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The operation for prolapse and fixed retroflexion of the uterus
738 Schubert,
THE
G. :
Monatsschrift
AMERICAN
JOURNAL
The Operation fur
OF
OBSTETRICS
for Prolapse
Geburtshilfe
und
AND
GYNECOLOGY
and Fixed Retroflexion
Gynakologie,
19‘76, lxxv,
of the Uterus.
69.
Twelve years ago, the author described an operation which fixed the uterus in an anterior position by means of a transplanted hand of fascia. He formerly used a piece of fascia from the fascia lata but now uses a preparation of the pericardium of an ox. The operation is carried out as follows: After perform ing the necessary cystocele and rectocele operation, the ahdomen is opened. The middle of the piece of fascia to be used is sewn to the uterus at the insertion of the utcros:~cral ligaments. The inguinal canals are then pierced with clamps and the free ends of the fascial strip are pulled through these canals. The uterus is drawn up into an anterior position and the fascial ends sewn to each other over the fascia. of the recti muscles. Of the 100 patients operated upon by this method, 93 were traced. Two of the patients died soon after the operation, one on the day after operation of hemorrhage and the other on the 19th day of embolism. Among the remaining PO there was not a single recurrence even though 15 of them had gone through :I pregnancy. In all the examined women, the uterus was anteflexed. The advantage of this operation is that in addition to its assurance against a recurrence, it can be performed at any age witlrout regard to the rcproductivc function of the patient. J. P. GREENMILL.
Benthin, W. : Prolapse Therapy. 1927, lxxv, 384.
Nonatsschrift
fiir
Geburshilfe
und GynLkologie,
In mild cases of prolapse of the uterus, Renthin advocates the Alexander-Adams operation regardless of age, but the uterus must he movable and not abnormally enlarged. If there is weakness of sphincter rontrol, and the patient is near or past tho menopause, a vaginal fixation operation should be performed. Where the uterus is very large, neither of those operations should be dono. In such cases the cervix should be fixed to the abdominal mall after amputating the body of the In cases of marked descensus with cystocele formation, and in cases of uterus. actual prolapse, the type of operation to be performed depends upon the age of the patient. In patients who are in the reproductive period, an abdominal cervical fixation should he done but in Iv-omen past the menopause, this operation or an interposition operation may he performed. The latter operation should be done only when there is advanced sphincter weakness. J. P. GREENIIILL.
An Operation for Creating an Abdominal “Shelf” Bonney: Visceroptosis in Women. Lancet > 1946, ccxi, 487.
in Certain
Cases of
The symptoms complained of by patients suffering from this form of visceroptosis are a sense of weakness preventing any prolonged exertion; backache, and pain referred to the lateral parts of the lower abdomen in the region of the appendix and cecum on the right side, and the point vvhere the colon crosses the pelvic brim on the left side. This pain which is evoked by standing and exertion, and which disappears with recumbency is probably due to a drag on the ovariopelvie ligaments. The writer feels that the downward extension of the peritoneal cavity plays an important part in the mechanism of defecation because it permits pressure to be brought to the upper part of the rectum by the intestinal coils forced into the pouch during straining. The operation is a combined operation for direct ventrofixation and round ligaA puckering suture is run along each round ligament starting ment shortening.
THE
G. :
Monatsschrift
AMERICAN
JOURNAL
The Operation fur
OF
OBSTETRICS
for Prolapse
Geburtshilfe
und
AND
GYNECOLOGY
and Fixed Retroflexion
Gynakologie,
19‘76, lxxv,
of the Uterus.
69.
Twelve years ago, the author described an operation which fixed the uterus in an anterior position by means of a transplanted hand of fascia. He formerly used a piece of fascia from the fascia lata but now uses a preparation of the pericardium of an ox. The operation is carried out as follows: After perform ing the necessary cystocele and rectocele operation, the ahdomen is opened. The middle of the piece of fascia to be used is sewn to the uterus at the insertion of the utcros:~cral ligaments. The inguinal canals are then pierced with clamps and the free ends of the fascial strip are pulled through these canals. The uterus is drawn up into an anterior position and the fascial ends sewn to each other over the fascia. of the recti muscles. Of the 100 patients operated upon by this method, 93 were traced. Two of the patients died soon after the operation, one on the day after operation of hemorrhage and the other on the 19th day of embolism. Among the remaining PO there was not a single recurrence even though 15 of them had gone through :I pregnancy. In all the examined women, the uterus was anteflexed. The advantage of this operation is that in addition to its assurance against a recurrence, it can be performed at any age witlrout regard to the rcproductivc function of the patient. J. P. GREENMILL.
Benthin, W. : Prolapse Therapy. 1927, lxxv, 384.
Nonatsschrift
fiir
Geburshilfe
und GynLkologie,
In mild cases of prolapse of the uterus, Renthin advocates the Alexander-Adams operation regardless of age, but the uterus must he movable and not abnormally enlarged. If there is weakness of sphincter rontrol, and the patient is near or past tho menopause, a vaginal fixation operation should be performed. Where the uterus is very large, neither of those operations should be dono. In such cases the cervix should be fixed to the abdominal mall after amputating the body of the In cases of marked descensus with cystocele formation, and in cases of uterus. actual prolapse, the type of operation to be performed depends upon the age of the patient. In patients who are in the reproductive period, an abdominal cervical fixation should he done but in Iv-omen past the menopause, this operation or an interposition operation may he performed. The latter operation should be done only when there is advanced sphincter weakness. J. P. GREENIIILL.
An Operation for Creating an Abdominal “Shelf” Bonney: Visceroptosis in Women. Lancet > 1946, ccxi, 487.
in Certain
Cases of
The symptoms complained of by patients suffering from this form of visceroptosis are a sense of weakness preventing any prolonged exertion; backache, and pain referred to the lateral parts of the lower abdomen in the region of the appendix and cecum on the right side, and the point vvhere the colon crosses the pelvic brim on the left side. This pain which is evoked by standing and exertion, and which disappears with recumbency is probably due to a drag on the ovariopelvie ligaments. The writer feels that the downward extension of the peritoneal cavity plays an important part in the mechanism of defecation because it permits pressure to be brought to the upper part of the rectum by the intestinal coils forced into the pouch during straining. The operation is a combined operation for direct ventrofixation and round ligaA puckering suture is run along each round ligament starting ment shortening.