Annals of Medical Practice (Volume 19) (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: tient had been previously operated upon by the late D. Hayes Agnew, with partial closure of abdominal wall. Present procedures: ventral suspension of the uterus, plastic reduction of the size of the vesical opening and resection of relaxed vaginal outlet. Operative result: Satisfactory union, with exception of small point in vesical vaginal septum. Ultimate result: Death from pyelonephritis one week after operation. Regarding the frequency of exstrophy in the female sex, Dr. Everitt had been able to collect from the literature the reports of sixty-one female cases operated upon, and eight in which no operation was attempted, making a total of seventy cases, including the one reported in this paper. The total number for both sexes is about 350; the proportion, therefore is approximately 20 per cent females. The associated anomalies found in females are prolapsus of the rectum, spina bifida, inguinal hernia, and undeveloped genitalia. The possibility of pregnancy has been shown by several writers. Operative measures were classified under three heads: (1) those in which the abdominal opening is closed by flaps; (2) direct suture of the bladder; and (3) diversion of the urine into some portion of the large intestine by transplanting of the ureters. The immediate mortality from these modes of operation was quoted from Katz as follows: Abdominal flaps 107 cases, 12 deaths. Direct suture of bladder textit{66 cases, 14 deaths. Diversion of the urine according to the method of Maydl and others 76 cases, 22 deaths. The average mortality, therefore, is about 20 per cent. MYOMECTOMY. DR. CHARLES P. NOBLE. Dr. Noble's paper upon this subject was based upon sixty-six myomectomies from his own practice out of a total of three hundred and thirty-seven operat...