two technics. One consists in utilizing the labia minora. I have had one experience with this which was most gratifying. The patient remained at the hospital seventeen days. I had an opportunity to examine the patient several years after operation and subsequent to marriage, and she had Another procedure is the one devised by been having perfectly satisfactory coitus. Frank and Geist. The end-result after their operation is most satisfactory and permanent. It requires considerable patience in planning the plastic and in carrying However, it requires a minimum of six weeks of hospitalization out the technic later. and longer in some cases. Urethral coitus, which is occasionally encountered, appears to be satisfactory to such couples. The combination of anomalous conditions in the genital or urogenital sphere and remote organic anomalies is also well known. DR. G. W. EOSMAK-The field of genital deformities in the female is one of intense technical interest, and yet, it may be advisable in many cases to let well enough alone, because even the successful technical accomplishment of the restoration of the vaginal canal, so-called, may lead to a considerable degree of trouble later on. I doubt whether the restoration of an anatomic result is sufficient in most cases to make up for the lack of physiologic background, and I believe that is one point which many of our expert plastic operators have missed. While they may be able to restore anatomic details, they are not able to develop the physiologic background which is neeessary in a case of that kind. DR. ERNEST D. RESNIK-I would like to report a case of a patient twentytwo years old, who gave a history of amenorrhea of ten weeks’ duration. She was admitted to the hospital with a diagnosis of incomplete abortion. Examination rectally showed an apparently normal uterus on the right side, and on further examination a large mass was found on the left side, the size of a four and a half months’ pregnancy. Further inspection revealed a complete duplication of the uterus cervix and vagina. On speculum examination the right small uterus had a small piece of placenta protruding through the cervix indicating a pregnancy and abortion on the right side, an& the uterus on the left side was still carrying the pregnancy at about four and a half months.